Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Abscess”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 757 records · Page 42Linked to original sources
PubMedDate not supplied

Aerobic and anaerobic bacteriology of intracranial abscesses.

The bacteriologic and clinical findings of 39 pediatric patients with intracranial abscess are presented. Twenty-three children presented with brain abscess and 16 with subdural empyema. Predisposing conditions were present in all instances. Sinusitis was present in 25 children and 4 patients each had chronic otitis media, dental abscess, and congenital heart disease. The abscess was located in the frontal area in 14 patients, parietal in 13, and temporal in 12. Anaerobic organisms alone were recovered in 22 patients (56%), aerobic bacteria alone in 7 (18%), and mixed aerobic and anaerobic bacteria in 10 (26%) patients. There were 79 anaerobic isolates (2 per specimen). The predominant anaerobes were anaerobic Gram-positive cocci (29 isolates); Bacteroides sp. (12, including 5 Bacteroides fragilis group), Fusobacterium sp. (14 isolates); and Prevotella sp. and Actinomyces sp. (6 isolates each). A total of 17 aerobic or facultative isolates (0.4 per specimen), including 11 Gram-positive cocci and 6 Haemophilus sp., were recovered. Antimicrobial therapy was administered to all patients. Nine patients (i.e., 6 with sinusitis and subdural empyema, 3 with sinusitis and brain abscess) did not respond to antimicrobial therapy and aspiration of the abscess, and required surgical drainage of inflamed sinuses. These findings indicate the major role of anaerobic organisms in the polymicrobial etiology of intracranial abscess in children.

Adolescent↗
PubMed1996

Human immunodeficiency virus infection and other risk factors for skin abscesses and endocarditis among injection drug users.

OBJECTIVE: To study incidence rates of and risk factors for skin abscesses at the site of injection and episodes of endocarditis among injection drug users (IDU). DESIGN: A comprehensive, open cohort study of drug users on the natural history of human immunodeficiency virus (HIV) infection. METHODS: From 1986 to 1994, injection drug users in Amsterdam were included in the study. Incidence rates of self-reported skin abscesses and verified episodes of endocarditis were calculated. In uni- and multivariate Poisson regression analysis, risk factors for skin abscesses and endocarditis were determined. RESULTS: 521 HIV-seronegative and 237 HIV-seropositive IDU were followed for 1640 person-years. A total of 545 skin abscesses were reported by 269 IDU (incidence 33/100 person-years). HIV infection, female gender, prostitution among females, foreign nationality, injection of heroin and cocaine, a high frequency of injecting, and obtaining syringes through the needle exchange program were independently and positively associated with skin abscesses. During follow-up, 17 verified episodes of endocarditis were observed (incidence 1.3/100 person-years). Endocarditis was independently associated with HIV infection and a previous history of endocarditis. Furthermore, women and IDU with a skin abscess appeared to be at an increased risk for endocarditis. CONCLUSIONS: HIV infection is an independent risk factor for skin abscesses and endocarditis. Also, women are at an increased risk for these injection-related infections. Prevention activities, like promotion of skin cleaning, should be directed at those IDU in whom one or more risk factors have been identified.

Abscess↗
PubMed2006

Rate of malignancies in breast abscesses and argument for ultrasound drainage.

BACKGROUND: Biopsy of a breast abscess wall has been performed for years without evidence. Aspiration of breast abscesses has been increasing in popularity without widespread acceptance. METHODS: A 10-year retrospective review of 206 surgical biopsies after incision and drainage of breast abscesses. A literature review of breast abscess treated with ultrasound-guided aspiration. RESULTS: Over 10 years, 4.37% (9/206) patients were diagnosed with malignancy in the abscess cavity wall tissue. None of the 197 patients with a negative biopsy returned with breast cancer. Single, multiple, and combined aspiration success rates of 79.8% (364/458), 11.0% (50/458), and 90.9% (482/532) with surgical intervention necessary in 9.1% (50/532). Ultrasound versus hand guidance (92.5% versus 81.9 %, P < .01) improved success rate. CONCLUSIONS: The rate of associated malignancies with breast abscess is very low and does not warrant mandatory surgical drainage. The use of ultrasound-directed aspiration of breast abscesses is effective and should be first-line therapy.

