• The Korean Journal of Pain
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• 제9권2호
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• pp.434-438
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• 1996

Epidural abscess is associated with placement of epidural catheter is very rare. We experienced two cases of epidural abscess formation after placement of epidural catheter for pain management. A 63 years old female patient received thoracic epidural catheterization for management of pain due to herpes zoster on right T4 dermatome. Two weeks after catheterization, she complained of paraparesis and anesthesia below $T_4$ dermatome. Four weeks later magnetic resonance images was performed and revealed epidural abscess on $T_2-T_5$. Emergent decompressive laminectomy was performed but neurologic symptoms were not improved. In other case, a 75 years old male patient received lumbar epidural catheterization for management of Buerger's disease. About on month later, pus was aspirated from lumbar epidural space. But further evaluation could not be achieved because he wanted to discharge against advice. We emphasize that epidural abscess results sequele serious and prompt diagnosis and treatment is important.

• Clinical and Experimental Pediatrics
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• 제54권8호
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• pp.350-353
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• 2011

A 47-day-old male infant presented with fever, poor oral intake, irritability, and right-sided bluish buccal swelling. Contrast-enhanced computed tomography of the neck showed a round mass lesion of about $2.0{\times}1.5cm$ that suggested abscess formation in the right masticator space. Ultrasound-guided extraoral aspiration of the abscess at the right masseter muscle was successful. Staphylococcus aureus was identified in the culture from the aspirated pus and blood. Appropriate antibiotics were given and the patient recovered. The patient underwent follow-up ultrasonography that showed an improved state of the previously observed right masseter muscle swelling at about 1 month after hospital discharge. A masticator space abscess usually originates from an odontogenic infection in adults. We report a case of masticator space abscess in a 47-day-old infant in whom septicemia without odontogenic infection was suspected.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.39-42
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• 2013

Cholelithiasis, duodenal ulcer, duodenal perforation and tumor invasion may lead to choledochoduodenal fistula (CDF). CDF often has no specific symptoms and may be incidentally detected in an upper gastrointestinal radiographic study or endoscopy; but in some cases, it may be accompanied by recurrent cholangitis and liver abscess. In this paper, a case of recurrent liver abscess caused by CDF is reported. A 62-year-old female was admitted to the authors' hospital because of right upper quadrant pain and fever. The abdominal computed tomography showed a liver abscess in the right lobe. A duodenal fistulous orifice was detected with endoscopy, and a contrast was injected through the duodenal orifice using a catheter under fluoroscopy. The injection of the contrast revealed a fistulous track between the duodenal bulb and the common hepatic duct. In fistulas complicated by recurrent liver abscess, surgery or medical management may be needed. The CDF in this case study was treated via endoscopic clipping.

• 대한관절경학회지
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• 제10권2호
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• pp.199-202
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• 2006

소아의 급성 혈행성 골수염은 골의 혈액 공급과 구조의 차이로 인하여 환자의 나이에 따라 병의 효과들이 다르게 나타난다. 2세 이상의 소아에서 골수강내 및 골막의 혈액공급이 모두 손상되었을 때, 광범위한 농양을 형성한다. 농양부를 따라 긴 절개를 하더라도, 철저한 배농과 모든 괴사조직의 제거가 항상 가능하지는 않다. 저자들은 최근 11세 여아에서 경골에 광범위 농양을 형성한 급성 골수염을 2개의 소절개와 4-mm 내시경을 이용하여 성공적으로 치료하였다

• The Korean Journal of Pain
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• 제19권2호
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• pp.266-270
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• 2006

A case of an epidural abscess, a rare but possibly devastating complication of epidural instrumentation and catheterization, which occurred in a cancer pain patient with an epidural port connected to the epidural catheter, is described. Although cases of a catheter related epidural abscess have been intermittently reported, those following epidural port implantation are very rare, with no case having been reported in Korea. Herein, the case of a 31-year-old man, who developed an epidural abscess 54 days after subcutaneous implantation of an epidural port connected to an epidural catheter, is reported. Methicillin-sensitive staphylococcus aureus was detected in a culture of the purulent discharge. Magnetic resonance imaging was essential, not only for the diagnosis of the epidural abscess, but also for determining the extent of spread. The patient refused further evaluation and treatment, and expired 22 days later.

