1/34. Preseptal cellulitis secondary to Proteus species: a case report and review.BACKGROUND: Preseptal cellulitis is a serious ocular condition that--if left untreated--has the potential to cross the septal barrier, spread to the posterior orbit, and may result in fatal complications. Because it is difficult to determine the pathogen responsible for any cellulitis without aspirating a culture sample, treatment is usually instituted by an assumption of the most common causative organisms, Staphylococcus or streptococcus. CASE REPORT: A 42-year-old black woman manifested signs and symptoms consistent with right preseptal cellulitis. Throughout treatment, visual acuity remained 20/20 for both eyes, extraocular muscles were unrestricted without pain, and anterior globe structures were clear. The patient was started on a regimen of 250-mg oral dicloxacillin four times a day. When no response was seen at 36 hours, the patient was changed to 500-mg oral ciprofloxacin every 12 hours. She responded to the 500-mg ciprofloxacin and recovered with no sequelae. An abscess, which had formed during the cellulitis, self expressed and this material was cultured. The cultures identified the responsible organism as Proteus species, an unexpected pathogen in a well-groomed patient. CONCLUSION: This case demonstrates the need to consider alternate pathogens when treating preseptal cellulitis, change medications accordingly, and consider alternate treatments as needed.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/34. Nephrobronchial fistula secondary to xantogranulomatous pyelonephritis.We report a case of staghorn nephrolithiasis that evolved into xanthogranulomatous pyelonephritis with perinephric abscess, nephrobronchial fistula, and lung abscess. The patient was an intravenous drug abuser who tested positive for human immunodeficiency virus, without evidence of acquired immunodeficiency syndrome. He presented with a 2-month history of untreated repeated episodes of left flank pain and hyperpyrexia. Treatment involved left nephrectomy, debridement of abscess, tube drainage, and intravenous antibiotics. The patient illustrates the need to consider untreated nephrolitiasis as a predisposing factor for pulmonary complications.- - - - - - - - - - ranking = 3keywords = abscess (Clic here for more details about this article) |
3/34. Protean infectious types and frequent association with neurosurgical procedures in adult serratia marcescens CNS infections: report of two cases and review of the literature.serratia marcescens is a rare pathogen of adult central nervous system (CNS) infection. We report on the clinical features and therapeutic outcomes of two adult patients with such infections. The clinical characteristics of 13 other reported adult cases are also included for analysis. The 15 cases were nine males and six females, aged 19-83 years, in whom, underlying post-neurosurgical states and ear operation were noted in 93% (14/15). fever and conscious disturbance were the most common clinical manifestations of these 15 cases, followed by hydrocephalus, seizures, and wound infections. The manifestation types were protean, including meningitis and focal suppurations such as brain abscess, cranial and spinal epidural abscess, cranial subdural abscess, and infected lumbar pseudomeningocele. One case of S. marcescens CNS infection was diagnosed postmortem; the other 14 were diagnosed by the positive culture from CSF or pus. Antibiotic therapy with or without neurosurgical intervention was the management strategy in 14/15 cases. The therapeutic results showed a high mortality rate.- - - - - - - - - - ranking = 3keywords = abscess (Clic here for more details about this article) |
4/34. Sonographic detection of multiple brain abscesses in a newborn with iga deficiency.We report the case of a neonate with selective iga deficiency and multiple brain abscesses diagnosed with sonography. Brain sonography revealed multiple abscesses in the left hemisphere; the abscesses ranged from 10 to 20 mm. Cultures obtained from the cerebrospinal fluid and blood were positive for proteus mirabilis. The neonate responded promptly to broad-spectrum antibiotic therapy and had no neurologic sequelae. Because iga deficiency is associated with infections, we believe it was a predisposing factor for the brain abscesses.- - - - - - - - - - ranking = 8keywords = abscess (Clic here for more details about this article) |
5/34. Venous sinus thrombosis after proteus vulgaris meningitis and concomitant clostridium abscess formation.A 19-y-old woman presented with proteus vulgaris meningitis as a complication of chronic otitis media. Despite treatment with ceftazidime and amikacin no clinical improvement was observed. Cranial MRI revealed right-sided mastoiditis/otitis media and venous sinus thrombosis. After mastoidectomy, repeat cranial MRI demonstrated abscess formation in the venous sinuses. The abscess was drained. clostridium spp. was isolated from the abscess culture.- - - - - - - - - - ranking = 7keywords = abscess (Clic here for more details about this article) |