Abscess↗
PubMed2005

Mastoid subperiosteal abscess: a review of 51 cases.

OBJECTIVE: To present a large study on subperiosteal abscess (SA) that represents the most frequent complication of acute mastoiditis. METHOD: A retrospective study was conducted on 49 patients who underwent mastoidectomy for SA. RESULTS: The patients ranged in age from 8 months to 21 years. Two patients were re operated on the same side due to recurrent abscess. Forty-five percent of the patients were treated using antibiotics at home and 58.8% of patients had no history of middle ear infection prior to admission. CT underestimated abscess in two patients who were operated on based on their clinical signs. Perisinus abscess was drained during mastoidectomy in one child. Purulent discharge was obtained from the abscess in 41 cases. The most common isolated pathogens were Streptococcus pyogenes and Staphylococcus aureus. Cholesteatoma was found during mastoidectomy in six patients (11.3%). Twenty-four patients (49%) developed postoperative sequela including various middle ear infections, mastoiditis, recurrent SA and impaired hearing. CONCLUSIONS: Mastoid SA is a unilateral mainly children's disease that can recur. Cholesteatoma can associate the abscess and could be found in older children and recurrent abscess. High morbidity rate requires long-term follow-up for these patients.

Abscess↗
PubMed2004

Spinal epidural abscess presenting as intra-abdominal pathology: a case report and literature review.

Spinal epidural abscess is a rare infectious disease. However, if left unrecognized and untreated, the clinical outcome of spinal epidural abscess can be devastating. Correctly diagnosing a spinal epidural abscess in a timely fashion is often difficult, particularly if the clinician does not actively consider the diagnosis. The most common presenting symptoms of spinal epidural abscess include backache, radicular pain, weakness, and sensory deficits. However, early in its course, spinal epidural abscess can also present with vague and nondescript manifestations. In this report, we describe a case of spinal epidural abscess presenting as abdominal pain, and review the literature describing other cases of spinal epidural abscess presenting as intra-abdominal pathology.

Abdomen, Acute↗
PubMed2006

Computerized tomography (CT)-guided aspiration of abscesses: outcome of therapy at a tertiary care hospital.

OBJECTIVE: To review the experience with percutaneous aspiration of abscesses at a general, tertiary care hospital from 2000 to 2005. METHODS: Computerized medical records of 90 patients who underwent radiologically guided drainage of 92 fluid collections were reviewed for demographic data, co-morbid conditions, location, radiographic imaging characteristics and culture results and to determine the long-term outcome of the procedure. RESULTS: Sixty-seven of 92 (73%) abscesses were cured without the need for open surgical drainage; 44 were cured within 14 days, and 23 had delayed resolution requiring prolonged antibiotics and/or a second drainage. Of the abscesses 85% were drained using a catheter in situ, the remaining aspirated using a needle. Twenty-five (27%) of the 92 abscesses failed percutaneous drainage, requiring open surgical drainage or lead to sepsis and death. Neither co-morbid conditions nor the location of abscesses affected the outcome of drainage. Patients who had sterile cultures of aspirated material after receiving antibiotics prior to the procedure had a significantly higher cure rate than otherwise (P<0.05). Catheter drainage was associated with a significantly higher cure rate than was needle aspiration (P<0.05). CONCLUSION: Percutaneous drainage, along with appropriate antibiotics, is an effective approach to treat deep abscesses. Drainage, itself, is the major determinant of outcome, rather than the location, characteristics of the abscess or condition of the patient prior to the procedure.

Abscess↗
PubMed2003

Cut it out: Managing hepatic abscesses in patients with chronic granulomatous disease.