• The Korean Journal of Pain
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• 제2권1호
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• pp.94-96
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• 1989

경막외 농양의 항생이 경막외 카테타 거치로 인한 것은 드물고 다른 감염증과 골수염의 혈행성 전파로 기인된 것이 대부분이며 원인군은 황색 포도상구균이 가장 많다. 농양 발생시 환자는 농양형성 부위의 통증과 압통, 고열, 하지마비 등의 증상을 나타내게되며 척수조영술이나 전산화 단층촬영 등으로 진단이 가능하며 항생제의 투여와 추궁절제술을 시행하여 농양으로 인한 척수압박을 해소하는 동시에 배농시키는 등의 적극적 치료를 시행하여야 한다. 본 환자는 고령으로 인한 면역능력의 저하와 어울려 카테타 관리 및 약물 주입시의 감염으로 인하여 경막의 농양이 발생하였으나 전신적인 항생제 투여만으로 잘 치유된 경우이다. 이와 같은 합병증을 예방하기 위해서는 경막외 천자시 뿐만 아니라 카테타 거치 후의 카테타 관리 및 카테타를 통한 약물 주입시에도 무균 조작을 철저히 해야할 것이다.

• Restorative Dentistry and Endodontics
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• 제16권1호
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• pp.236-244
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• 1991

Numerous studies have been focused on the immunologic aspects of inflamed pulp and periapical tissues. The purpose of this study was to evaluate levels of serum IgG and IgM in patients of acute pulpitis and acute apical abscess using Enzyme-Linked Immunosorbent Assay. Streptococcus mutans, Streptococcus sanguis, Bacteroides intermedius and Bacteroides gingivalis were grown for use as antigen and they were harvested by centrifugation. The patients were divided into 3 groups; patients of acute apical abecess, acute pulpitis and normal control 5 patients of each group were selected and their blood was obtained via intravenous puncture. Sera were prepared by centrifugation of each blood samples. Then serum antibodies were measured by modified ELISA. The following results were obtained; 1. Serum IgM levels of patients with acute pulpitis and acute apical abscess seemed to be slightly higher than those of normal control 2. Serum IgG levels of patients with acute apical abscess were slightly higher than those of normal control 3. Serum IgG and IgM levels of acute apical abscess patients and serum IgM levels of acute pulpitis were highest to Bacteroides gingivalis.

• 대한두개안면성형외과학회지
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• 제25권3호
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• pp.141-144
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• 2024

A 76-year-old woman, initially thought to have a simple abscess on her right upper eyelid, presented to our department of plastic and reconstructive surgery. Enhanced three-dimensional facial computed tomography (CT) revealed an abscess on the right upper lid, with a pyomucocele present in the right frontal sinus, accompanied by bone erosion in the superior wall of the right orbit. Based on the results of the CT scan, we diagnosed an atypical Pott's puffy tumor (PPT) with an abscess on the upper lid originating from the frontal sinusitis. First, surgical incision and drainage were performed in our department, and a percutaneous vacuum drain was placed. To provide a more definitive treatment, endoscopic sinus surgery (ESS) was subsequently performed by otorhinolaryngologists. The patient was discharged without any complications 5 days after ESS. At a 1-year follow-up, no recurrence or notable neurological symptoms were observed. In the case we observed, the patient presented with an upper eyelid abscess and cellulitis, indicating possible orbital involvement. For such patients, a CT scan is necessary. Given the possibility of PPT, it is critical to perform a comprehensive differential diagnosis rather than defaulting to a straightforward approach involving abscess treatment.

