• Title/Summary/Keyword: Diagnosis of abscess

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Acute Kidney Injury Accompanied by Acute Pyelonephritis and Renal Abscess in a Child with Vesicoureteral Reflux (소아에서 방광 요관역류가 동반된 급성 신우신염 및 신장 농양으로 인한 급성 신부전 1례)

  • Park, Cheol;Kim, Min-Sang;Kim, Mi-Kyung;Yim, Hyung-Eun;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.16 no.1
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    • pp.63-67
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    • 2012
  • Acute pyelonephritis (APN) is a relatively common bacterial infection in children. In previously healthy children, acute kidney injury (AKI) is very rare in the course of APN without urinary tract obstruction, renal hypoperfusion due to hypotension or exposure to nephrotoxic agents. We describe a case of AKI secondary to APN and renal abscess in a child with vesicoureteral reflux. With antibiotic treatment and adequate hydration, the patient was improved. APN should be included in the differential diagnosis of AKI and adequate treatment by proper antibiotics is crucial for full recovery of renal function.

Surgical Treatment of the Spontaneous Spinal Epidural Abscess (자발성 척추 경막외 농양의 수술적 치료)

  • Lee, Jung-Kil;Kim, Soo-Han;Kim, Eun-Seong;Kim, Tae-Sun;Jung, Shin;Kim, Jae-Hyoo;Kang, Sam-Suk;Lee, Je-Hyuk
    • Journal of Korean Neurosurgical Society
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    • v.29 no.8
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    • pp.1037-1042
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    • 2000
  • Objective : The goal of this study was to recognize the clinical feature and associated risk factors in spinal epidural abscess(SEA), and to improve the outcome accordingly. Methods : A retrospective study was performed in 14 patients with SEA who underwent surgical intervention at our hospital between 1990 and 1999. Results : After a mean follow-up period of 10.2 months(range, 1-57 months), 8 patients had no or minimal deficits, 4 patients had severe paresis or plegia and/or bowel/bladder dysfunction, and 2 patients died due to medical complications. Staphylococcus aureus was the predominant pathogen, isolated in 9 patients(64.3%). Cervical and thoracic spinal epidural abscesses showed a tendency to develop rapidly and were associated with severe neurological deficits. Conclusion : Thoracic spinal epidural abscesses were associated with a poorer prognosis than those in other regions. Therefore, it should be treated more aggressively. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

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Successful Treatment of a Case with Rhino-Orbital-Cerebral Mucormycosis by the Combination of Neurosurgical Intervention and the Sequential Use of Amphotericin Band Posaconazole

  • Yoon, Young-Kyung;Kim, Min-Ja;Chung, Yang-Gu;Shin, Il-Young
    • Journal of Korean Neurosurgical Society
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    • v.47 no.1
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    • pp.74-77
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    • 2010
  • Rhino-orbital-cerebral (ROC) mucormycosis is an uncommon, acute and aggressive fungal infection. It remains a challenging problem to clinicians despite aggressive debridement surgery and antifungal therapy. The authors describe a case of ROC mucormycosis with pericranial abscess occurring in a female patient with uncontrolled diabetes mellitus. The infection initially developed in the right-sided nasal sinus and later progressed through the paranasal sinuses with the invasion of the peri-orbital and frontotemporal region, due to the delayed diagnosis and treatment. Numerous non-septate hyphae of the zygomycetes were identified by a punch biopsy from the nasal cavity and by an open biopsy of the involved dura. The patient was treated successfully with extensive debridement of her necrotic skull and surrounding tissues, drainage of her pericranial abscess and antifungal therapy, including intravenous amphotericin B for 61 days and oral posaconazole for the following 26 days. She returned to a normal life and has had no recurrence since the end of her treatment 15 months ago.

