Cases reported "Sepsis"

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1/188. lemierre syndrome and acute mastoiditis.

    lemierre syndrome seldom follows an episode of pharyngotonsillitis. Characteristically, it is comprised of septic thrombosis of the internal jugular vein and bacteremia, leading to lung emboli and metastatic abscess formation. We describe lemierre syndrome that complicates an acute mastoiditis, with considerations regarding its pathogenesis and management. Despite its sporadic occurrence, awareness of lemierre syndrome is important, since early recognition reduces both the morbidity and mortality associated with it.
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ranking = 1
keywords = abscess
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2/188. Pericardial abscess--a rare complication of sepsis.

    Pericardial abscess is a very rare complication of sepsis. Authors describe the case of a 69-year-old woman. In her case staphylococcus sepsis led to pericardial abscess. During the course positive blood cultures (3x) indicated the sepsis and pus was obtained from the left pleural cavity (pleuropneumonia). Concomitant purulent process in the left shoulder also was noted. Decline immunity due to long-standing corticoid therapy (prednisone) for proctocolitis idiopathica was observed. Following antibiotic treatment successful surgical evacuation of the pericardial abscess was performed.
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ranking = 7
keywords = abscess
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3/188. retropharyngeal abscess on a Ga-67 scan: a case report.

    A retropharyngeal abscess is a potentially fatal deep neck infection. Classical symptoms include fever, neck swelling, sore throat, dysphagia, and cervical rigidity. Sometimes small children present with nonspecific symptoms. We report a rare case whereby the Ga-67 citrate scan was the first investigation to reveal an inflammatory process in the retropharyngeal or submastoid region of a 3-year-old child with sepsis. This directed the line of investigation to a more precise anatomic imaging modality, CT scanning, to localize the abscess. With prompt administration of intravenous antibiotics, the child recovered quickly and did not require surgery. The Ga-67 scan is thus a useful screening test to detect inflammatory foci because of its high sensitivity. It is also valuable in the follow-up of the patient's response to therapy.
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ranking = 6
keywords = abscess
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4/188. Iliopsoas haemophiliac pseudotumours with bowel fistulation.

    Two cases of iliopsoas haemophilic pseudotumours are presented. In one patient a fistula developed between a pseudotumour and the large bowel. This resulted in an abscess involving the pseudotumour and adjacent tissues. It resolved after 5 years of therapy involving percutaneous drainage and closure of the fistula. The second patient had a massive pseudotumour that had obstructed both ureters. Later he suffered a fatal mixed Gram negative septicaemia probably related to erosion into the colon.
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ranking = 1
keywords = abscess
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5/188. Lemierre's syndrome with bilateral empyema thoracis.

    A 31-year-old patient is described with thrombophlebitis of the right jugular vein, and anerobic septicemia (Lemierre's syndrome). Multiple pulmonary abscesses and bilateral fibrinopurulent empyema were also present. Treatment included intravenous antibiotics, heparin, and video-assisted thoracoscopic debridement of pleural cavities. A favorable outcome was observed.
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ranking = 1
keywords = abscess
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6/188. Low blood glucose levels and other complications during growth hormone supplementation in sepsis.

    blood glucose levels in the high normal range or even moderate hyperglycemia is the expected profile in septic postoperative patients receiving high-calorie enteral alimentation. The addition of growth hormone as an anabolic agent should additionally reinforce this tendency. In a cancer patient undergoing partial gastrectomy with lymphadenectomy and suffering from postoperative subphrenic abscess and prolonged sepsis, tube feeding (38.3 kcal/kg/day) and growth hormone (0.17 IU/kg/day) were simultaneously administered for 25 days. blood glucose levels were in the lower limits of the normal range before growth hormone introduction, and continued with a similar tendency during most of the therapeutic period. Two additional complications, namely heart arrest and peripheral edema, were documented during the same period. It is concluded that sepsis was the most likely mechanism for low glucose values, and that high-calorie enteral diet and growth hormone supplementation did not prevent that result. It is uncertain whether heart arrest was due to the drug, but its association with peripheral edema is well documented in clinical series.
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ranking = 1
keywords = abscess
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7/188. Successful high dose therapy for relapsed mediastinal large B cell lymphoma following surgical repair of anterior chest wall defect.

    We describe a man with relapsed large B cell mediastinal lymphoma and associated infected large anterior chest wall defect who required high dose salvage therapy for his underlying disease. An initial mediastinotomy wound, associated with recurrent sepsis, had developed into an abscess, then fistula and eventually a large anterior chest wall defect. Safe use of salvage chemotherapy required reconstructive surgery consisting of a pedicled muscle flap. The subsequent high dose chemotherapy was carried out without complications and 15 months later the patient is alive and well.
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ranking = 1
keywords = abscess
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8/188. lemierre syndrome: magnetic resonance imaging and computed tomographic appearance.

    lemierre syndrome consists of septic thrombophlebitis of the internal jugular vein secondary to oropharyngeal infection, usually with fusobacterium necrophorum. Septic metastatic emboli and distant infection are characteristic. We describe the imaging appearance of lemierre syndrome in an adolescent female by both magnetic resonance imaging and computed tomography. This case illustrates the rapid onset and characteristic progression of the rare syndrome of Lemierre. In addition, we used magnetic resonance imaging to effectively distinguish between inflammatory venous thrombosis and abscess, thus avoiding surgery in our patient. Early directed antibiotic therapy is mandatory to ensure good outcome.
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ranking = 1
keywords = abscess
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9/188. Multimicrobial sepsis including clostridium perfringens after chemoembolization of a single liver metastasis from common bile duct cancer.

    A 65-year-old woman underwent resection of a distal common bile duct carcinoma (Whipple's procedure). Twelve months later a single hepatic metastasis was detected and a chemoembolization was performed. Immediately after chemoembolization the patient developed a multimicrobial sepsis including clostridium perfringens. CT scans depicted pathognomonic signs of gas-containing abscess in the necrotic liver metastasis. She was subsequently treated with broad-spectrum antibiotics, abscess drainage and hyperbaric oxygen therapy. We conclude that antibiotic prophylaxis is recommendable for chemoembolization of liver metastasis in patients with risk factors like intestinal biliary reflux (bilioenteric anastomosis or papillotomy and biliary stenting) and bile duct cancer, otherwise severe sepsis including clostridium bacteremia may occur.
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ranking = 2
keywords = abscess
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10/188. staphylococcus aureus pericarditis masquerading as anterior mediastinal mass: mediastinal mass from pericarditis.

    Pseudomediastinal mass as a result of bacterial pericarditis is a rare clinical presentation. We report one such case in a patient with end-stage renal disease receiving hemodialysis, who presented primarily with manifestations of right heart compression due to a large encapsulated pericardial abscess and, surprisingly, with no overt signs of sepsis. Surgical drainage, pericardiectomy, and antibiotic therapy led to a successful outcome.
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ranking = 1
keywords = abscess
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