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PubMed1989

Histological analysis of liver parenchyma and choledochal wall, and external diameter and intraluminal pressure of the common bile duct in controls and patients with common bile duct stones with and without acute suppurative cholangitis.

The purpose of this prospective controlled study was to determine the changes in intraluminal pressure and diameter of the common bile duct in a total of 121 bile patients with choledocholithiasis, and the consequences of these alterations for choledochal mucosa and liver histology. In fact, the reflux of bacteria from the obstructed biliary tract into the bloodstream is responsible for producing the clinical syndrome of acute suppurative cholangitis. Group I (26 patients) served as controls, Group II (50) had choledocholithiasis with clear green bile, and Group III (45) were patients with acute suppurative cholangitis with pus in the biliary tract. Ultrasonography revealed gallstones in all the patients. The external diameter of the common bile duct in patients with choledocholithiasis and acute suppurative cholangitis was significantly greater than in those of the other groups. Patients with acute suppurative cholangitis also had a higher intraluminal pressure than those of Groups I or II.

Acute Disease↗
PubMed1983

[Continuous aspiration in prevention of postoperative wound suppuration].

The aspiration method of preventing suppurations (after Redon) was used in 948 patients. After "pure" operations suppurations were found to appear in 0,8%, after "conventionally pure" operations in 1,3% and after operations associated with a considerable postoperative risk of a wound infection--in 17% of cases. The aspiration--irrigation method of preventing suppurations was used in 69 patients operated under conditions of a developing purulent process. Suppuration of the wounds was found to develop in 1,3% of cases.

Drainage↗
PubMed1982

[An experimental production of suppurative otitis media in dog, and a trial to evaluate the therapeutic effect of cefmetazole on this otitis media].

An experimental suppurative otitis media in dog was produced to evaluate the therapeutic effects of cefmetazole (CMZ) in this study. In order to induce a definite case of otitis media, 1.0 mg of dexamethasone was administered intramuscularly to dog, 12 hours before a bacterial inoculation into the middle ear of it. For inoculation, 5 x 10(8) live bacteria of S. aureus, strain 571 (UOP) was prepared from its 18 hour-bouillon culture and added 0.9 ml of 5% mucin solution for a total inoculation fluid of 1.0 ml. This fluid was injected into the middle ear on one side by inserting a 'mouse syringe' with a swollen tip down the external auditory meatus to pierce the tympanic membrane. On the opposite side, only 1.0 ml of micin solution was injected. In this way, suppurative otitis media which definitely lasted until the 15th day following the bacterial inoculation was realized. Since in each positive controls, the onset of suppurative otitis media had been confirmed on the 4th day after inoculation, the intravenous administration of CMZ (three times a day; 9 : 30, 15 : 30, 21 : 30) was started at the end of the 4th day and continued through the 7th day. The dogs thus treated were sacrificed on the 10th day after inoculation and the live bacteria count within the middle ear, signs of inflammation on the tympanic cavity, and accumulation of pus were examined. The therapeutic effect of CMZ was rated as 'effective' in cases where S. aureus-571 was found to be negative. All the animals administered a daily dose of 30 mg/kg or above it, were found to be S. aureus-571 free, thus the satisfactory therapeutic effect of CMZ was demonstrated. Especially, at the daily dose of 120 mg/kg the membrane of the tympanic cavity in all cases exhibited a picture of a radical cure to almost the same degree as the control side membranes, and any signs of inflammation were hardly observed. The last mentioned phenomena had been observed too by the authors on the treatment of the experimentally induced pyometra in bitches, with CMZ. Thus it is assumed that in treating some suppurative diseases with CMZ, it may be advisable to initiate the administration at relatively large doses in order to achieve generally better and quick effect.

Animals↗
PubMed1996

[Unusual case of acute suppurative thyroiditis].

Acute suppurative thyroiditis is an acute disease of the thyroid gland. In this paper the authors report a case of acute suppurative thyroiditis complicated by abscessual evolution in an addict patient study with ultra-sonography and treated with fine needle aspiration and antibiotic therapy. The patient reached our observation for a swelling of the neck. Ultrasonography showed diffuse hypoechogenicity in both thyroid lobes and mixed nodule with hyperechoic trabeculas inside. This nodule underwent fine needle aspiration (FNA) for cytologic and cultural evaluation. Diagnosis was acute suppurative thyroiditis. Ultrasonography presented features similar to other thyroid pathology (sub-acute thyroiditis, haemorrhagic cyst, thyroid lymphoma and anaplastic carcinoma). In our case none of the ultrasonographic features were diagnostic except hyperechoic trabeculas inside. Ultrasonographic features of acute suppurative thyroiditis are very rare in the literature. Ultrasonography and fine needle aspiration are the only methods that confirm this diagnosis.

Acute Disease↗
PubMed1999

Hodgkin's disease mimicking suppurative lymphadenitis: a fine-needle aspiration report of five cases.

