1/28. Generalized tetanus in a patient with a diabetic foot infection.tetanus is a preventable disease that continues to affect people in the united states due to poor immunization practices in our health care system. A 57-year-old man with type 2 diabetes mellitus, hypertension, and end-stage renal disease with many hospital admissions came to the hospital emergency department because of a blackened great toe. He denied pain in the toe or knowledge of foot injury. The patient also complained of temporomandibular tenderness accompanied by inability to open his mouth completely. The man's problems progressed to generalized tetanus and required a long hospitalization. clostridium tetani can flourish in the anaerobic environment of a diabetic foot infection. Practitioners should be aware of tetanus as a rare but potentially serious complication of diabetic foot infections.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/28. Descending necrotizing mediastinitis due to odontogenic infections.OBJECTIVE: Acute purulent mediastinitis caused by oropharyngeal infection is termed descending necrotizing mediastinitis. Such infections usually have a fulminate course, leading to sepsis and frequently to death. The purpose of this study is to show the importance of early diagnosis, aggressive surgical intervention, and optimal antibiotics chemotherapy in controlling this fatal infectious disease. STUDY DESIGN: Two patients with descending necrotizing mediastinitis due to odontogenic infection who were treated at our institution are described. RESULTS: Both patients survived. CONCLUSIONS: From the patients, 23 different aerobic and anaerobic bacteria were isolated. All of the isolates were susceptible to carbapenem. Early evaluation by means of cervicothoracic computed tomography scanning was extremely useful for diagnosis and surgical planning. knowledge of anatomic pathways from the mouth to the mediastinum is essential. We believe that tracheostomy is not always necessary. In both of the cases presented, mediastinal drainage was completed through use of a transcervical approach. However, a more aggressive drainage including tracheostomy might be necessary when the infection extends below the carina.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
3/28. Spontaneous bacterial peritonitis induced by intraarterial vasopressin therapy.Two patients developed spontaneous bacterial peritonitis after infusions of vasopressin into the superior mesenteric or gastroduodenal arteries for upper gastrointestinal hemorrhage. The peritonitis in these patients differed from the typical picture in which a single aerobic organism is responsible, by the presence of multiple organisms, some of which were anaerobic. These findings suggest that the arterial vasoconstriction decreased the integrity of the intestinal mucosal barrier and permitted the transmural migration of enteric organisms from the lumen of the bowel into the ascites-filled peritoneal cavity.- - - - - - - - - - ranking = 0.58161408571617keywords = cavity (Clic here for more details about this article) |
4/28. Infected total hip replacement after dental procedures.Three cases are reported in which there was a worrisome association between dental work and an infected total hip replacement. The patients had long asymptomatic intervals subsequent to implantation of prosthetic hip joints. After dental procedures, infections became apparent in these hips. Such infections carry an enormous and crippling morbidity. The potential complications of transient bacteremia in the patient with a cardiac valvular prosthesis are appreciated and the importance of prophylactic antibodies for dental work in such patients is well known. Although we emphasize that there is no proof that the infections in our patients were metastatic from the mouth, the sequence of events is suggestive. We recommend prophylactic antibiotics for dental work in the patient with a total hip replacement.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
5/28. brain stem abscess treated surgically. Wtih special note upon the employment of thorium dioxide.A 10-year-old girl, with congenital heart disease, harboring a brain stem abscess, was recently treated at the UCLA Hospital. Needle aspirations of the abscess was performed through a posterior occipital craniectomy, and thorium dioxide (Thorotrast) was placed within the abscess cavity as a marker. Postoperatively, the patient improved temporarily but died 18 days later. autopsy examination included radioactive analysis of brain and liver tissue. Radioautographs were superimposed on H&E preparations of the abscess wall to localize the extent of activity of the thorium dioxide. The unusual occurrence of this abscess in a young patient, clinically diagnosed and treated by operation, provided a rare opportunity to assess the problem of the surgical accessibility of brain stem abscess as well as to reevaluate a role for thorium dioxide as a marker for intracranial purulent collections.- - - - - - - - - - ranking = 0.58161408571617keywords = cavity (Clic here for more details about this article) |
