1/8. A vanishing liver abscess complicated with klebsiella pneumoniae chest wall abscess: a case report.Septic metastasis is a unique feature of klebsiella pneumoniae liver abscess in taiwan. The case we report is a vanishing K. pneumoniae liver abscess with septic metastasis of the chest wall. The initial finding of a 36 year-old male with no previous medical history, was a huge hepatic mass presented on the sonography during a physical checkup. hepatitis b, C serology, tumor markers and evidence of metastatic diseases were all negative. A computerized tomography examination was also inconclusive about its nature. Due to the patient's refusal of a liver biopsy, only oral antibiotics were medicated at the outpatient department. Unexpectedly, the follow-up computerized tomography, taken 4 weeks later, demonstrated that the liver mass was nearly absent, while a protruding painful lesion developed over the right chest wall. Under sono-guided aspiration, the chest wall mass was proved to be a pyogenic abscess. The Gram stain revealed gram-negative bacilli and the bacterial culture yielded K. pneumoniae. Under the impression of K. pneumoniae liver abscess with chest wall septic metastasis, after performing percutaneous drainage of the chest wall abscess, the patient was only given parenteral antibiotics for treatment. Both the liver and the chest wall abscesses were at last completely eradicated.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/8. Bacterial subretinal abscess: a case report and review of the literature.PURPOSE: To report a case of Klebsiella subretinal abscess with a successful visual outcome with treatment and to review the literature pertaining to focal intraocular infection in bacterial endophthalmitis. methods: Clinical data including medical history, findings on physical examination, blood cultures, and an abdominal computed tomographic scan were collected in a 32-year-old man with Klebsiella sepsis, liver abscesses, and a focal subretinal abscess. Ocular data including visual acuity, fundus photographs, fluorescein angiography, and ultrasound were evaluated, as were results of culture and histopathologic studies. RESULTS: Despite immediate intervention, including vitreous tap and intravitreal antibiotics, the eye deteriorated, with enlargement of the abscess. A pars plana vitrectomy was performed in which the subretinal abscess material was removed after an extensive retinectomy of the involved area in association with an endophotocoagulative barrier and intravitreal amikacin without gas or oil tamponade. culture confirmed Klebsiella subretinal infection. A retinal detachment occurred 1 month postoperatively and was successfully repaired. visual acuity was 20/30 and has remained stable for 14 months. CONCLUSION: Klebsiella endophthalmitis with subretinal abscess formation is a rare but devastating ocular condition. In the present case, prompt intervention with extensive retinectomy, complete abscess excision, and intravitreal antibiotic therapy resulted in unprecedented visual recovery.- - - - - - - - - - ranking = 16.629291151968keywords = physical examination, physical (Clic here for more details about this article) |
3/8. Emphysematous septic arthritis due to klebsiella pneumoniae.A 60-year-old woman with rheumatoid arthritis developed acute emphysematous septic arthritis of the knee due to klebsiella pneumoniae. She was brought to the hospital in septic shock with disseminated intravascular coagulation and had striking physical signs and roentgenograms showing distention of the knee with gas. She also had an infection of the hand with subcutaneous gas. After surgical drainage and institution of antibiotic therapy, she remained critically ill for several days but gradually improved. Two months later, she was ambulating independently. Emphysematous septic arthritis is rare. Four cases have previously been reported, but none were caused by Klebsiella.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/8. Micturition syncope: an atypical case.A forty-nine-year-old man had episodes of micturition syncope associated with an asymptomatic urinary tract infection. Treatment of the infection resolved the syncopal episodes. Micturition syncope occurs in the standing position; physical, electrocardiographic, and electroencephalographic studies usually have normal results. The case reported here is atypical in that micturition syncope was the only apparent symptom of urinary tract infection.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/8. Clinical update on rhinoscleroma.rhinoscleroma is recognized more frequently now because of the recent influx of immigrants from endemic central america. This chronic infectious disease presents with three overlapping clinical stages and can involve any part of the respiratory tract. A review of the clinical presentation leads to a patient evaluation plan consisting of physical examination and radiographic studies. A highly sensitive and specific method is introduced for identification of Klebsiella rhinoscleromatis in the biopsy specimen using the immunoperoxidase technique. A study of the immune status of the patient revealed general immunological competence except in effective phagocytosis of the organism by the Mikulicz cells. The choice of chronic antibiotic therapy should be guided by individual patient consideration with respect to age and sex. Repeat biopsies help determine the duration of antibiotic therapy. Relapses do occur and close observation is the key to long-term follow-up of the patient.- - - - - - - - - - ranking = 16.629291151968keywords = physical examination, physical (Clic here for more details about this article) |
6/8. Fulminating gas-forming psoas muscle abscess due to klebsiella pneumoniae following a deep neck infection.Psoas muscle abscess due to klebsiella pneumoniae infection is rare. We report a 55-year-old diabetic man who presented with progressive back pain of 1 month's duration. The patient had undergone surgical drainage for a deep neck infection with K. pneumoniae 43 days previously. On the present admission, physical examination revealed tenderness over the anterior upper aspect of both thighs, and computed tomography showed pneumoretroperitoneum dissecting the bilateral iliopsoas muscles. Parenteral administration of antibiotics was started immediately. Due to the patient's poor health status, we opted for repeated computed tomographic and sonographic-guided percutaneous drainage rather than surgical drainage. blood and pus cultures revealed only K. pneumoniae. The patient recovered without significant sequelae. This report stresses the risk of metastatic infections caused by K. pneumoniae, especially in diabetic patients. Our experience suggests that repeated percutaneous drainage is feasible in cases of severe iliopsoas abscess, especially when risks associated with surgery are high.- - - - - - - - - - ranking = 16.629291151968keywords = physical examination, physical (Clic here for more details about this article) |
7/8. A case of superior vena cava syndrome caused by klebsiella pneumoniae.A 27 yr old man presented with productive cough, fever and manifestations of superior vena cava syndrome. He was an alcoholic but had been in good health until 3 days prior to admission. The physical examination, the chest radiograph and the results of the sputum culture were compatible with klebsiella pneumoniae pneumonia of the right upper lobe. The superior vena cava scintigram using technetium-99m showed near total occlusion of the superior vena cava, while sputum cytology, chest computed tomography, and bronchoscopy were all negative for malignant aetiology. Antibiotic therapy brought about slow resolution of the pneumonia and also of the superior vena caval obstruction. The follow-up scintigram showed normalized venous flow of the superior vena cava. To our knowledge, this is the first case of superior vena cava syndrome developed in probable association with klebsiella pneumoniae pneumonia.- - - - - - - - - - ranking = 16.629291151968keywords = physical examination, physical (Clic here for more details about this article) |
8/8. Recurrent meningitis associated with congenital paravertebral dermal sinus tract.Recurrent meningitis is a rare but important event that needs to be searched for a predisposing factor. Congenital dermal sinuses occurring in the midline are among the etiological factors. Here, an 18-month-old boy with three attacks of recurrent meningitis due to a paramedian dermal sinus tract is presented. Klebsiella was the cultured causative agent. The lesion was suspected on physical examination and demonstrated by lumbosacral magnetic resonance imaging. To the best of our knowledge, this is the first case in English-language literature of the paravertebrally located dermal sinus tract resulting in recurrent meningitis. Therefore, a careful physical examination, especially including the paravertebral region beside the midline, is essential. magnetic resonance imaging is a non-invasive descriptive method in the evaluation of congenital dermal sinus tracts.- - - - - - - - - - ranking = 33.258582303936keywords = physical examination, physical (Clic here for more details about this article) |