BACKGROUND: Hepatic abscesses develop in patients with chronic granulomatous disease (CGD) because the liver is a site of constant bacterial challenge. The authors investigated the roles of drainage and hepatic resection in the management of liver abscesses in CGD patients. METHODS: Medical records of CGD patients with hepatic abscesses from 1990 to 2001 were reviewed. RESULTS: There were 6 patients. Mean age of initial abscess was 7.2 years (range, 3 weeks to 18.9 years). All abscesses involved the right lobe of the liver (2 single, 4 multiple). All patients received appropriate antibiotics. Four patients were treated with one to 6 drainage procedures over one to 4 admissions before ultimately undergoing resection. The other 2 patients underwent primary resection without preliminary drainage. Of the 6 resections, 4 were nonanatomic, and 2 were anatomic. There was one major postoperative complication (bleeding) requiring reoperation. There were no recurrences after resection (mean follow-up 4.3 yr). Mean total days in hospital for the treatment of liver abscess was 49 in the preliminary drainage group and 8.5 in the primary resection group. Three patients required admission into the intensive care unit, one after a drainage procedure and 2 after resection. CONCLUSIONS: For CGD patients with hepatic abscesses, drainage procedures are associated with recurrence and prolonged hospitalization. Primary hepatic resection removing all involved tissue is safe and definitive for the management of this problem.

Adolescent↗
PubMed2000

Proinflammatory cytokine, chemokine, and cellular adhesion molecule expression during the acute phase of experimental brain abscess development.

Brain abscess represents the infectious disease sequelae associated with the influx of inflammatory cells and activation of resident parenchymal cells in the central nervous system. However, the immune response leading to the establishment of a brain abscess remains poorly defined. In this study, we have characterized cytokine and chemokine expression in an experimental brain abscess model in the rat during the acute stage of abscess development. RNase protection assay revealed the induction of the proinflammatory cytokines interleukin (IL)-1alpha, IL-1beta, IL-6, and tumor necrosis factor-alpha as early as 1 to 6 hours after Staphylococcus aureus exposure. Evaluation of chemokine expression by reverse transcription-polymerase chain reaction demonstrated enhanced levels of the CXC chemokine KC 24 hours after bacterial exposure, which correlated with the appearance of neutrophils in the abscess. In addition, two CC chemokines, monocyte chemoattractant protein-1 and macrophage inflammatory protein-1alpha were induced within 24 hours after S. aureus exposure and preceded the influx of macrophages and lymphocytes into the brain. Analysis of abscess lesions by in situ hybridization identified CD11b+ cells as the source of IL-1beta in response to S. aureus. Both intercellular adhesion molecule-1 and platelet endothelial cell adhesion molecule expression were enhanced on microvessels in S. aureus but not sterile bead-implanted tissues at 24 and 48 hours after treatment. These results characterize proinflammatory cytokine and chemokine expression during the early response to S. aureus in the brain and provide the foundation to assess the functional significance of these mediators in brain abscess pathogenesis.

Acute-Phase Proteins↗
PubMed1983

Indium-111 tropolonate leucocyte scanning in the detection of intra-abdominal abscesses.

Indium-111 leucocyte scanning is established as an accurate method for localising intra-abdominal abscesses. With the currently available cell labelling techniques there is a variable and significant delay in localisation of abscesses which is a major disadvantage in comparison with ultrasound or computed tomography. We have examined the speed and accuracy of localisation of leucocytes labelled in plasma with a new chelating agent, indium-111 tropolonate, in 90 patients with suspected intra-abdominal abscess. In 50 patients a comparison with ultrasound was made. Nineteen patients had abscesses. The sensitivity and specificity of labelled leucocytes were 95% and 99%, respectively. Comparative results for ultrasound were 60% and 83%. In nine out of 10 patients with abscesses scanned sequentially from 40 min after return of the labelled cells, activity corresponding to the abscess was already visible on the 40 min scan. These results demonstrate that indium-111 plasma labelled leucocyte scanning is both rapid and an accurate method of detecting abscesses.

Abdomen↗
PubMed1999

Medical treatment of renal and perirenal abscesses: CT evaluation.

