Cornual Abscess Rupture: A Rare Etiology of Acute Abdomen

Ruptured cornual abscess or pyometra can resemble other more common causes of acute abdomen, including appendicitis, diverticulitis, tubo-ovarian abscess, and perforated viscus. Despite its rarity, the diagnosis of ruptured pyometra should always be considered in females presenting with acute abdominal pain, particularly in the setting of a retained intrauterine device

Predisposing factors of brain abscess in Ardabil

Background: Brain abscess is a focal intracerebral infection, which begins as a localized area of cerebritis and develops into a collection of pus surrounded by a well-vascularized capsule. In the present study, we studied all patients with brain abscess admitted in Ardabil Fatemi hospital. Patients and methods: In a retrospective hospital-based study, 24 patients with brain abscess entered the study. Medical records of patients were reviewed from January 2004 to January 2006. Brain abscess was defined as one or more localized lesions with the following characteristics in brain imaging (CT scan): hypodense center with a peripheral uniform ring enhancement following the injection of contrast material, or affected region surrounded by variable hypodense area of brain edema or nodular enhancement or area of low attenuation without enhancement. Predisposing factors for brain abscess were surveyed by reviewing medical records. Results: The study population included 17 males and 7 females with the mean age (± standard deviation) of 27.0±21.3 years. The following predisposing factors were noted in 22 (91.6%) patients; contiguous focus of infection (sinusitis and chronic otitis media) in 10 (41.6%), congenital heart disease in 5 (20.8%), post traumatic complications in 3 (12.5%), super infected hydatid cyst in 2 (8.3%) and neurosurgical complications in 2 cases (8.3%). Conclusion: Ear in cerebellar and temporal lobe, frontal sinus in frontal lobe and heart in parietal lobe abscesses should be evaluated for the possible source of infection. Meanwhile, hydatid cyst may be an important risk for brain abscess in endemic areas like Ardabi

A note on the prothrombin time abnormality in the patients with amebic liver abscess

Amebic liver abscess is reported worldwide and can present with a a wide spectrum of clinical manifetations. Similar to the other liver diseases, the prothrombin time abnormality can be seen in the patients with amebic liver abscess. We retrospectively studied the prothrombin times among 30 Thai hospitalized patients with amebic liver abscesses and did not find any correlation between the prothrombin time and any other studied manifestatio

Management of deep space infections of the neck

Infections of the deep neck spaces often present a clinical challenge for the ENT surgeon. Management of these complex suppurations of the neck requires in fact a multidisciplinary approach due to possible complications like mediastinitis, septic shock and MSOF, life threatening bleeding and ICU management. The spread of infection from the primary site to other regions is possible through the lymphatic, arterial and venous vessels, or directly along the fasciae. There are several classifications for the etiology, pathogenic mechanism and site of evolution, the most frequently encountered clinical forms being peritonsillar abscess, retropharyngeal abscess, lateropharyngeal abscess, and the deep cervical abscess. All of these abscesses are suppurative complications of primary neck infections. Extensive inflammation and suppuration of the neck requires in most cases multiple incisions for drainage such that patients experience significant scarring of the neck. Along with the presence of the tracheostomy and nazo-gastric feeding tube, the aesthetic aspect of the neck surgery involves a high degree of psychological stress for the patients. As a conclusion and in line with literature data, patients must be fully informed about the technique and the outcome of the surgery so that they can provide informed consent since the pathology can be both life- threatening and mutilating

Brain abscess following rituximab infusion in a patient with pemphigus vulgaris.

BackgroundImmunocompromised patients are at increased risk for developing meningitis or, rarely, brain abscess with opportunistic organisms like Listeria monocytogenes.Case reportA 52 year-old Saudi Arabian woman who was diagnosed with pemphigus vulgaris and diabetes and had been on prednisolone and azathioprine for about 4 years. She presented with headache, low-grade fever, and left-sided weakness 2 weeks after receiving the second dose of rituximab infusion. Magnetic resonance imaging revealed an enhanced space-occupying lesion with multiple small cyst-like structures and vasogenic edema in the right temporoparietal area. Her blood culture was positive for Listeria monocytogenes, and a brain biopsy showed necrotic tissues with pus and inflammatory cells. She recovered after a 6-week course of antibiotics with ampicillin and gentamycin.ConclusionsBrain abscess due to Listeria monocytogenes is a risk that should be considered when adding rituximab to the regimen of a patient who is already Immunocompromised

Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report

Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis.Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy.Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition.Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging

Gingival Abscess Removal Using a Soft-Tissue Laser

Gingival abscess, also known as parulis, is defined as a localized, acute inflammatory lesion that may arise from a number of sources, including microbial plaque infection, trauma, and foreign body impaction. It often presents as a smooth, fluctuant, red-color swelling and can occasionally be painful. It is generally limited to marginal and interdental gingiva. Based on its location it has been classified as a type of periodontal abscess which does not involve any attachment loss. The treatment comprises of removal of the cause and, in acute situations, excision of the abscess. A typical gingival abscess is easy to diagnose; however, as suggested by the lack of literature, it is rarely seen in clinical situations. This article presents a clinical case of a gingival abscess located adjacent to recently-placed implants, and discusses its etiology, histopathology, and treatment with an 810-nm soft-tissue diode laser