1/43. actinomycosis of the central nervous system: surgical treatment of three cases.Three cases of actinomycotic brain infection are described, 2 of which manifested as cerebral abscess, the third as epidural empyema. Complete resolution of the infection was always achieved by means of surgical treatment and prolonged antibiotic therapy. The cases reported emphasize the importance of a combined approach in the treatment of this unusual cause of brain infection.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/43. Endoscopic stereotactic surgery for intraventricular loculated empyema: case report.BACKGROUND: Ventriculitis accompanied by formation of an intraventricular loculated empyema is a very unusual complication of purulent meningitis. CASE DESCRIPTION: A 62-year-old man presented with acute purulent ventriculitis secondary to a small paraventricular abscess. The well-documented computed tomography scans demonstrated the development of an intraventricular loculated empyema in the posterior portion of the left lateral ventricle. A stereotactically guided endoscopic procedure was performed to drain and rinse the empyema and to remove membranous tissue in order to establish free communication with the ventricular system. In the further course, a ventriculoperitoneal shunt was placed. The patient had recovered almost completely 1 year after the procedure. CONCLUSIONS: Ventriculitis frequently results in severe morbidity and often causes death. Intraventricular pathologies can be treated effectively by endoscopic stereotactic methods. To our knowledge, this is the first case of successful treatment of an intraventricular loculated empyema in an adult.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
3/43. clostridium difficile brain empyema after prolonged intestinal carriage.clostridium difficile, the most common cause of antibiotic-associated diarrhea, is occasionally isolated from extraintestinal sites and is usually found as part of a polymicrobial flora. We report a case of brain empyema that occurred after the recurrent intestinal carriage of a nontoxigenic strain of C. difficile. brain abscess cultures contained both toxigenic and nontoxigenic isolates. Pulsed-field gel electrophoresis showed that nontoxigenic isolates from the intestine and from the brain were identical.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
4/43. Pleural empyema in association with renal sepsis.Five cases of pleural empyema in association with perinephric abscess or renal infection are presented. This represents 4 per cent of a series of 122 pleural empyemas, or 30 per cent of empyemas with subdiaphragmatic aetiology. It is suggested that the renal tract should be investigated in all cases of recurrent or non-resolving pleural empyema of uncertain aetiology.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
5/43. Refractory empyema caused by an intraoperative rib fracture sustained during esophagectomy: report of a case.A 57-year-old woman underwent esophagectomy with three-field lymphadenectomy for lower esophageal cancer, followed by gastric roll reconstruction through the posterior mediastinum. A laparotomy and right thoracotomy with partial resection of the right fifth rib were performed. A purulent discharge requiring drainage developed postoperatively and continued for 3 months despite anastomotic integrity and the absence of a bronchopleural fistula. An empyema developed 3 months after drain removal, and a thoracostomy tube was reinserted. A displaced fragment of the right fifth rib was identified within the abscess cavity. drainage and irrigation were not curative, and removal of the bone fragment was performed 18 months after the initial procedure. The patient has been symptom-free during 1 year of follow-up. We believe that the rib fragment functioned as a foreign body, which complicated treatment of the patient's postoperative infection.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
6/43. Extensive subgaleal abscess and epidural empyema in a patient with acute frontal sinusitis.Acute frontal sinusitis can be a serious condition because of its potential life-threatening complications. These complications, including spread of infection to the frontal bone and intracranially, require prompt diagnosis and intervention to avoid morbidity and mortality. We report a case of acute frontal sinusitis in a 16-year-old girl who presented with fever, severe headache, and vomiting of 3 days' duration. Generalized fluctuant swelling of the nasal root, and bilateral supraorbital and frontoparietal regions was noted. Computed tomography (CT) demonstrated left pansinusitis, extensive subgaleal abscess and epidural empyema with osteomyelitis of the frontal bone. External frontoethmoidectomy with mucoperiostectomy were performed. Endoscopic sinus surgery was then conducted for intranasal ethmoidectomy. Intraoperative cultures grew viridans streptococci, coagulase-negative staphylococci and peptostreptococcus micros. The patient received 3 weeks of treatment with intravenous antibiotics (penicillin 3 MU 4-hourly, ceftriaxone 500 mg 12-hourly, metronidazole 500 mg 6-hourly) and was discharged uneventfully and prescribed additional oral antibiotics for 5 weeks (clindamycin 150 mg 6-hourly and chloramphenicol 250 mg 6-hourly). CT revealed complete resolution of the abscess and clear maxillary and ethmoid sinuses at 7 weeks posttreatment. The patient was free of sinus infection at 4-years follow-up, without noticeable cosmetic deformity.