AIM: A retrospective study of our experience of CT evaluation and follow-up of 16 solitary and multiple renal abscesses treated successfully with antibiotics alone and evaluated with CT at the onset of symptoms and after therapy. MATERIALS AND METHODS: Seven patients had a solitary renal abscess, five had multiple renal abscesses and four had renal and perinephric abscess. None of the abscesses were larger than 5 cm. RESULTS: In all 16 patients, the CT examination showed total renal and extrarenal regression of the abscesses. In four patients, scarring of the renal outline was observed on follow-up. CONCLUSIONS: The study demonstrates the opportunity to avoid aggressive interventional or surgical treatment of renal and perirenal abscesses of 5-cm diameter or less which can completely regress after antibiotic therapy of at least 4 weeks. The CT examination results are important both in the diagnostic phase to establish the extent of the lesions and in the follow-up to check the results of medical treatment.

Abscess↗
PubMed1997

Colonic involvement in patients with amebic liver abscess: endoscopic findings.

BACKGROUND: Amebic liver abscess is the most common form of extraintestinal amebiasis. Although the parasite enters the liver via the portal vein after invading large bowel mucosa, only 15% to 30% of patients have diarrhea. This study was done to evaluate colonic involvement in patients with amebic liver abscesses. METHODS: In a prospective study, colonoscopy was performed in 50 patients with amebic liver abscesses and 15 control patients with acute amebic colitis. The findings were correlated with clinical features and ultrasonographic appearances. RESULTS: Most patients with amebic liver abscesses presented with fever and abdominal pain. Complete examination of the colon was possible in 45 patients. Twenty six (58%) had evidence of lesions in the colon. Twenty-three of 45 (51%) patients had a few discrete, small ulcers restricted to the right side of colon. Three of 45 (7%) patients with liver abscesses, who also had diarrhea at presentation, had larger and more numerous ulcers with inflammation of the surrounding mucosa of the left colon. Control patients with amebic colitis presented with diarrhea. Endoscopically, they all had multiple large ulcers with diffuse inflammation of the intervening mucosa of the left colon, similar to that seen in patients with liver abscess having diarrhea. CONCLUSIONS: Colonic involvement is common in patients with amebic liver abscess but most patients do not suffer from diarrhea, possibly because of very limited extent of the pathology that is confined mainly to the right side of colon.

Adult↗
PubMed1986

Drainage of pediatric lung abscess by cough, catheter, or complete resection.

We treated eight children, aged 7 weeks to 17 years, for lung abscess. Each abscess followed an episode of aspiration or a bacterial pneumonia. Associated conditions were leukemia, congenital immune deficiency, endocarditis, cerebral palsy, and prematurity. Seven of the 8 children had polymicrobial infections, usually containing both aerobic and anaerobic bacteria. The success of medical treatment by antibiotics and chest physiotherapy was age related; 3 of the 8 children, aged 10 to 17 years, recovered on this regimen, whereas five children, aged 7 weeks to 7 years, required catheter drainage or resection for cure. Drainage by catheter pneumonostomy was performed for solitary peripheral bacterial abscesses. A large intercostal catheter was inserted into the cavity, either operatively or percutaneously. Wedge resection was performed for multiple, central, or fungal abscesses. Pneumonostomy was curative in 3 of 4 children. One chronic abscess recurred after pneumonostomy and required resection. Wedge resection was curative in the two children who came to thoracotomy; lobectomy was not necessary. Although all eight children recovered from their lung abscesses, three of them died within a year of sepsis. Lung abscess today occurs in immunocompromised children who are vulnerable to fatal infections. Chest physiotherapy is unlikely to achieve good drainage in children under 7 years of age. Medical failures can be identified within the first week of treatment. Early and aggressive surgical treatment is indicated in such children, and may be lifesaving.

Adolescent↗
PubMed1996

Recurrent appendicitis after initial conservative management of appendiceal abscess.

