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PubMed1984

[Chronic maxillofacial suppuration due to unknown plant foreign bodies. Apropos of 2 cases with CT scanning].

Common features in two patients with chronic suppurative lesions of the maxillofacial region from vegetable foreign bodies were : foreign body origin of the accident ; chronic nature of the suppuration (7 and 23 months respectively) ; multiple operations by different surgical teams ; radiotransparency of the foreign bodies. Positive signs on CT scanning can confirm the diagnosis, but cannot exclude it when normal images are obtained. The number and localization of wood fragments may limit the value of the scan, and fistulography and xeroradiography may then provide confirmation of the diagnosis. Operative treatment may be difficult due to fragmentation of the wood into multiple pieces, a possible source of recurrence of infection.

Child↗
PubMed1984

[Role of immunotherapy in the treatment of suppurative mediastinitis].

In the treatment of 34 patients with suppurative mediastinitis a specific immune therapy was used in addition to surgical methods. Direct specific immune therapy as an element of the complex treatment of suppurative mediastinitis resulted in a more favourable development of the process and reduced lethality.

Antitoxins↗
PubMed1984

[Clinical studies of cefoxitin with special reference to pulmonary suppuration and pyothorax with respiratory tract infection].

Cefoxitin (CFX) was administered to 12 patients with respiratory tract infections, including mainly patients with pulmonary suppuration or pyothorax. The results were as follows: CFX was effective in 75% of the total patients, and in 83% of the 6 patients with pulmonary suppuration or pyothorax. Microorganisms which were considered to be causative were isolated in 8 of 12 patients. Bacteriological responses were "eradicated" in 4 patients, "replaced" in 3 patients, "unchanged" in 1 patient. A slight elevation of S-GPT was observed in one patient and elevation of A1-P in another following CFX administration; however, these values returned to normal shortly after completion of drug administration. No adverse effects, allergic symptoms or laboratory abnormalities were observed.

Adolescent↗
PubMedDate not supplied

[Developmental aspect of renal suppurations. Apropos of 2 cases].

The authors set out to differentiate between two types of renal parenchymal suppuration in the light of two personal cases treated recently - renal abscess and localized acute bacterial nephritis (LABN), which is perhaps no more than a preliminary stage in the formation of a renal abscess. Case 1 concerns a LABN, diagnosed by CT scan. The treatment was purely medical and monitoring scans show no anomalies. Case 2 was a gathered abscess, also diagnosed by CT scan, and treated by surgical drainage. The interest of the differentiation between these two types of suppuration is essentially therapeutic. Once gathered, the abscess must be drained surgically, whereas the LABN can be treated medically, with close supervision to ensure complete cure. The differential diagnosis between the two is mainly by scanner, with a study of the respective densities.

Abscess↗
PubMed1984

Immunological abnormalities in patients with chronic bronchial suppuration: a possible relationship with endotoxaemia.

Chronic bronchial suppuration has been associated with elevations in immunoglobulin levels, circulating autoantibodies and immune complexes but the cause is obscure. In order to investigate one possible explanation we studied eight male subjects (mean age 54.9 years, range 39-68) and 16 female subjects (mean age 45.2 years, range 24-68) with bronchial suppuration attributed to bronchiectasis. Gram-negative organisms were found in the sputum of 95% of subjects. Forty per cent (10 subjects) had elevations in immunoglobulin levels and 60% (15 subjects) had circulating autoantibodies. Eighty-eight per cent (21 subjects) had mild-moderate increases in the level of C-reactive protein. Endotoxin was detected using the limulus amoebocyte lysate test in 50% (12 subjects). Endotoxin was found only in patients with an immunological abnormality and was more likely to be detected in those with both elevated immunoglobulins and circulatory autoantibodies. It is suggested that the endotoxin may be of aetiological significance in the development of autoantibodies and elevations of immunoglobulin levels.

Adult↗
PubMed1976

[Changes in the serum proteins in suppurative surgical infection in cattle].