- - - - - - - - - - ranking = 6keywords = abscess (Clic here for more details about this article) |
7/43. Abscess and empyema caused by legionella micdadei.legionella micdadei is the second most common species implicated in the occurrence of legionella pneumonia (D. J. Bremer, Semin. Respir. Infect. 4:190-205, 1987). Although there has been a reported lung abscess caused by dual infection (L. micdadei and L. pneumophila), there are no known cases of L. micdadei as the only causative organism. We report a case of a patient with a lung abscess from which L. micdadei was the sole organism isolated.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
8/43. Intraorbital abscess: a rare complication after maxillary molar extraction.BACKGROUND: The orbit is prone to being affected by an odontogenous infection, owing to its anatomical proximity to the maxillary sinus. A possible reason for an ophthalmic manifestation of a dental abscess is extraction of an acutely inflamed tooth. CASE DESCRIPTION: The authors describe the treatment of a man who had painful swelling and redness in the area of his right eye after having a maxillary molar extracted a few days previous. A general dentist referred the patient to the clinic after he began to experience a progressive deterioration of vision of his right eye. Emergency surgical intervention prevented impending loss of vision, and subsequent healing was uneventful. CLINICAL IMPLICATIONS: To avoid serious complications, clinicians should not perform a tooth extraction when the patient is in the acute stage of a maxillary sinus infection. Appropriate diagnostic imaging and profound evaluation of the clinical state play major roles in managing the treatment of patients with inflammatory processes that involve the oral and paraoral regions.- - - - - - - - - - ranking = 5keywords = abscess (Clic here for more details about this article) |
9/43. Dropped gallstone as a nidus of intra-abdominal abscess complicated by empyema.We describe a patient who developed an intra-abdominal abscess and empyema from a dropped gallstone at the time of laparoscopic cholecystectomy 1.5 years ago. As minimally invasive surgeries become conventional, clinicians should be aware of this increasingly common complication.- - - - - - - - - - ranking = 5keywords = abscess (Clic here for more details about this article) |
10/43. A case of streptococcus intermedius empyema.OBJECTIVE: To report a case of empyema caused by streptococcus intermedius as a complication of community-acquired pneumonia (CAP). CASE SUMMARY: An 85-year-old woman with a history of chronic obstructive pulmonary disease, asthma, heart failure, and hypothyroidism developed empyema as a result of 2 episodes of CAP and an acute exacerbation of chronic bronchitis within the past 2 months. Therapy with intravenous levofloxacin 750 mg every 48 hours was initiated. culture results of the empyema fluid yielded pure growth of a rarely encountered microorganism, S. intermedius. Intravenous piperacillin/tazobactam 3.375 g every 6 hours was added to the antimicrobial therapy at that time. However, cultures continued to show S. intermedius. Surgical decortication was unsuccessful, and the patient died after a 30 day hospital stay. DISCUSSION: Early, appropriate antimicrobial therapy is the mainstay of CAP treatment. Although rare, empyema or thoracic abscess can occur despite this therapy, due to mucosal changes caused by CAP. Historically, antimicrobial therapy used to treat organisms that typically cause CAP also has activity against S. intermedius. However, growth of this microorganism and failure to respond to therapy should alert clinicians to the possibility of empyema or abscess formation. CONCLUSIONS: Despite historical in vitro susceptibility data of S. intermedius, antimicrobial therapy may be ineffective, and more extreme measures may be needed to achieve a successful outcome. Early, appropriate antimicrobial therapy needs to remain the mainstay of the treatment of CAP in an attempt to prevent fatal complications such as this from occurring.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
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