6/34. brain abscess complicating cerebral infarct.PRESENTATION: We report a case of a 68-year-old man who suffered ischemic strokes in the left middle cerebral artery territory and three months later, following urosepsis, developed a cerebral abscess in the infarcted area. DISCUSSION: A literature search found only eight other cases. We discuss herein the common clinical aspects of brain abscess complicating strokes, the co-existent diseases, and point out the possibility of underreporting this rare but treatable complication. CONCLUSION: Cerebral abscess should be suspected in patients with a previous brain infarction or haemorrhage, who develop bacteremia and impaired consciousness without a clear explanation to their condition. Advanced age, and medical conditions known adversely to affect immunological competence reinforce the clinical suspicion.- - - - - - - - - - ranking = 7keywords = abscess (Clic here for more details about this article) |
7/34. Ruptured renal microaneurysms complicated with a retroperitoneal abscess for a patient with systemic lupus erythematosus.renal artery aneurysm is extremely rare among patients with systemic lupus erythematosus.(SLE). Herein, we report on a 22-year-old male lupus patient who presented with acute abdominal pain, anemia and subsequent hypertension. Abdominal computed tomography revealed a peri-renal hematoma over the right kidney. A renal angiography revealed bilateral renal microaneurysms. The patient subsequently developed a right-side retroperitoneal abscess 4 weeks after hematoma formation and received an emergent laparotomy with drainage. Subsequent culture ofthe abscess-derived fluid revealed the presence of proteus mirabilis and escherichia coli. Following appropriate antipyretic and immunosuppressive drugs therapy, the patient recovered successfully. To the best of our knowledge, this is the first report of SLE associated with a retro-peritoneal abscess probably secondary to a ruptured renal microaneurysm.- - - - - - - - - - ranking = 7keywords = abscess (Clic here for more details about this article) |
8/34. psoas abscess twenty-one years after ipsilateral nephrectomy.We report an unusual case of psoas abscess, which developed twenty-one years after ipsilateral nephrectomy and was caused by infrequent pathogen, proteus mirabilis. It was diagnosed by computed tomography and was drained percutaneously with a nephrostomy tube guided by ultrasonography.- - - - - - - - - - ranking = 5keywords = abscess (Clic here for more details about this article) |
9/34. Neonatal Proteus meningoencephalitis. Case report.Proteus is an uncommon pathogen in neonatal meningitis and has, to our knowledge, not previously been described from scandinavia. Our case illustrates the typical course of the disease when onset is within the first two weeks of life. The typical patient is a previously healthy, sometimes slightly preterm infant, who develops multiple brain abscesses and has a very poor prognosis. In cases with a later onset, factors predisposing for infection are common and the outcome is less severe. Our patient was a girl born at a gestational age of 36 full weeks, who was a little less alert than normal during the first three days and then became dramatically sick with convulsions and apnoeas. She died at the age of six days with severe brain damage.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
10/34. Intracranial complications following mastoidectomy.Mastoidectomy is a common surgical procedure in otology. However, postoperative complications of various degrees of severity may occur. We present 4 children who underwent mastoidectomy for middle ear and mastoid disease and developed postoperative intracranial complications. One child was operated on for brain abscess 1 week after the initial mastoidectomy. Another child appeared with seizures 5 days after the initial mastoidectomy and a subdural empyema was drained during revision surgery. Large bone defects with exposed middle cranial fossa dura were found at revision surgery in both cases and proteus vulgaris and methicillin-resistant staphylococcus aureus were isolated from the mastoid and abscess cavities in these children. A small epidural collection was diagnosed in the third patient 2 days after initial mastoid surgery and was managed with intravenous antibiotics only. The other child was found to have sigmoid sinus thrombosis the day after mastoidectomy that was performed for nonresponsive acute mastoiditis. This child received both intravenous antibiotics and anticoagulants. Timely revision surgery, combinations of third- or fourth-generation cephalosporins with vancomycin or metronidazole and the addition of anticoagulants in cases of sinus thrombosis can lead to full recovery.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
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