Studied were the serum proteins of 3 cattle with a spontaneous suppurative surgery infection and 10 cattle with an experimental infection of the same character. It was found that in such cases there is a rise in the total protein, the alpha and gamma globulins, and a drop in the albumin and the beta-globulins. The experimental suppurative infection caused by Corynebacterium pyogenes produces changes of a higher degree in the protein spectrum than the experimental infection caused by Str. pyogenes. In cases in which the general status of the organism is more strongly involved in the infection process the changes in the protein fractions are more strongly expressed.

Alpha-Globulins↗
PubMed1981

alpha-Difluoromethylornithine (alpha DFMO) and phenoxybenzamine hydrochloride in the treatment of chronic non-suppurative prostatitis.

In a single-blind, placebo-controlled, cross-over study in 11 patients with chronic non-suppurative, culture-negative prostatitis, alpha-difluoromethylornithine (alpha DFMO) (18 g/day) was administered orally for 1 month. Ten patients completed the study. In part II of this investigation, 60 mg/day phenoxybenzaminehydrochloride, an alpha-adrenergic receptor blocking compound (alpha ABC), was studied in 11 patients with chronic non-suppurative prostatitis in an open-phase design. Several patients had a decrease in prostate size and associated pain symptoms with alpha DFMO treatment. One patient with gross hematospermia prior to treatment had a remission on alpha DFMO and a return hematospermia on subsequent placebo treatment. Six subjects with microscopic hematuria post-prostatic palpation had a decrease in RBC counts while on alpha DFMO treatment. There was a 16% fall in hematocrit and hemoglobin following alpha DFMO treatment, which returned to pretreatment values within 2 months after stopping the drug. alphaABC distinctly improved symptoms of chronic prostatitis. Five patients remained disease free for a period of 3-6 months and 10 patients had a decrease of RBC counted in the urine. alpha ABC was accepted by the patients despite the fact of frequent orthostatic dysregulation and aspermia.

Adult↗
PubMed1983

[Dynamics of the ultrastructural changes in opportunistic bacteria in the suppurative wound of an autografted extremity].

The electron-microscopic study of opportunistic bacteria under conditions of a suppurative inflammatory process developing in the autotransplanted extremity in white rats was carried out. The staphylococcal infection of the wound on the autotransplanted extremity in white rats was accompanied by the appearance of a capsule-like formation on the bacterial cell wall, similar to the immunoglobulin covering on the cell wall of bacteria treated with blood serum. The changes of this formation were observed in time course. After the opening and draining of the suppurative focus the contamination of the wound with Gram-negative bacteria occurred. Effective combined methods of treatment were used under experimental and clinical conditions.

Amputation, Traumatic↗
PubMed1978

[State of the homeostatic constants in suppurative lung diseases].

110 cases of suppurative lung diseases were examined, 78 of them were operated upon. The studies of external respiration function, total and pulmonary hemodynamics, a number of metabolic processes and of renal function were carried out. It was demonstrated that suppurative-inflammatory processes in the lungs give rise to considerable changes in some parts of homeostasis. The main factor controlling the depth of physiological and biochemical shifts in the body is the degree of intoxication which determines the predominance of metabolic disturbances.

Acid-Base Equilibrium↗
PubMed1982

[Significance of the study of leucine aminopeptidase activity of the blood serum in patients with suppurative surgical infections].

A study of the diagnostic and prognostic significance of determining the leucineaminopeptidase activity in the blood serum was carried out in patients suffering from suppurative surgical infections. The obtained results reveal the important role of leucineaminopeptidase (LAP) in the pathogenesis of developing septic complications in these patients. A local suppurative process does not cause considerable changes of LAP activity of the blood serum. The generalization of infection however is accompanied by a marked hyperfermentemia. A persistent and manifest increase of LAP during several days (higher than ten times and more) is a poor prognostic sign.

Fever↗
PubMed1982

[Acute suppurative thyroiditis].

Authors present a case of acute suppurative thyroiditis gland being normal before in a 5 8/12 year old. Plasma TSH, T3 and T4 remained within normal ranges. An alpha haemolytic streptococcus was isolated from suppuration and thyroglossal duct remnant was not identified. Surgical treatment was quickly followed by recovery. Some considerations about clinical picture, pathogenesis, etiology, prognosis and treatment are made. Usefulness of thyroid scan is emphasized.

