1/67. Acute bronchopulmonary infection due to Streptococcus milleri in a child with cystic fibrosis.An 8 year old girl with cystic fibrosis had severe respiratory disease associated with chronic pseudomonas aeruginosa bronchopulmonary infection. Despite regular courses of intravenous antipseudomonal antibiotics, she continued to deteriorate over 18 months with persistent productive cough, worsening respiratory function, and increasing oxygen dependence. During her 11th admission Streptococcus milleri was isolated from sputum cultures in addition to P aeruginosa. She failed to respond to antipseudomonal antibiotics but improved dramatically with the addition of intravenous benzylpenicillin. Although S milleri is considered a normal mouth commensal and its isolation from sputum of cystic fibrosis patients is of uncertain significance, it was associated with clinically significant infection in this child. S milleri was eradicated with antibiotic treatment and clinical improvement has been maintained.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
2/67. Streptococcus milleri infection and pericardial abscess associated with esophageal carcinoma: report of two cases.We report 2 cases of esophageal carcinoma with esophago-mediastinal fistula that developed pericardial abscess due to streptococcus intermedius infection. streptococcus intermedius, a generally harmless commensals in healthy humans, is not usually associated with infections of the oral cavity but may account for non-oral purulent infections. This report, however, highlights that streptococcus intermedius infection can be life-threatening for some patients such as those with esophageal carcinoma with fistula.- - - - - - - - - - ranking = 5.3933516071372keywords = oral cavity, cavity (Clic here for more details about this article) |
3/67. brain abscesses from neglected open head injuries: experience with 17 cases over 20 years.We are reviewing our experience with 17 civilian cases with post-traumatic brain abscesses treated in the era of CT scanning over a period of 20 years. The principal cause for this intracranial complication was the neglected compound depressed fracture. One was a newborn infant with left parietal abscess caused by a vacuum extraction. We have used the following methods of treating the abscesses: single burr hole aspiration in the newborn with an excellent result; repeated aspiration, with debridement of the depressed fracture, in 5 cases (1 death); aspiration with early subsequent excision, via craniotomy, in 7 cases (no death), and primary excision, via craniotomy, in 4 cases (1 death). The early subsequent excision of the abscess, 2 or 3 days after the initial aspiration, has proved in our experience very satisfactory. In cases with bone fragment into the abscess cavity the excision of the abscess is indicated. The cultured pus from the abscess cavity showed mixed flora (streptococci and staphylococci) in 7 cases; staphylococcus aureus in 4; staphylococcus epidermidis in 2, and no growth in 4 cases. Antibiotics play an important role in the treatment of post-traumatic brain abscesses.- - - - - - - - - - ranking = 2.3167193335248keywords = cavity (Clic here for more details about this article) |
4/67. Surgical management of primary lung cancer in an elderly patient with preoperative empyema.A 74-year-old man with primary lung cancer developed preoperative empyema but was successfully managed surgically. The patient was given a diagnosis of c-T2N1M0, stage IIB, moderately differentiated squamous cell carcinoma, but before surgery pneumothorax and empyema developed, resulting from rupture of the carcinoma. Thoracic drainage, lavage and systemic administration of antibiotics improved his empyema. As there were no malignant cells in the drainage fluid, right middle-lower bilobectomy, empyemal cavity resection and lymph node dissection were performed. The bronchial stump was covered with an intercostal muscle flap. Thoracic drainage, lavage and systemic administration of antibiotics were performed for 6 days following the operation. The patient was discharged on the 27th postoperative day without any complications having developed. The pathological diagnosis of the tumor was p-T4N2(#7)M0, stage IIIB, br(-), ly( ), v( ), p3(pleura), pm1 and d0. He died of recurrence at home 18 months after the operation. We believe the following to be the minimum requirements for surgical management of such patients: (1) immediate thoracic cavity drainage and lavage with systemic antibiotic therapy, aiming at infection control before surgery; (2) prophylactic lavage of the thoracic cavity during and after surgery and (3) coverage of the bronchial stump with an adequate flap. Six reported cases of primary lung cancer with preoperative empyema are also discussed.- - - - - - - - - - ranking = 3.4750790002873keywords = cavity (Clic here for more details about this article) |
