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[Simultaneous occurrence of intermuscular calcified deposits and suppuration on the leg (author's transl)].

Simultaneous occurrence of an unusual amount of intermuscular calcified deposit and suppuration in the extensor muscle group has been reported here. A short review is given on the main clinical types of intermuscular calcification. Their case is considered to be worth of publication for the purulent complication of calcified intermuscular deposits which has been unknown in the literature.

Aged↗

[Acute obstructive suppurative cholangitis].

Acute obstructive suppurative cholangitis is a potentially lethal complication of biliary tract obstruction, caused by passage of septic material into the circulation originating from pus under tension in the biliary ducts. Of the three cases presented herein, decompression occurred spontaneously in the second one, and was achieved surgically in the other two. The diagnosis is based in Charcot's triad of: Abdominal Pain, Fever and Jaundice, with or without history of biliary disease. Progression leads to septicemia, shock and death. Treatment is surgical and it should be carried out as soon as the diagnosis is made. Effective decompression of the biliary tract is obtained by cannalization of the choledoccus with a T-Tube. Delayed treatment increases mortality, thus the importance of early recognition.

Acute Disease↗

[Calcified and suppurated epidermoid cyst of the spleen (author's transl)].

Reporting a case of epidermoid cyst of the spleen revealed on suppuration brings the authors to review the classification of epidermoid cyst. These are benign tumors in the main present clinically with left hypochondrium pain and the possibility to palpate a splenomegaly or mass in this hypochondrium. The diagnostic approach includes diverse investigations, in particular a series of radiological examinations; surgical intervention will confirm and avoid complications.

Adolescent↗

[Still current aspects of primary pulmonary suppurations].

The paper presents the results of a clinical study carried out in 74 male and 11 female patients presenting with primitive pulmonary suppurations. The onset was of the acute type in 71 cases, and the radiological changes, mainly located in the right lung (in 60 patients) consisted in cavitary aspects -- frequently of the hydro-aerial type in 59 patients, and diffuse non-homogeneous opacities in the other 26. Identification of the germs responsible for the infection in the bronchial secretion maintains its significance, and facilities, with the aid of the antibiogram, an orientation of the therapy. One should stress that the Strep. aureus variety, the pyocyanic bacilli, and Klebsiella strains have determined the most severe forms of the disease. The complex therapy included administration of antibiotics. The treatment was energetic and prolonged. In 63 of the subjects penicillin perfusions were applied, while in 67 of the patients large amounts of antibiotics and sulphonamides were given simultaneously by different routes without iatrogenic effects. The persistence of radiological cavitary sequels in 40 patients (of which in 6 were of important dimensions), and the average duration of the hospitalization (38,4 days, far above the general average for the year 1979 -- 22,2 days), illustrates the difficulties in the assistance of these patients and make necessary practical measures for a rapid diagnosis in view of applying an adequate etiologic therapy, as well as the necessity for dispensarization after discharging, at least for those of the patients that still have cavitary sequelae.

Adult↗

[Therapeutic evaluation of an ampicillin suppository (KS-R1) used against acute suppurative otitis media in children: a comparison with an oral preparation].

A comparative well-controlled study was performed to evaluate the efficacy and tolerability of KS-R1 (ampicillin rectal suppository, 125 mg X 4/day) administered to the rectum as compared with those of orally administered ampicillin (ABPC) with same dosage. The results obtained were as follows. The clinical effect of the drug was judged in 100 cases (suppository group in 45 cases, oral group in 55 cases) out of 111 cases. The overall efficacy rates evaluated on standard criteria were 93.3% for the suppository group and 89.1% for the oral group. There was no statistically significant difference between 2 groups. Evaluation by stratification according to the dose, disease type and age also revealed a slightly higher efficacy rate on each parameter in the suppository group, but no significant difference between 2 groups. The bacteriological effects evaluated in 84 cases (suppository group in 38 cases, oral group in 46 cases) were 94.7% and 93.5%, respectively. There was no statistically significant difference between 2 groups. Side effects were evaluated in 101 cases (suppository group in 46 cases, oral group in 55 cases), but the incidence rate showed no significant difference between the 2 groups; 3 cases (each 1 of abdominal pain, periproctal redness and periproctal erosion) were observed in suppository group and 2 cases (each 1 of stomach pain + soft stool and diarrhea) in oral group. The results indicate that KS-R1 is equally effective and tolerable against acute suppurative otitis media compared to oral administration of ABPC, and considered to be useful.

Administration, Oral↗

[Cervico-facial suppuration of oro-dental origin due to Eikenella corrodens].

Several cases are reported of cervico-facial suppuration of buccodental origin, the infection being due to Eikenella corrodens, a facultative anaerobic germ that is difficult to culture. Conditions appropriate to the growth of these germs are discussed with respect to etiological, bacteriological and clinical factors. Therapy is outlined and a selective bibliography proposed.

Adult↗

Cochlear pathology in chronic suppurative otitis media.

Chronic suppurative otitis media (COM) is reported to cause elevation of bone-conduction thresholds either by damage to cochlear sensorineural structures or by alteration in the mechanics of sound transmission in the ear. A retrospective study was made of the medical records of 87 patients with unilateral uncomplicated COM to document that abnormality in bone conduction does exist. In a separate study the cochlear pathology in 12 pairs of temporal bones with unilateral COM was studied by light microscopy. Infected ears showed higher than normal mean bone-conduction thresholds by amounts ranging from 1 dB at 500 Hz to 9.5 dB at 4,000 Hz. The temporal bones showed no greater loss of specialized sensorineural structures in infected ears than in normal control ears. Because there is no evidence that COM caused destruction of hair cells or cochlear neurons, alteration in the mechanics of sound transmission becomes a more plausible explanation for the hearing losses.