Spontaneous, suppurative-necrotizing changes associated with Hodgkin's disease (HD) are not infrequent. They are mostly observed in the nodular sclerosis variant of HD and can cause an erroneous histologic diagnosis of suppurative lymphadenitis. Few cytologic reports describing this presentation of HD are available. We describe 5 cases of HD that showed cytologic abscess-like smears dominated by a massive neutrophilic infiltrate and necrosis. Since therapy can induce similar changes, this study did not include patients with known HD. In 2 cases erroneously diagnosed as suppurative lymphadenitis, the presence of neoplastic cells was minimal and only detected after revision. A third case was misdiagnosed as abscessified metastasic carcinoma. Two cases were correctly identified as HD, although in one, the possibility of anaplastic large-cell lymphoma could not be ruled out. In conclusion, necrosis and massive neutrophilic infiltrates can occur spontaneously and can be prominent findings in smears from patients with HD, mainly the nodular sclerosis variant. The cytopathologist should always consider this possibility in the presence of an abscessified, suppurative, lymphadenitis-like aspirate. A detailed search for the characteristic neoplastic cells of HD is mandatory in these cases.

Adolescent↗
PubMed2005

Plasmacytoid monocytes in cat scratch disease with special reference to the histological diversity of suppurative lesions.

It has been suggested that plasmacytoid monocytes (PMOs) play an essential role in T-cell-dependent immune response. Indeed, numerous PMOs are found in close topographical association with epithelioid cell granulomas in hypersensitivity-type granulomas, such as tuberculosis and sarcoidosis. The key pathologic process in cat scratch disease (CSD) usually involves a B-cell-associated granulomatous reaction. Histologically, CSD appears to exhibit a histopathologic diversity, including suppurative lesions without epithelioid cell granulomas (early lesion), in which the microabscesses were surrounded by monocytoid B-cells (MBCs), suppurative granulomas containing MBCs (intermediate lesion), and suppurative granulomas without MBCs (late lesion). However, the presence or absence of PMO in CSD has not been studied previously. We examined 14 cases of CSD. In early lesions, numerous clusters of PMO were detected in the MBCs. In intermediate lesions, both MBCs and PMOs were found to be decreased in number, while late lesions contained no or only a few MBCs and PMOs. Overall, these findings suggest that PMOs may play a role in MBC-associated granulomatous response and in hypersensitivity granulomatous response. Moreover, the association with MBCs and PMOs indicates a functional relationship of MBCs with PMOs in the formation of suppurative lesions in CSD.

Abscess↗
PubMed2002

Nine cases of piriform sinus fistula with acute suppurative thyroiditis.

OBJECTIVE: Acute suppurative thyroiditis is a disease of an infection originated from the piriform sinus via congenital fistula. The purposes of this study are the establishment of accurate and necessary examinations for the diagnosis and necessary treatment for complete remission of this disease. METHODS: We reported nine cases with acute suppurative thyroiditis who were treated by operation. Preoperative examinations and operative procedures for nine cases were investigated. RESULTS: A congenital fistula was detected in seven of nine patients preoperatively, and in all seven patients, the fistula was detected during the operation. Serum thyroglobulin was elevated in four of five patients who were examined the serum level. Ultrasonogram was performed in eight cases, and localized swelling of the thyroid lobe was observed in all cases. No inflammatory recurrence was observed in eight cases, and recurrence was observed in one case where complete fistelectomy was not performed. CONCLUSION: Measurements of serum thyroglobulin, ultrasonography, and pharyngoesophagography were useful in the diagnosis of acute suppurative thyroiditis. Complete removal of the fistula with or without affected thyroid lobe is necessary to prevent recurrent suppuration.

Acute Disease↗
PubMed2005

Epidemiological and microbiological diagnosis of suppurative keratitis in Gangetic West Bengal, eastern India.

PURPOSE: To determine the epidemiological pattern and risk factors involved in suppurative corneal ulceration in Gangetic West Bengal, eastern India, and to identify the specific microbial agents responsible for corneal infections. METHODS: All patients with suspected microbial keratitis presenting to the corneal clinic at Disha Eye Hospital, Barrackpore, West Bengal, India, from January 2001 to December 2003 were evaluated. Sociodemographic data and information pertaining to the risk factors were recorded. After diagnosing infective corneal ulcer clinically, corneal scraping and cultures were performed. RESULTS: Over a three-year period, 1198 patients with suppurative keratitis were evaluated. Ocular trauma was the most common predisposing factor in 994 (82.9%) patients (P< 0.0001), followed by use of topical corticosteroids in 231 (19.28%) patients. Cultures were positive in 811 (67.7%) patients. Among these culture positive cases, 509 (62.7%) patients had pure fungal infections (P< 0.001), 184 (22.7%) patients had pure bacterial infections and 114 (14.1%) had mixed fungal with bacterial infections. Acanthamoeba was detected in 4 (0.49%) patients. The most common fungal pathogen was Aspergillus spp representing 373 (59.8%) of all positive fungal cultures (P< 0.0001), followed by Fusarium spp in 132 (21.2%) instances. Most common bacterial isolate was Staphylococcus aureus, representing 127 (42.6%) of all the bacterial culture (P< 0.0001) followed by Pseudomonas spp 63 (21.1%). CONCLUSION: Suppurative keratitis in Gangetic West Bengal, most often occurs after a superficial corneal trauma with vegetative or organic materials. Fungal ulcers are more common than bacterial ulcers. Aspergillus spp and Staphylococcus aureus were the most common fungus and bacteria respectively. These "regional" findings have important public health implications for the treatment and prevention of suppurative corneal ulceration in this region of India.

