Search PubMed⌕ Search

Biomedical subjects

E B Rotheram

Publications and source records attributed to E B Rotheram.

11 recordsLinked to original sources

Pyogenic vertebral osteomyelitis of the posterior elements.

Lone pyogenic involvement of the posterior elements of the vertebrae is a rare event. We present two cases of isolated lumbar vertebral infection of the posterior elements and review 13 cases previously reported in the literature. Clinical presentation, laboratory and radiographic findings, microbiological etiology, and treatment were evaluated. Back pain, an elevated erythrocyte sedimentation rate, and computed tomography or magnetic resonance imaging were most useful in identifying the presence and extent of infection. Antibiotic therapy with or without surgical intervention was successful in all cases.

Adult↗

Infectious complications of hepatic cryosurgery.

Hepatic cryosurgery is a novel procedure for patients with metastatic liver disease. To date, no reviews of the infectious complications of this procedure have been published. One hundred and fifty patients underwent 158 hepatic cryosurgical procedures at Allegheny General Hospital (Pittsburgh) from November 1987 through July 1995. Gastrointestinal malignancies accounted for 93% of the underlying diagnoses. The following 12 infections were directly related to the cryosurgical procedure: hepatic abscess (six), intraperitoneal abscess (three), ascending cholangitis (two), and an intrahepatic device (Infusaid; Strato/Infusoid, Norwood, MA) infection (one). Enterococcus was the most commonly isolated organism. Seven of the 12 infections were polymicrobial. The patients who developed infections had longer hospital stays (26 days vs. 13 days) and had more days of fever (6.5 days vs. 2.3 days). than those who did not develop infections. If perioperative manipulation of the biliary tree is avoided, the infection rate in patients who undergo hepatic cryosurgery may be decreased even further. Overall, cryoablation of the liver is not related to an increased risk of infection.

Age Factors↗

Use of computerized tomography in nonsurgical management of brain abscess.

Two patients with hematogenous brain abscesses demonstrated by computerized tomographic (CT) scans were successfully treated without surgical intervention. The first patient had congenital cyanotic heart disease and multiple brain abscesses complicated by presumed rupture into the ventricles. By the time these clinical diagnoses were established, she had shown substantial improvement after antibiotic therapy alone. The second patient with bronchiectasis had a single abscess in the dominant hemisphere. Medical management was successful. Subsequent CT scans in both patients provided reassurance that clinical improvement was accompanied by anatomical healing. The use of noninvasive diagnostic techniques should encourage the formulation of new criteria for the management of cerebral abscess in carefully evaluated and closely observed patients.

Adult↗