1/16. Primary cutaneous nocardiosis in an immune-competent patient. We present a patient who was hospitalized due to a purulent skin lesion with a surrounding erythematous area in the region of the right paranasal crease accompanied by a swelling of the right eyelid. Initially the diagnosis of a carbuncle caused by an infection with staphylococcus aureus was supposed. A surgical debridement was performed and an antibiotic therapy was started. Only special microbial investigations requested by the clinician led to the diagnosis of a cutaneous infection with nocardia brasiliensis. The presented case is remarkable because the nocardia infection was in an immune-competent patient and the patient showed a primary cutaneous nocardiosis without dissemination. ( info) |
2/16. Conservative management of renal carbuncles in children. Renal carbuncles have traditionally been treated with surgical drainage and appropriate antibiotic therapy. Recently, 2 pediatric patients with well-documented renal carbuncles were treated with antibiotic therapy alone. Close follow-up documented complete resolution in both cases. Late studies showed no evidence of renal scarring or functional compromise. ( info) |
3/16. Conservative approach in treating acute renal carbuncle. During the years 1980-82 seven patients with renal carbuncles successfully underwent conservative treatment with antibiotics alone. early diagnosis was made using excretory urography and nephrotomography, ultrasound and computerized tomography scan. follow-up studies showed a normal kidney in six of the seven patients. One patient had a clinical remission, but ultrasound follow-up showed a small area in the right kidney with a few low-level echoes, representing focal scarring. ( info) |
4/16. Devastating scalp infections. The treatment of scalp wounds is occasionally complicated by infection. Although infected scalp wounds are generally limited and readily treated, they can progress to devastating proportions if not promptly and aggressively managed. This report highlights three such cases of severe infection: extensive subgaleal abscess, fatal necrotizing fasciitis, and widespread carbunculosis. The authors emphasize the need for proper assessment of scalp wounds, meticulous cleansing and closure of all fresh wounds, definitive drainage of newly infected wounds, and adherence to sound surgical principles in managing these wounds. ( info) |
5/16. Renal carbuncle: simulation of tumor response to epinephrine. A case of renal carbuncle with unusual angiographic findings is presented. The abscess showed abnormal vessels on selective angiogrpahy which were enhanced after intra-arterial epinephrine. New foci of abnormal vessels were also seen on the postepinephrine angiogram. ( info) |
6/16. Percutaneous aspiration of renal cortical abscess. Two patients with renal cortical abscesses were treated successfully by an intensive antibiotic regimen together with percutaneous aspiration, rather than by the conventional treatment of open drainage, which often is followed by secondary nephrectomy. This adaptation of percutaneous aspiration to the management of renal carbuncle coincides with a change in the causative microorganism which today is often a gram-negative coliform rather than a hematogenously borne staphylococcus, which usually complicates some pre-existing abnormality in the urinary tract. ( info) |
7/16. Significance and evaluation of calcifications associated with renal masses. Although there are numerous references in the medical literature suggesting that calification associated with renal masses is indicative of malignant disease, our recent experience with four cases emphasizes that it is not possible to predict the nature of these lesions. The significance and etiology of renal calcification are discussed as well as the indications for clinical evaluation. ( info) |
8/16. Renal carbuncle: diagnosis and management. Six cases of renal carbuncle are presented. Nonstaphylococcal carbuncles now greatly outnumber those of staphylococcal origin. Diagnostic modalities are discussed. No radiologic or laboratory investigation is specific, but the diagnosis should be suspected in most cases if adequate attention is given the patient's signs and symptoms. Surgical treatment is recommended. ( info) |
9/16. Periorbital soft-tissue and socket reconstruction. Deformities of the periorbital soft tissue and socket after trauma or infection may involve the bony framework, orbital contents, and periorbital soft tissues, requiring careful evaluation. Soft-tissue reconstruction necessitates the appreciation of a three-dimensional defect. Structural reconstruction in conjunction with prosthetic replacement of the globe requires careful planning. Three cases illustrating problems and results after reconstructions are presented. ( info) |
10/16. Case study: carbuncle of the neck with extensive tunnelling. A 40 year old female developed a carbuncle at the base of the neck on the right side near the hairline. Despite her attempts to treat the carbuncle at home "it continued to enlarge and fester" (became inflamed and suppurated). She was admitted to the hospital and, following surgical incision and drainage, ET nurse consultation was requested to establish a wound treatment regimen. ( info) |