PubMed · 3324430
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P Bagi, S Dueholm, M Nordsten. 1987-11-16. [Appendiceal swelling].. https://pubmed.ncbi.nlm.nih.gov/3324430/
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Splenic abscesses are caused by Staphylococcus aureus, Streptococcus and bacteria belonging to the family Enterobacteriaceae. We report a case of splenic abscess caused by an unusual serotype of Salmonella. A 55 year old man was admitted with complaints of fever and abdominal pain. On the basis of clinical findings and laboratory reports, a diagnosis of chronic myeloid leukemia was made. Ultrasonography of the abdomen revealed a single large cystic lesion in the spleen. Percutaneous drainage of the abscess was carried out. Salmonella enterica serotype Worthington was isolated from a pus sample taken from the abscess. The isolate was resistant to ampicillin, gentamicin, cefotaxime, chloramphenicol and tetracycline, and sensitive to amikacin and norfloxacin. Serotype Worthington is an emerging pathogen. This is the first report of isolation of this serotype from a splenic abscess. In seriously ill patients, such infections should be treated with a combination of antibiotics to circumvent problems with multidrug resistance.
BACKGROUND: The incidence of pancreatic tuberculosis is extremely rare, and it frequently misdiagnosed as pancreatic neoplasms. The nonsurgical diagnosis of this entity continues to be a challenge. CASE PRESENTATION: A 33 year old male with six-month history of intermittent right epigastric vague pain and weight lost had found a solitary pancreatic cystic mass and diagnosed as pancreatic cystadenocarcinoma. The chest X-ray film and physical examination revealed no abnormalities. Abdominal ultrasound (US) examination showed an irregular hypoechoic lesion of 6.6 cm x 4.4 cm in the head of pancreas, and color Doppler flow imaging did not demonstrate blood stream in the mass. The attempts to obtain pathological evidence of the lesion by US-guided percutaneous fine needle aspiration failed, an exploratory laparotomy and incisional biopsy revealed a caseous abscess of the head of pancreas without typical changes of tuberculous granuloma, but acid-fast stain was positive. CONCLUSIONS: Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially for young people in developing countries.
INTRODUCTION: Several options for treatment of abscesses in the breast have appeared during the last two decades. No randomised studies comparing these options have been performed. MATERIAL AND METHODS: A retrospective study of the treatment of breast abscesses over a four-year-period. Incision or puncture was employed at the discretion of the responsible doctor. RESULTS: A total of 87 women with various types of breast abscesses were treated by means of incision (42 women equal to 48%) or aspiration of pus by puncture (45 women equal to 52%). After incision which was done in general anaesthesia in 38 women (90%) the patients were discharged after 2.9 days (mean), median 2.0 days, and 39 of 45 women treated by means of puncture were discharged after 2.1 days (mean), median 1.0 day, p = 0.001. In six women, puncture treatment was possible as outpatient procedure. Concerning puncture the majority of patients were treated in local analgesia or without any medication. Recurrent abscess formation was observed in eight women (19%) after incision and in nine women (20%) after puncture. DISCUSSION: The two treatment schedules are effective, but abscess treatment by means of puncture is preferred as the most convenient method for the patient and as a cost-effective treatment. Finally, recommendations for the future schedule of breast absess treatment are specified.