Two Cases of Spinal Epidural Abscess in Hemodialysis Patients

  • Kim, Young Hwan;Yoo, Jin Taek;Jung, Soon Myung;Kwon, Sang Chang;Ryu, Seung Min;Jang, Mun;Choi, Jung
    • Journal of Yeungnam Medical Science
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    • v.30 no.1
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    • pp.36-38
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    • 2013
  • While epidural abscesses are rare in hemodialysis patients, they can cause severe neurological complications that can be fatal because only nonspecific symptoms appear in the early stages of the infection. Their incidence increased recently due to intravenous drug abuse, invasive spinal surgery, percutaneous vertebral procedures, and the development of diagnostic modalities. The increased number of cases is related to the use of dialysis catheters in hemodialysis patients. If a patient has fever and back pain, doctors should eliminate the possibility of other common diseases and consider spinal epidural infection. Early diagnosis and proper treatment are important to prevent neurological complications. In this paper, the symptoms, blood work, magnetic resonanceimaging (MRI) findings, and clinical course of two hemodialysis patients who developed spinal epidural abscesses are described.

A Case of Second Branchial Cleft Cyst Presenting as a Parapharyngeal Cystic Mass (부인두강 낭성 종물로 발현된 제2새열 낭종 1례)

  • Kim, Byung Ha;Do, Nam Yong;Cho, Sung Il;Park, Jun Hee
    • Korean Journal of Bronchoesophagology
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    • v.18 no.2
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    • pp.60-63
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    • 2012
  • Second branchial cleft cysts are usually present as a fluctuant neck mass along the anterior border of the sternocleidomastoid muscle. When they are found in this typical location, accurate diagnosis on initial presentation is not difficult. Parapharyngeal presence of the branchial cleft cyst is very rare. We report a case of second branchial cleft cyst presenting as a parapharyngeal cystic mass in 51-year-old male. Before coming to our clinic, the patient had been diagnosed as parapharyngeal abscess, resulting in several attempts at removal. However, symptoms and parapharyngeal abscess recurred. We performed complete surgical resection of the parapharyngeal cystic mass via transoral approach only with oropharyngeal incision. The cystic mass was located in the parapharyngeal space and did not have tract-like structure. Histopathologic examination confirmed that the excised cyst was branchial cleft cyst. Patient discharged without any surgical complication and there was no evidence of recurrence for 2 years follow-up.

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An Analysis of Infection-Related Complications after Epidural Block (경막외 차단술 후 발생한 감염 관련 합병증의 분석)

  • Jo, Dae Hyun;Hong, Ji Hee;Kim, Myuong Hee
    • The Korean Journal of Pain
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    • v.19 no.2
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    • pp.164-167
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    • 2006
  • Background: There have been an increasing number of reports about infection-related complications after epidural block, and the analysis of these previous reports may offer valuable information for the prevention and treatment of such complications. Methods: We searched for complications about infection that was related to epidural blockade procedures by using the Medline Search program. We analyzed the types of infection-related complications as well as the potential risk factors, the time course from symptom development to treatment, the causative organisms and the treatment outcomes. Results: Seventeen cases were identified. The types of complications were epidural abscess, subdural abscess, spinal arachnoiditis, bacterial meningitis and aseptic meningitis. Five patients received a single block and twelve patients received a continuous block with catheterization. The most common site of epidural catheterization was the lumbar area and eight patients had indwelling catheters for less than fifteen days. Eight patients had a diabetes mellitus as a risk factor and fourteen patients showed less than seven days from the development of symptoms to treatment. Eleven patients received laminectomy and intravenous antibiotics as a treatment and eight patients had full recovery without neurological deficit. Conclusions: Early diagnosis and treatment is essential for the favorable outcome of infection-related complication after epidural block. In addition, absolute sterile technique should always be performed and patient education concerning these potential complications must be accompanied.