6/28. Recurrent infection of a complex odontoma following eruption in the mouth.Odontomas are the most common odontogenic tumors, and are classified as either compound or complex lesions. Although its underlying etiology remains unclear, a number of factors appear to be involved (e.g., prior trauma). The lesions are generally diagnosed in the second decade of life, often in the context of routine dental X-ray examinations. A complex odontoma is described in a 22-year-old woman referring discomfort due to overinfection following its aperture into the oral cavity in the distal alveolar region of 2.6. Initial treatment consisted of antibiotics and antiinflammatory drugs. Computed axial tomography revealed a solid, irregular mass in the distal zone of the left maxilla, imprinting upon the region of the maxillary sinus on the same side. Surgical resection was performed, raising the alveolar mucosa and upper left vestibular fundus. The surgical piece contained the amorphous adenoma mass and the tooth 2.7.- - - - - - - - - - ranking = 8.8087337844435keywords = oral cavity, mouth, cavity (Clic here for more details about this article) |
7/28. Percutaneous treatment of a patient with infected necrotizing pancreatitis.BACKGROUND: A 50-year-old man with an acute episode of alcohol-induced chronic edematous pancreatitis and an inflammatory stenosis of the biliary tract was treated by implantation of a plastic endoprosthesis at a rural hospital in germany. Because of his worsening condition, the patient was referred to the intensive care unit of the University Hospital, Regensburg, germany. Contrast-enhanced CT revealed complete necrosis of the body and tail of the pancreas, formation of large retrogastric and paraduodenal fluid collections, and fluid along Gerota's fascia, as well as in the paracolic gutters. Antibiotic treatment was adjusted according to the results of microbiological testing after diagnostic puncture of the necrotic cavity. INVESTIGATIONS: CT scan, CT-guided fine-needle aspiration and fluoroscopy. DIAGNOSIS: Infected acute necrotizing pancreatitis. MANAGEMENT: Interventional treatment using large-bore percutaneous catheters to perform percutaneous necrosectomy, fragmentation of necrotic pancreatic tissue with a snare catheter and dormia basket, and aspiration. parenteral nutrition and antibiotics were also administered.- - - - - - - - - - ranking = 0.58161408571617keywords = cavity (Clic here for more details about this article) |
8/28. Two patterns of impalement injury to the oral cavity: Report of four cases and review of literature.Impalement injuries to the oral cavity are common, and typically resolve with minimal intervention. We encountered two distinct patterns of injury that required active intervention in four consecutive patients. The first two patients, aged 2 and 7 years, sustained injuries to the floor of mouth and subsequently developed infectious complications necessitating surgical drainage. The other two, aged 4 and 5 years, sustained injuries to the junction of the hard and soft palate, avulsing deep flaps that required repair. Neurovascular complications, despite their rarity have earned maximal discussion in the literature. We feel that traumatic lacerations and infectious complications have far more clinical relevance due to their frequency of occurrence, and should thus occupy a more prominent position in the management flow chart.- - - - - - - - - - ranking = 25.043668922217keywords = oral cavity, mouth, cavity (Clic here for more details about this article) |
9/28. agrobacterium radiobacter peritonitis in two patients maintained on chronic peritoneal dialysis.We report two patients with end-stage renal disease maintained on chronic peritoneal dialysis who developed peritonitis in which the infecting organism was agrobacterium radiobacter, normally a rare pathogen in humans. Both patients initially responded to antibiotics, but later relapsed and required catheter removal. Neither had been exposed to soil or plant material. A radiobacter is yet another of a growing list of unusual organisms that infect the peritoneal cavity of peritoneal dialysis patients.- - - - - - - - - - ranking = 0.58161408571617keywords = cavity (Clic here for more details about this article) |
10/28. Infected pancreatic necrosis possibly due to combined percutaneous aspiration, cystogastric pseudocyst drainage and injection of a sclerosant.This paper reports on a patient who was treated by percutaneous aspiration, instillation of a sclerosant (polidocanol) and cystogastric drainage for a post-acute pancreatic pseudocyst. Five weeks after admission to hospital for the first episode of an acute necrotizing pancreatitis, the 60-year-old man underwent a percutaneous, ultrasound-guided puncture and aspiration of a voluminous pancreatic pseudocyst. Ten days later, recurrent fluid collection led to a second puncture, combined with the injection of polidocanol (15 ml; 1%) into the cyst cavity. Since this treatment failed, a percutaneous cystogastric drain ("double--pigtail") was inserted five days later. After developing acute abdominal pain and incipient sepsis, the patient was sent for surgical intervention twelve days after the second treatment with percutaneous aspiration and injection of polidocanol. During the operation an infected pancreatic pseudocyst with extensive contaminated necrosis of the pancreas and duodenal perforation was found. Necrectomy was performed, followed by continuous lavage of the omental bursa. intensive care therapy was necessary for one week. Duodenal leakage persisted for nearly three weeks, the stopped spontaneously. The patient was discharged in quite a good state of health after 33 days of postoperative treatment. Although spontaneous development of infected pancreatic pseudocysts and pancreatic abscesses in necrotizing pancreatitis is known, a possible involvement of the drainage procedures, especially in combination with the injection of a sclerosant must be considered.- - - - - - - - - - ranking = 0.58161408571617keywords = cavity (Clic here for more details about this article) |
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