1/191. Surgical presentation of melioidosis in india.BACKGROUND: melioidosis, the disease caused by burkholderia pseudomallei, is common in Southeast asia. It has also been reported from india, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites. methods: All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated. RESULTS: Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed. CONCLUSION: melioidosis is under-diagnosed in india, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.- - - - - - - - - - ranking = 1keywords = abscess (Clic here for more details about this article) |
2/191. Hepatosplenic candidiasis after neutropenic phase of acute leukaemia.Hepatosplenic candidiasis following granulocytopenic periods is a relatively recently recognised problem in immunocompromised patients, particularly in those with acute leukaemia. We present three patients in whom diagnosis of hepatosplenic candidiasis was suspected on the basis of ultrasonographic (US), computed tomographic (CT) findings and confirmed by laparoscopy and biopsy of liver lesions. All three patients were successfully treated briefly with amphotericin b, followed by a longer period of fluconazole. In one patient laparotomy and surgical evacuation of abscesses was performed. This condition could be more often recognised by careful follow-up of liver function test, c-reactive protein level, ultrasonography, CT and MRI after recovery from chemotherapy-induced neutropenia.- - - - - - - - - - ranking = 0.25keywords = abscess (Clic here for more details about this article) |
3/191. pyoderma gangrenosum with liver, spleen and bone involvement in a patient with chronic myelomonocytic leukaemia.pyoderma gangrenosum is a neutrophilic dermatosis of unknown aetiology. Visceral involvement by pyoderma gangrenosum is rare, the lung being the most frequent site of extracutaneous disease. We describe a 73-year-old man with pyoderma gangrenosum and chronic myelomonocytic leukaemia in whom aseptic hepatosplenic abscesses and bony lesions were associated.- - - - - - - - - - ranking = 0.25keywords = abscess (Clic here for more details about this article) |
4/191. Splenic abscess 10 years after splenic trauma: a case report.Splenic abscess is an uncommon complication of splenic trauma. Splenic abscess presents within several months of the trauma. We report a case of a splenic abscess 10 years after trauma and review the current understanding of splenic abscesses.- - - - - - - - - - ranking = 2keywords = abscess (Clic here for more details about this article) |
5/191. Portal venous gas associated with splenic abscess secondary to colon cancer.We report a successfully treated case accompanied by portal venous gas, which was associated with splenic abscess due to penetration of colon cancer. In June, 1998, a 67-year-old Japanese man was referred to our hospital because of a continuous fever over 40 degrees C and portal venous gas detected by computed tomography (CT). CT revealed low density areas in the spleen and wall thickening of the descending colon next to the spleen. barium-enema examination demonstrated an extrinsic filling defect in the splenic flexure of the colon. splenectomy, resection of the pancreatic tail and left hemicolectomy were performed Histopathological studies showed moderately differentiated adenocarcinoma, which made a fistula at the bottom of the ulceration to the spleen. The postoperative course was uneventful. The portal venous gas was likely to have resulted from a bacterial infection in the portal venous systems secondary to the splenic abscess.- - - - - - - - - - ranking = 1.5keywords = abscess (Clic here for more details about this article) |
6/191. Splenic abscess after appendicitis.We report an appendicitis complicated by a splenic abscess in a patient with polycystic kidneys and multiple cystic lesions in the liver. Clinical decision making for operative intervention was made difficult by the extensive intra-abdominal abnormalities seen on computer tomography. Finally curation was achieved by splenectomy and appendectomy.- - - - - - - - - - ranking = 1.25keywords = abscess (Clic here for more details about this article) |
7/191. tuberculosis: a rare cause of splenic abscess.Splenic abscess is a rare condition associated with septicemic conditions. Splenic abscess due to tuberculosis is still rarer, mostly diagnosed in immuno-compromised hosts. A case of tubercular splenic abscess without any underlying disease is reported.- - - - - - - - - - ranking = 1.75keywords = abscess (Clic here for more details about this article) |
8/191. Splenic abscess following blunt abdominal trauma.A rare case of splenic abscess occurring after blunt abdominal trauma in a previously healthy boy is reported. The diagnosis was made by ultrasonography. The patient recovered after splenectomy and drainage of subphrenic and intraperitoneal pus.- - - - - - - - - - ranking = 1.25keywords = abscess (Clic here for more details about this article) |
9/191. A case of multiple splenic abscesses managed non-operatively.We report the case of a previously fit 22-year-old man who developed multiple splenic abscesses of unclear aetiology and was successfully treated with percutaneous drainage of the largest abscess and antibiotic therapy.- - - - - - - - - - ranking = 1.5keywords = abscess (Clic here for more details about this article) |
10/191. Splenic abscess: report of six cases and review of the literature.Splenic abscesses are rare but appear to be increasing in frequency. Recent advances in radiologic techniques have affected the diagnosis and management. The purpose of this study was to evaluate these effects. The medical records of one institution were retrospectively reviewed and six cases of splenic abscesses seen between 1989 and 1999 were identified. All patients had predisposing conditions with metastatic hematogenous infection in three and one each with trauma, immunodeficiency, and a contiguous site of infection. fever was present in all patients with chills and vomiting in five and three patients, respectively. Left upper quadrant tenderness appeared in four patients and leukocytosis was found in every patient except one with the acquired immunodeficiency syndrome. Chest roentgenograms were abnormal in five patients with a left pleural effusion most common. Ultrasound revealed the defect in both patients it was utilized in and computed tomography was diagnostic in all cases. The causative organisms were anaerobes in two cases and candida albicans, streptococcus viridans, escherichia coli, and citrobacter freundii each present in one case. radiology guided percutaneous drainage was attempted in four patients but was only successful in one. splenectomy with antibiotics was curative in the remainder with a 100 per cent survival. These data suggest that percutaneous drainage may be appropriate for certain patients initially, but the high failure rate demonstrates that splenectomy remains the standard treatment.- - - - - - - - - - ranking = 1.5keywords = abscess (Clic here for more details about this article) |
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