Abscess↗
PubMed1981

Acute suppurative cholangitis secondary to malignant obstruction.

Acute suppurative cholangitis due to malignant obstruction of the distal biliary tract is uncommon. Only 16 cases have been documented in the English literature (excluding patients with previous surgery for their malignant tumours). The authors add five new cases and discuss the clinical characteristics of the process. The possible relation of endoscopic retrograde cholangiography to the pathogenesis of acute suppurative cholangitis in these patients is presented and prophylactic antibiotic therapy is advised once obstruction is demonstrated. Immediate operative decompression of the obstructed common bile duct as a life-saving procedure is of prime importance, in preparation for a later palliative or curative surgical procedure.

Acute Disease↗
PubMed1993

[Role of the splanchnic nerve in hypotension induced by acute obstructive suppurative cholangitis].

A model of acute suppurative cholangitis with septicemia but without shock was made in 14 rabbits. Fourty-eight hours afterwards, reoperation was performed with the right major splanchnic nerve and right celiac plexus exposed for monitoring. A catheter with an inflatable rubber bag was inserted into the common bile duct via the duodenum for injection with water into the rubber bag to produce a biliary high pressure of 20 kPa, which was subsequently maintained for 2 hours. The right major splanchnic nerve impulse frequency was found significantly increased (P < 0.01). The study shows that the fall of blood pressure or shock in the early stage of acute obstructive suppurative cholangitis is induced predominantly by acute biliary hypertension, and our findings would be complementary to Reynolds' hypothesis of the production of shock.

Animals↗
PubMed1976

[Age aspects of remote outcome of acute lung suppuration].

Among 375 patients (adults and children) having acute suppurative processes in the lung, treated conservatively, 165 were examined in later terms up to 15 years, using modern bronchological methods, considerable changes being revealed in 66.2%: residual cavities, chronic abscesses, bronchitis deformans and bronchiectases. In children suppuration in the lung showed a more grave course, but reparative processes were much better pronounced. The studies conducted allowed a conclusion on the rationality of widening indications to radical surgical treatment in adult patients and the necessity of a dispensary control over children and adult patients, including those discharged with a recovery.

Acute Disease↗
PubMed1976

Acute suppurative cholangitis secondary to calcific pancreatitis.

In the absence of calculi or carcinoma, the occurrence of acute suppurative cholangitis secondary to calcific pancreatitis is extremely rare. This report describes the successful management of acute suppurative cholangitis by surgical decompression and use of a new aminoglycoside, amikacin.

Acute Disease↗
PubMed2004

Microbiology and drug sensitivity patterns of chronic suppurative otitis media.

OBJECTIVE: To identify the commonest microorganisms associated with chronic discharging ears and their antimicrobial sensitivities. DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: This study was carried out from August 2003 to February 2004 at the Department of Otorhinolaryngology and Head and Neck Surgery, Fauji Foundation Hospital, Rawalpindi. MATERIALS AND METHODS: A total of 124 patients with unilateral or bilateral active chronic suppurative otitis media attending the outpatient clinic were included in the study. All patients were evaluated through detailed history and clinical examination. Pus samples were collected from the discharging ear(s) and sent to the hospital laboratory where culture and sensitivity studies were done for aerobes, anaerobes and fungi and antibiotic sensitivity patterns. RESULTS: Overall microbiology of 142 samples was studied. Among them, 108 (76%) were pure cultures and 34 (23.9%) were mixed. There were 186 isolates including 182 (97.8%) aerobes, nil anaerobes and only 4 (2.1%) fungi. Pseudomonas aeruginosa 94(50.5%) was the most common isolate, followed by Staphylococcus aureus 44 (23.6%). Drug sensitivities pattern of Pseudomonas aeruginosa showed that ciprofloxacin was active against majority 95.8% of isolates followed by amikacin 83.3%, gentamicin and tobarmycin 60% and cefotaxime 41.6%. Staphylococcus aureus isolates were resistant to penicillin, ampicillin and amoxicillin in 77.2% whereas majority was sensitive to coamoxiclav 81.8% and cephradine 86.3%. CONCLUSION: Commonest organisms isolated from chronic discharging ears were Pseudomonas aeruginosa and Staphylococcus aureus. Majority of isolates of Pseudomonas aeruginosa were sensitive to ciprofloxacin. Majority of strains of Staphylococcus aureus were resistant to penicillin. Cephradine and coamoxiclav were effective against most of the isolates of Staphylococcus aureus.