5/67. ludwig's angina in the pediatric population: report of a case and review of the literature.ludwig's angina is a rapidly progressing cellulitis involving the submandibular neck space. It is characterized by brawny induration of the submental region and floor of mouth, bearing the potential for rapid airway obstruction. airway management, antibiotics, and judicious surgical intervention are the mainstays of successful therapy. We present a case of ludwig's angina in a 5-year-old child and offer a meta-analysis of pediatric cases of ludwig's angina described in the literature over the past 30 years. The presentation, etiology, management, and potential complications of this disorder in the pediatric population are discussed.- - - - - - - - - - ranking = 1keywords = mouth (Clic here for more details about this article) |
6/67. Origins of staphylococcus epidermidis and streptococcus oralis causing bacteraemia in a bone marrow transplant patient.coagulase-negative staphylococcal bacteraemia in immunocompromised patients is often associated with the use of central venous catheters, while the proposed origin of viridans streptococci causing bacteraemia in this patient group is the oral cavity. This report describes an episode of polymicrobial bacteraemia caused by staphylococcus epidermidis and streptococcus oralis followed by several further episodes of S. epidermidis bacteraemia in a 15-year-old boy after bone marrow transplantation. Pulsed-field gel electrophoresis (PFGE) of SmaI chromosomal dna digests was used to compare blood culture and oral isolates of S. epidermidis and Str. oralis. The results indicated that the mouth was the source of both S. epidermidis and Str. oralis causing the first episode of bacteraemia. PFGE further demonstrated that the central venous catheter was the origin of a second strain of S. epidermidis responsible for subsequent episodes of staphylococcal bacteraemia. Both the oral mucosa and central venous lines should be considered as potential sources of organisms, including coagulase-negative staphylococci, associated with bacteraemia in immunocompromised patients.- - - - - - - - - - ranking = 6.3933516071372keywords = oral cavity, cavity, mouth (Clic here for more details about this article) |
7/67. Streptococcus viridans intra-amniotic infection associated with antecedent cunnilingus.Introduction of bacteria into the amniotic cavity has been associated with oral sex through an ascending infectious route. Previous reports have implicated both capnocytophaga and fusobacterium nucleatum via this process. We report a case of Streptococcus viridans intra-amniotic infection occurring at 25 weeks' gestation. Patient questioning revealed a close temporal relationship between the onset of symptoms and previous episodes of cunnilingus. The diagnosis of subclinical bacterial colonization of the amniotic fluid should be considered in patients presenting with preterm labour and no apparent aetiology. A history of recent cunnilingus may be associated with the presence of Streptococcus viridans in the amniotic fluid.- - - - - - - - - - ranking = 1.1583596667624keywords = cavity (Clic here for more details about this article) |
8/67. Primary peritonitis in adults.Infection within the peritoneal cavity without an identifiable source of contamination is rare. The diagnosis is one of exclusion, and can be made with certainty only after a thorough laparotomy. The response to antibiotic therapy is usually prompt and gratifying.- - - - - - - - - - ranking = 1.1583596667624keywords = cavity (Clic here for more details about this article) |
9/67. Hepatic abscess as a complication of the sump syndrome.We report a case of hepatic abscess associated with the sump syndrome. The patient was a 66-year-old woman who had undergone cholecystectomy and side-to-side choledochoduodenostomy for a common bile duct (CBD) stone in 1983, and who presented with fever and right lower chest pain. A hepatic abscess was diagnosed; after it was drained, percutaneous transhepatic biliary drainage was performed. Bacteriological studies revealed the presence of bacteroides fragilis and streptococcus intermedius in the pus in the hepatic abscess cavity, and klebsiella pneumoniae and pseudomonas aeruginosa in the bile. The hepatic abscess and cholangitis rapidly resolved in response to two drainage procedures. At surgery, simple closure of the anastomosis was performed, because free drainage was observed from the distal CBD into the duodenum, despite the existence of a periampullary diverticulum.- - - - - - - - - - ranking = 1.1583596667624keywords = cavity (Clic here for more details about this article) |
10/67. Group-F streptococcal pleuro-pericarditis in a mesothelioma patient after dental surgery (case report).A 71-year-old mesothelioma patient developed pleuro-pericarditis and pleural empyema. Bacteriological examinations and serological identification proved group F Streptococcus in the pleural fluid. Anamnestic data suggested that the source of infection might have been the oral cavity after dental surgery.- - - - - - - - - - ranking = 5.3933516071372keywords = oral cavity, cavity (Clic here for more details about this article) |
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