Therapy for children with appendiceal abscess remains controversial. The authors present two such cases initially treated conservatively, without interval appendectomy, that later had recurrent appendicitis. An 8-year-old boy presented with fever, abdominal pain, and a right-lower-quadrant abscess (noted by ultrasonography). During laparotomy, the abscess was drained and the appendix was not found. He was lost to follow-up but returned 2 1/2 years later with perforated appendicitis. An appendectomy was performed, and image-guided drainage of a postoperative abscess was required. A 10-year-old girl presented with fever and right-lower-quadrant pain. Computed tomography showed a multiloculated mass. During laparotomy, the cecum was found to be densely adherent to the pelvic organs and bowel, so the surrounding abscess was drained. Interval appendectomy was refused. The patient returned 8 months later with recurrent acute appendicitis and an appendiceal abscess requiring appendectomy and drainage. Although initial drainage alone of appendiceal abscess is efficacious, the authors strongly advocate interval appendectomy as a critical component of the complete management of this entity.

Abscess↗
PubMed2002

Current treatment and outcomes of perinephric abscesses.

PURPOSE: We characterize the treatment and outcomes of perinephric abscesses in a contemporary cohort of patients. MATERIALS AND METHODS: We reviewed the experience with perinephric abscesses at a single community based hospital. Abdominal computerized tomography (CT) was widely available during the study period and experience with radiographic guided percutaneous drainage was extensive. Therapy and intervention for individual patients were dictated by the treating physician. RESULTS: Of the 25 patients identified with perinephric abscesses 3 (12%) ultimately died. Although 40% had multiple risk factors for perinephric abscesses only 35% were identified at presentation. Urine cultures were positive in 72% of patients and CT had a diagnostic sensitivity of 92%. Ten patients with a mean abscess size of 1.8 cm. were treated with antibiotics alone (mean hospitalization 10 days) while 11 with a mean abscess size of 11 cm. received antibiotics and initial percutaneous drainage (mean hospitalization 30 days). Of the 11 patients treated with percutaneous drainage 4 ultimately required surgical exploration and nephrectomy. CONCLUSIONS: The clinical characteristics of perinephric abscesses have not changed significantly but improved imaging with CT allows earlier diagnosis and treatment, which likely contributed to the reduced mortality in our cohort compared to historical series. With accurate staging and careful followup, a variety of treatments can be successful, including antibiotics alone or in conjunction with percutaneous drainage and urinary drainage. Open surgical drainage and nephrectomy may eventually be required in some patients and should be considered if adequate drainage is not achieved.

Abscess↗
PubMed1995

Pathogenesis-based treatment of recurring subareolar breast abscesses.

BACKGROUND: When a subareolar breast abscess (SBA) is incised and drained, an extraordinarily high frequency of recurrence is noted. METHODS: To develop a pathogenesis-based treatment plan, 24 women with a total of 84 abscesses were monitored. RESULTS: In nine women SBA was under the left areola, under the right, in 7 and in eight the SBA occurred either simultaneously or sequentially under both areolae. In 11 of 24 patients a chronic lactiferous duct fistula also existed. In four of 24 patients four SBAs were treated with antibiotics; alone; all recurred. In 16 of 24 patients initial treatment was incision and drainage plus antibiotics; all recurred. When the abscess plus the plugged lactiferous duct was excised, there were no recurrences; however, in four patients a new abscess in a different duct occurred, which was treated by en bloc resection of all subareolar ampullae, without further recurrence. Patients with a fistulous tract had the fistula, its feeding abscess, and its plugged lactiferous duct excised, without recurrence. In first time SBA the organism was usually staphylococcus; in recurrences mixed flora was isolated. Pathologic findings ranged from squamous metaplasia with keratinization of lactiferous ducts to chronic abscess. CONCLUSIONS: The cause of SBA is plugging of lactiferous duct within the nipple by keratin. To prevent recurrence the abscessed ampulla with its plugged proximal duct needs excision.

Abscess↗
PubMed2001

Streptococcal brain abscess: analysis of clinical features in 20 patients.