• 대한기관식도과학회지
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• 제3권2호
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• pp.293-301
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• 1997

The tonsillitis has long been one of the most common disease in the otolaryngologic field. Peritonsillar abscess occurs when bacterial infection of the tonsil spreads to the potential peritonsillar space deep behind the tonsil, and it usually occurs in patients with recurrent tonsillitis or in those with tonsillitis who have been inadequately treated. We studied retrospectively 71 patients who had been diagnosed as acute tonsillitis and 82 patients who had been diagnosed as peritonsillar abscess and had admitted in our department of the Ulsan Dong Kang Hospital from January, 1995 to September, 1997. Especially in the bacteriologic studies, we compared acute tonsillitis and peritonsillar abscess with chronic tonsillitis. The following results were obtained： 1) The sex distributions of acute tonsillitis were 47 males(66%) and 24 females(34%) cases, but 57 males(70%) and 25 females(30%) in cases of peritonsillar abscess. There were predominant in male and frequently affected in second and third decades in 53 cases(76%) of acute tonsillitis and 56 cases(68%) of peritonsillar abscess. 2) It was same found in each season. 3) The duration from onset of symptom to visit in our department was 3.92 days in cases of acute tonsillitis and 5.95 days in cases of peritonsillar abscess in average 4) The major symptoms were sore throat, swallowing difficult. And others were fever, fatigability, dysarthria, trismus, headache, otalgia. 5) Among the 71 cases of acute tonsillitis and 82 cases of peritonsillar abscess, most temperature of patients at visit were 36.6-37.5 $^{\circ}C$ in each 36 cases(51%), 57 cases(70%). 6) In each disease, 35 cases(47%), 45 cases(75%) consisted of single infection and 39 cases(53%), 15 cases(25%) consisted of mixed infection. In acute tonsillitis, 111 strains were isolated from 74 cases, the most common strain was 69 strains(62.2%) of $\alpha$-hemolytic streptococci. In the peritonsillar abscess, 77 strains were isolated from 60 cases, the most common strain was 49 strains(63.6%) of $\alpha$-hemolytic streptococci. In chronic tonsillitis, 563 strains were isolated from 382 cases, the most common strain was 334 strains(50.3%) of $\alpha$-hemolytic streptococci. 7) In acute tonsillitis and peritonsillar abscess, the most common leukocyte levels were reported with 10, 000-15, 000/$\mu$L in 23 cases(32%). The CRP levels were reported with abnormal findings in 61 cases(97%), 63 cases(95%) above 0.3 in each cases.

• Clinical and Experimental Pediatrics
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• 제63권7호
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• pp.272-277
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• 2020

Background: The optimal management of perianal abscess in children is controversial. Purpose: To evaluate the efficiency of conservative treatment of perianal abscess in children and identify parameters that predict therapy failure. Methods: All cases of children younger than 14 years of age with perianal abscesses between 2001-2016 were evaluated. Results: Of the 113 enrolled patients, 64 underwent subsequent surgery for advanced disease (primary surgery group). Conservative treatment was initiated in 49 patients (primary conservative group) but was stopped because of inefficiency in 25 patients, who were referred for surgery after a median 7.03 days (range, 2 to 16 days). The other 24 patients (48%) initially achieved complete remission after conservative treatment, but 10 were readmitted after a median 34 months (range, 3 to 145 months) with recurrent disease. There were no significant differences in permanent success after conservative treatment between infants (10 of 29, 34%) and older children (4 of 20 [20%], P=0.122). Overall, conservative treatment alone was effective in only 14 of 113 patients. Recurrence after surgery occurred in 16 patients (25%) in the primary surgery group and 11 patients (22%) in the primary conservative group (P=0.75). Univariate analysis of predictors for conservative treatment failure revealed inflammatory values (C-reactive protein and white blood count, P=0.017) and abscess size (P=0.001) as significant parameters, whereas multivariate analysis demonstrated that only abscess size (odds ratio, 3.37; P=0.023) was significant. Conclusion: Conservative treatment of perianal abscess is permanently efficient in only a minority of children but is not associated with a higher recurrence rate after subsequent surgery. Abscess size is a predictor for therapy failure.