Cases reported "Abscess"

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1/123. Acute inflammatory (non-purulent) arthritis concomitant with a developing breast abscess.

    A 34 year old female presented 7 weeks post-partum with acute diffuse arthritic manifestations and pyrexia. Extensive investigations (grossly raised erythrocyte sedimentation rate [ESR], c-reactive protein [CRP], normal serology and others) were performed to pursue a diagnosis. Subsequently a breast abscess was diagnosed. Surgical treatment of this led to almost immediate resolution of the joint complaints and return of ESR/CRP to normal levels. This was considered a hitherto unreported case of acute non-purulent inflammatory arthritis concomitant to an existing infection elsewhere in the body. The pathogenic mechanism is unclear but speculatively toxin-mediated.
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2/123. An unusual complication of minitracheostomy.

    A 72-year-old woman had a minitracheostomy inserted for sputum retention. This was undertaken by a relatively junior resident who opted to use an early model minitracheostomy kit Minitrach II. The following day the patients condition deteriorated and intubation was warranted, at which time it was apparent to senior staff that the minitracheostomy had been malpositioned. Ten days later, formal tracheostomy was performed under general anaesthesia. After incision, an abscess in the thyroid gland was found. histology subsequently revealed a Hurthle cell tumour of the thyroid. Thyroid abscess is exceedingly rare. It typically occurs in abnormal thyroid tissue and with a focus on infection. The combination of Hurthle cell adenoma and a foreign body (the minitracheostomy) was evidently causative in this instance. This complication of minitracheostomy insertion has not to our knowledge, previously been reported.
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3/123. Limitations of imaging for foreign bodies in parapharyngeal abscess and the importance of surgical exploration.

    A rare cause of parapharyngeal abscess in association with a wooden skewer is presented. Despite the use of both ultrasound and computed tomography (CT) scanning as diagnostic tools, the foreign body could not be identified. Only through a meticulous exploration of the neck was the foreign body located. The importance of surgical exploration even with negative imaging is discussed.
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4/123. Xanthogranulomatous tubo-ovarian abscess resulting from chronic diverticulitis.

    We report a case of xanthogranulomatous tubo-ovarian abscess which was preoperatively suspected to be an adnexal neoplasm. With foreign body material found in the abscess wall and vegetable fiber in the tubal lumen, a previously treated chronic diverticulitis was the presumed cause. culture studies showed polymicrobial isolates which included escherichia coli, an enteric pathogen. After surgery, administration of antibiotics, and revision of delayed subcutaneous wound healing, the patient is reportedly well.
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5/123. Complications of ornamental Christmas bulb ingestion. Case report and review of the literature.

    Unusual complications ensued when a 14-month-old boy ingested an ornamental Christmas bulb. Profuse rectal bleeding, a large ischiorectal abscess, and an acute condition of the abdomen necessiated a sigmoid colostomy with drainage of the ischiorectal abscess. Following this, repeated episodes of hemorrhage via the colostomy and rectum required multiple operative procedures. The last of these was a total colectomy with an ileostomy and rectal mucous fistula. The patient subsequently developed intestinal obstruction that required lysis of adhesions and drainage of a chronic subhepatic abscess, due to perforation of the terminal part of the ileum. The patient required five months of hospitalization and further surgery to reconstruct gastrointestinal continuity. hemorrhage is an infrequent complication of foreign body ingestion, as reported in the literature. We theorize that the problems in this case were the result of the extreme thinness (0.033 cm) and the brittleness of the glass fragments.
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6/123. Neonatal infectious spondylitis of the cervical spine presenting with quadriplegia: a case report.

    STUDY DESIGN: A case report.- OBJECTIVE: To highlight the evaluation and treatment of neonatal infectious spondylitis of the cervical spine. SUMMARY OF BACKGROUND DATA: Most authors advise intravenous antibiotics as first-choice treatment. The place of aspiration or operative drainage is debated, as is the position and duration of immobilization. methods: A 3-week-old neonate was presented with intermittent quadriplegia. RESULTS: Additional investigation demonstrated an osteolytic process in the body of C3 with a large epidural abscess compressing the spinal cord. Because an infectious spondylitis of C3 was suspected, aspiration of the abscess was performed, and antibiotic therapy was started. The patient improved to neurologically normal within 3 weeks and remains asymptomatic throughout a follow-up period of 7 years. CONCLUSIONS: Neonatal infectious spondylitis should be diagnosed early and treated promptly; otherwise, it may have devastating consequences.
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7/123. chest pain: overlooked manifestation of unsuspected esophageal foreign body.

    Two cases of unsuspected esophageal foreign body ingestion with chest pain as the main symptom are reported. Both patients had extensive cardiac evaluation to rule out myocardial ischemia. They were discharged home with continuing chest pain and odynophagia. Both patients were denture wearers, and further questioning revealed the coincidence of chest pain with taking meals. Further evaluation revealed an impacted esophageal foreign body in one patient and an esophageal perforation with a mediastinal abscess in the other. These cases illustrate the importance of considering esophageal foreign bodies as factors in chest pain.
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8/123. Intraosseous bioabsorbable poly-L-lactic acid screw presenting as a late foreign-body reaction: a case report.

    A 17-year-old woman complained of a localized painful swelling in her foot 30 months after internal fixation of a closed tarsometatarsal joint fracture with interfragmentary poly-L-lactic acid screws. Aspiration revealed a sterile abscess. Radiographs displayed an osteolytic lesion corresponding to a screw track in the first tarsometarsal joint. Formation of a draining sinus tract required surgical excision of a small granulomatous lesion. Histologic analysis found deposits of birefringent polymeric particles surrounded by a nonspecific foreign-body type reaction. This represents the first reported case of a draining sinus tract secondary to the use of polylactic acid screw fixation.
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9/123. Retained foreign body in the orbit and cavernous sinus with delayed presentation of superior orbital fissure syndrome: case report.

    Reports of delayed onset of neurological symptoms after penetrating intracranial trauma are rare. We present the case of a patient who presented with superior orbital fissure syndrome 72 hours after reported trauma to the right eye. Subsequent workup revealed a foreign body located within the orbit, passing through the superior orbital fissure and into cavernous sinus, impinging on the right cavernous carotid artery. Evidence of an intraorbital abscess was also present. Surgical management consisted of a combination of frontopterional and orbital approaches to fully expose both the cavernous sinus and the orbital contents. The foreign body was removed and the abscess was drained. The carotid artery was found to be intact. At 10-month follow-up examination, a slight ptosis and medial gaze of the right eye persist. All other symptoms have resolved.
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10/123. Group F streptococcal bacteremia complicating a Bartholin's abscess.

    BACKGROUND: Group F streptococci are gram-positive cocci typically isolated from wound infections and abscesses. bacteremia with group F streptococcus is uncommon, and the lower gynecologic tract has not been reported as a source. We report a case of a Bartholin's abscess leading to group F streptococcal bacteremia. CASE: A 31-year-old female noted fever and rigors 30 min after manipulation of a 3-day-old vulvar abscess. An empty Bartholin's gland abscess was found on examination, and blood cultures grew beta-hemolytic group F streptococci. The patient was treated with ampicillin/sulbactam, symptoms improved, and follow-up blood cultures revealed no growth. CONCLUSION: Group F streptococci are known to inhabit various body sites and have a predilection for forming abscesses; however, bacteremia is infrequent. They have occasionally been identified in true infections of the genitourinary tract but only very rarely in Bartholin's abscesses. This case of group F streptococcal bacteremia following self-drainage of a Bartholin's abscess constitutes the first such description in the medical literature.
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