Adolescent↗

[Therapeutic implications derived from the pathogenesis of suppurated otitis media].

The author discusses the pathogenic mechanisms considered to occur in the course of suppurated otitis media. These mechanisms are explained on the basis of experimental research work and laboratory investigations, published in the medical literature. With reference to the pathogenic aspects described the author tries to justify certain therapeutical attitudes and to criticize others. The theoretical rationale is illustrated by cases in the author's own experience.

Anti-Bacterial Agents↗

[New oral cephem antibiotic, cefroxadine capsules, against superficial suppurative disease in the field of surgery].

Cefroxadine was administered at dose level of 750 mg/day to 21 cases of superficial suppurative diseases and the following results were obtained: The effective rate determined by the treating doctor was 9/21 (42.9%). The effective rate by the evaluation standard was 12/21 (57.1%). The negative-conversion rate was 11/11 (100%) in the 11 cases in which bacteriological effects were clarified. No side effects were observed in all of the 21 cases.

Administration, Oral↗

Treatment of acute suppurative nephritis.

The diagnostic problems and treatment of acute suppurative nephritis are discussed on the basis of 146 patients. The biological properties of the pathogens isolated from urine and their manifestation with clinical symptoms are discussed. The role of incorrectly prescribed antibiotics in changing the characteristic symptoms and thus making diagnosis difficult is stressed. It appears from the material that in 20% of the operated patients all x-ray and laboratory tests gave negative results, despite the fact that in the course of operation abscesses were detected under the renal capsule. In 60% of the cases x-rays supplied reliable information for the indication of surgical intervention. The history of fever and shaking fits and the progression revealed by careful observation of the patients are considered the most important information needed for deciding for surgery.

Acute Disease↗

Suppurative abomasitis associated with Clostridium septicum infection.

A 1-week-old calf and two 1-month-old lambs from different farms in eastern South Dakota had severe abomasitis characterized by diffuse suppurative inflammation, edema, and emphysema. Clostridium septicum in the abomasal wall of each was identified by immunofluorescence and isolation. The lesions and microbiologic findings established the disease as braxy, a condition infrequently reported in the United States and thought to affect sheep only.

Abomasum↗

Chronic bronchial suppuration and inflammatory bowel disease.

Seven patients with severe, unexplained chronic bronchial suppuration and inflammatory bowel disease are reported. In three, rapidly progressive bronchiectasis developed within one year of procto-colectomy, in two it developed in association with an exacerbation of colitis and in the other two a milder, limited colitis post-dated the start of the lung disease. The high incidence of arthropathy and skin rashes suggests a systemic disease, and personal and family histories of auto-immune conditions were common. Antinuclear antibodies were detected in six and smooth muscle antibodies in five of the seven patients and there was no evidence of liver disease. Evidence of circulating immune complexes was found in two patients. In the four patients who received corticosteroid therapy there was an impressive improvement in cough, sputum volume and dyspnoea, especially when taking high doses. Because of the time relationships of the bowel and lung symptoms, we suggest that these disorders may be related.

Adrenal Cortex Hormones↗

Choice of treatment for chronic suppurative otitis media.

Many otolaryngologists appear to be confused regarding the indications for tympanoplasty and the choice of procedure for tympanoplasty, particularly if there is associated mastoid disease. This paper presents one otolaryngologist's approach to the patient with chronic suppurative otitis media and describes the indications for surgery and choice of surgical procedure based on a simple classification of the disease process.

Cholesteatoma↗

[Treatment errors in suppurative and inflammatory diseases].

The experience of treatment of 1011 patients with suppurative inflammatory diseases is described. In 292 of them the surgical intervention was found to be late. The analysis of errors has shown that it is not necessary to wait for the appearance of reliable symptoms of accumulation of pus. In the postoperative period 34 patients were not given proper drainage of purulent cavities. When prescribing corticosteroids, contraindications should be taken into consideration as well as hormonal characteristics of the patient and the sensitivity of his microbial flora of antibiotics.

Adult↗

[Acute suppurative kidney inflammation].

In 12 years the authors treated 97 patients with suppurative nephritis in their Department. They performed 78 conservative operations and 19 nephrectomies. The symptomatology and diagnosis of the disease are briefly discussed. Attention iscalled to the importance of early diagnosis and the earliest possible surgical intervention. The dangers of unfounded antibiotic treatment and of chemotherapy are pointed out as these might mask the classical symptoms and render early diagnosis more difficult.

Acute Disease↗

Acute suppurative thyroiditis.

Acute suppurative thyroiditis is a rare disease which may be confused with other, more common thyroid disorders. Gram-positive organisms such as Streptococcus, Staphylococcus, and Pneumococcus are most frequently responsible for this condition. Appropriate antibiotics should be selected to control local and systemic signs of infection. Incision and drainage of fluctuant areas are indicated. Thyroid function almost always returns to normal with eradication of infection.

Acute Disease↗

[Renal pneumatisation simulating suppuration : possible consequence of renal artery embolisation. Two cases (author's transl)].

The authors report two cases of renal pneumatisation immediately following renal artery embolisation performed for carcinoma of the kidney. The particularly painful and inflammatory (high fever, leucocytosis, increased sedimentation rate) led to abdominal X-rays which revealed signs of gas in the kidney. In the first case this consisted of rounded clear areas distributed in a linear fashion and indicative of intravascular pneumatisation. In case n degrees 2, intravascular pneumatisation was accompanied by gas in the calyces. In the absence of suppuration and of proven infectious cause, the authors failed to find any explanation for the presence of gas bubbles in the vessels and calyces of the embolised kidney.

Aged↗