A CLINICO-STATISTICAL ANALYSIS ON THE FASCIAL SPACE INFECTIONS OF ORAL AND MAXILLOFACIAL REGION (구강 악안면 근막간극 감염에 관한 임상통계학적 분석)

  • Joo, Hyun-Ho;Weon, Dong-Whan;Lee, Sang-Hwy;Kim, Il-Hyun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.26 no.5
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    • pp.490-496
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    • 2000
  • We have conducted a retrospective study of 224 patients with the diagnosis of oral and maxillofacial infection who had been treated between 1988 and 1999 at Gyeong-Sang National University Hospital. This study was aimed to furnish the data of oral and maxillofacial infection and to aid diagnosis and treatment. The most common fascial space involved, as determined by clinical, radiologic, and operative findings, were the submandibular space(39.4%). The most frequent cause of oral and maxillofacial infection was odontogenic 68.8%. In the odontogenic cause, dental caries was the most common cause. Two-hundred three patients required surgical drainage of the abscess. Seventeen patients needed tracheostomy for airway control. The overall mortality was 0.9% despite aggressive anti-microbial therapy and early surgical intervention. All other patients had an uneventful recovery without major complication except osteomyelitis case(6.0%). The combination of early radiologic diagnosis, effective antimicrobial therapy, and intensive surgical management contributed to the good prognosis.

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Two Atypical Cases of First Branchial Cleft Anomalies (비전형적인 형태의 제 1 새성기형 환자 2예)

  • Kim, Su-Jong;Kim, Tae-Hun;Bang, Seung-Hwan;Woo, Jeong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.31-34
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    • 2017
  • First branchial cleft anomaly is a very rare disease and exhibits various clinical presentations. Therefore, the diagnosis of first branchial cleft anomaly may be difficult; the condition is often misdiagnosed and mismanaged. Accurate diagnosis is very important, because if not diagnosed correctly, patients with first branchial cleft anomaly would be treated with local incision and drainage repeatedly. We report two cases of first branchial cleft anomaly. The first patient visited for recurrent swell and discharge in the infra-auricular area with a history of previous incision and drainage. The other patient showed a cystic mass in the infra-auricular area and all of them were misdiagnosed initially by their treating specialists elsewhere. The objective of this study is to share our experiences of first branchial cleft anomaly, and emphasize its various clinical patterns and the significance of accurate diagnosis.

A study on 《Maek-beop, 脈法》 the oriental medicine scription from the tomb on Ma-wang-toe(馬王堆) (마왕퇴(馬王堆) 출토(出土) 의서(醫書) 중 《맥법(脈法)》에 관(關)한 연구(硏究) -경맥(經脈)과 맥진(脈診)과의 상관성(相關性)에 관(關)한 연구(硏究)-)

  • Seo, Yong-Won;Yoon, Jong-Hwa;Kim, Gap-Sung
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.210-224
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    • 2002
  • Objective : A study on $\ll$Maek-beop$\gg$ which is the first scription of pulse diagnosis method in history. Method : A translation of contents in $\ll$Maek-beop$\gg$ into modern concepts on the basis of researched books and the explanation of difficult characters and paragraphs to general concepts. Result : The pulse diagnosis method by comparison, moxibustion method, venesection method, a treatment of an abscess and the succession of treatment in $\ll$Maek-beop$\gg$ are delivered from $\ll$Sumen, 素問$\gg$, $\ll$Lingchui, 靈樞$\gg$. Conclusion : A $\ll$Maek-beop$\gg$ is the scription of the diagnosis of meridian and therapeutic method in $\ll$Zu bi shi yi mai jiu jing, 足臂十一脈灸經$\gg$, $\ll$yin yang shi yi mai jiu jing, 陰陽十一脈灸經$\gg$.

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Brain abscess in Korean children: A 15-year single center study

  • Lee, Cha-Gon;Kang, Seong-Hun;Kim, Yae-Jean;Shin, Hyung-Jin;Choi, Hyun-Shin;Lee, Jee-Hun;Lee, Mun-Hyang
    • Clinical and Experimental Pediatrics
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    • v.53 no.5
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    • pp.648-652
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    • 2010
  • Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.