Adolescent↗
PubMed2006

Predictors of chronic suppurative otitis media in children.

OBJECTIVE: To determine which factors predict development of chronic suppurative otitis media (CSOM) in children. DESIGN: Case-control study, with univariate and multivariate logistic regression analysis applied to determine which factors independently predict CSOM. SUBJECTS: Prognostic factors for CSOM were identified in (1) 100 children with CSOM and 161 controls aged 1 to 12 years and (2) 83 children who developed CSOM in the presence of a tympanostomy tube and 136 children with tympanostomy tubes who did not develop CSOM. RESULTS: Independent predictors for CSOM were previous tympanostomy tube insertion (odds ratio [OR], 121.4 [95% confidence interval {CI}, 38.9-379.3]); having had more than 3 upper respiratory tract infections in the past 6 months (OR, 12.2 [95% CI, 3.5-42.3]); having parents with a low education level (OR, 14.1 [95% CI, 2.9-68.6]); and having older siblings (OR, 4.4 [95% CI, 1.6-12.6]). Independent predictors for CSOM after tympanostomy tube insertion were having experienced more than 3 episodes of otitis media in the past year (OR, 4.9 [95% CI, 2.2-11.0]; attending day care (OR, 3.6 [95% CI, 1.7-7.8]); and having older siblings (OR, 2.6 [95% CI, 1.2-5.5]). CONCLUSIONS: Treatment with tympanostomy tubes is the most important prognostic factor for CSOM in children. In children who are being treated with tympanostomy tubes for persistent middle ear effusion, the most important prognostic factor for CSOM is a history of recurrent episodes of acute otitis media. This information should be taken into consideration and discussed with parents when considering insertion of tympanostomy tubes in children.

Case-Control Studies↗
PubMed1987

Imipenem and cilastatin in acute osteomyelitis and suppurative arthritis. Therapy in infants and children.

Twenty-five infants and children with acute osteomyelitis (n = 7), suppurative arthritis (n = 11), or both (n = 7) were treated with imipenem and cilastatin sodium. Patients ranged in age from 5 months to 11.3 years. Needle aspiration of infected sites was performed in all patients, and 11 (44%) required further surgical drainage. Imipenem and cilastatin sodium in a dosage of 100 mg/kg/d was used for children 3 years of age or younger, while older ones received 60 mg/kg/d intravenously, divided in four equal doses. Bacterial pathogens were identified in 15 patients (60%): Staphylococcus aureus in five, Haemophilus influenzae b in four, Pseudomonas aeruginosa in two, Streptococcus pneumoniae in one, group A Streptococcus in one, Kingella kingae in one, and Citrobacter amalonaticus in one. All isolates were susceptible to imipenem in vitro. Imipenem and cilastatin therapy was continued for a median of six days followed by treatment with appropriate orally administered antibiotics. Median peak serum bactericidal titers after imipenem and cilastatin infusions were 1:512 for S aureus, 1:32 for H influenzae b, 1:512 for streptococci, and 1:16 for gram-negative rods. All but one patient with P aeruginosa osteomyelitis responded favorably to imipenem and cilastatin. The median duration until resolution of symptoms was six days. Imipenem and cilastatin infusions were well tolerated, and side effects included maculopapular rash in one patient, watery diarrhea in one, and mild transient elevation of alanine aminotransferase levels in three. Because of imipenem and cilastatin's unusually broad spectrum of activity and its relative safety, this drug combination can be used for the initial, empiric therapy of acute bone and joint infections in pediatric patients.

Acute Disease↗