BACKGROUND: To assess the clinical features and therapeutic outcomes of brain abscess caused by streptococci. METHODS: Twenty patients, 18 males and 2 females, aged 3 to 76 years, collected over a 14-year period, have been identified at Kaohsiung Chang Gung Memorial Hospital. RESULTS: Among these 20 patients, 13 had viridans streptococci infection alone, one had non-A, non-B, and non-D streptococci infection alone, and the other 6 had mixed infections each including streptococci. The locations of all of the abscesses were supratentorial. Among these patients, 18 had a single abscess and 2 had multiple abscesses. Underlying conditions were common in our patients, including head trauma, heart disease, otopharyngeal infection, and medical procedures. Nineteen patients were treated surgically and 1 was treated with antibiotics alone. Nineteen survived and 1 died, with an overall mortality rate of 5%. CONCLUSION: The clinical presentations and underlying conditions varied according to the different streptococcal species. Streptococcal brain abscesses accounted for 17% of our cases with brain abscesses, and 30% of our streptococcal infections had polymicrobial infections. Although streptococcal brain abscesses were commonly associated with otopharyngeal infections or infectious endocarditis, they also appeared to be often related to neurosurgical events or medical procedures in recent years. Based on our study, prognosis is favorable with early diagnosis and prompt treatment.

Adolescent↗
PubMed1999

Successful treatment of brainstem abscess with stereotactic aspiration.

BACKGROUND: Brainstem abscess is an uncommon condition associated with a high mortality. We report a case of brainstem abscess in a 51-year-old female with a pulmonary arteriovenous fistula that was cured after appropriate antibiotic therapy following stereotactic aspiration. The value of stereotactic aspiration in the management of brainstem abscess is documented with a review of the relevant literature. CASE REPORT: A 51-year-old female with a pulmonary arteriovenous fistula suffered fever, diplopia and weakness on the right side. Magnetic resonance (MR) imaging of the brain showed a large cystic mass with ring-like enhancement in the brainstem. A diagnosis of brainstem abscess as a complication of pulmonary arteriovenous fistula was made. MR imaging-guided stereotactic exploration was carried out via the suboccipital transcerebellar approach and the pathogen of the brainstem abscess was identified. The brainstem abscess was cured after treatment employing antibiotics to which the pathogen was sensitive. CONCLUSIONS: Stereotactic aspiration is an effective procedure for brainstem abscesses. This procedure is less invasive than open surgery and can be performed even in patients in poor general condition.

Arteriovenous Fistula↗
PubMed1999

Diagnosis and therapeutic management of 18 patients with prostatic abscess.

OBJECTIVES: Our retrospective study aimed to analyze the findings and therapeutic strategies in 18 men who were admitted to our department as outpatient emergency cases with prostatic abscess. METHODS: During the period 1985 to 1997, prostatic abscess was diagnosed in 18 patients (mean age 48 years, range 20 to 68) on the basis of evidence of fluctuation at digital rectal examination and transrectal ultrasound (TRUS) findings. Diagnostic workup included analysis of midstream urine and abscess fluid for leukocytes and pathogens. Therapeutic options were conservative treatment and/or draining procedures. RESULTS: Predisposing diseases were found in 13 men. Fluctuation at digitorectal palpation was present in 15 patients. In 3 patients, diagnosis was based on TRUS. All men demonstrated leukocytes in their midstream urine. Causative pathogens in midstream urine were found in 11 patients. In 3 men, additional microbiologic evaluation of abscess fluid revealed uncommon pathogens. All patients received antibiotic treatment. Nine men with monofocal abscess less than 1 cm in diameter were treated with antibiotic therapy and a suprapubic catheter. Surgical drainage (transperineal or transrectal puncture, partly guided by TRUS, or transurethral unroofing) was performed in 12 patients and included 3 patients in whom conservative treatment failed. CONCLUSIONS: Our data confirm the importance of predisposing factors in the pathogenesis of prostatic abscess. Medical history and analysis of midstream urine indicated a diagnosis that was confirmed by digital palpation. In some cases, TRUS may improve diagnosis and treatment. Although both operative and conservative therapy strategies appear feasible, prostatic abscess chiefly requires individually selected drainage procedures.

Abscess↗