Administration, Topical↗
PubMed1992

Suppurative granulomatous lymphadenitis. Immunohistochemical evidence for a B-cell-associated granuloma.

The cellular composition of suppurative granulomas was investigated by the application of monoclonal and polyclonal antibodies to paraffin sections and compared with nonsuppurative, hypersensitivity-type granulomas. Macrophages, T cells, and dendritic cells showed a similar distribution in both types of granulomas. In addition to the presence of granulocytes, a major difference between suppurative granulomas and hypersensitive-type granulomas concerned their relationship with B lymphocytes. Hypersensitive-type granulomas were surrounded by small mantle B cells, but they did not contain any B lymphocytes. In contrast, variable numbers of B cells were found either at the periphery or in the center of suppurative granulomas. In view of their morphology (medium size, pale cytoplasm, irregular nuclear shape) and phenotype (L26 +/LN1 -/MB2 +/MT2 +) these B lymphocytes closely resembled monocytoid B cells. The monocytoid B cells might have a role in the recruitment of polymorphonuclear granulocytes and in the development of the necrosis, which occur within suppurative granulomas.

Acid Phosphatase↗
PubMed1992

Suppurative group A beta-hemolytic streptococcal infections in children.

Group A beta-hemolytic streptococci (GABHS) have once again become an important cause of serious suppurative disease in children. A 100% increase in the rate of GABHS bacteremia and an increased frequency in GABHS bacteremia in previously healthy children were observed in 1989 through 1990 compared with 1984 to 1988. Streptococcal isolates were characterized and patient demographic data were tabulated from children hospitalized with GABHS suppurative infections in 1989 through 1990. The differences in clinical manifestations and strains of GABHS were examined in patients with bacteremia, with or without focal site of infection, and in those with focal infections without bacteremia. Bacteremic children were significantly younger and had higher white blood cell counts at admission. No patient had a toxic shock-like syndrome. Although no specific strain was associated with suppurative infections, serum opacity reaction-negative organisms were more frequently associated with focal infections without bacteremia. The data suggest that GABHS may have become more virulent. Physicians should consider GABHS as an important cause of serious suppurative infection in children.

Age Factors↗
PubMed1991

Pharmacokinetics and synovial fluid concentrations of cephapirin in calves with suppurative arthritis.

Six calves with suppurative arthritis were given a single IM injection of sodium cephapirin at a dosage of 10 mg/kg of body weight. Cephapirin concentrations were serially measured in serum and in normal and suppurative synovial fluid over a 24-hour period. Mean peak serum concentration was 6.33 microliters/ml at 20 minutes after injection. The highest cephapirin concentrations in normal and suppurative synovial fluid were 1.68 and 1.96 micrograms/ml, respectively, 30 minutes after injection. Overall mean cephapirin concentration in normal synovial fluid for the first 4 hours (1.04 +/- 0.612 micrograms/ml) was not significantly different from that in suppurative synovial fluid (0.88 +/- 0.495 micrograms/ml; P greater than 0.05). Elimination half-life was 0.60 hours and clearance was 1,593 ml/h/kg.

Animals↗
PubMed1991

Serum and synovial fluid concentrations of ampicillin trihydrate in calves with suppurative arthritis.

Eight calves with suppurative arthritis were each given a single intramuscular injection of ampicillin trihydrate at a dose of 10 mg/kg. Ampicillin concentrations were measured serially in serum and in suppurative and normal synovial fluid over a 24-hour period. The mean peak serum concentration was 2.5 +/- 0.54 micrograms/ml 2 hours after injection. The highest concentration in normal synovial fluid was 3.5 +/- 0.40 micrograms/ml at 4 hours and the highest concentration in suppurative synovial fluid was 2.7 +/- 0.58 micrograms/ml at 2 hours. Overall mean ampicillin concentration in normal synovial fluid for the first 8 h (2.9 +/- 0.32 micrograms/ml) was significantly different from that in suppurative synovial fluid (2.1 +/- 0.33 micrograms/ml) and serum (1.9 +/- 0.30 micrograms/ml; p less than 0.05).

Ampicillin↗
PubMedDate not supplied

[Suppurative cervico-mediastinitis of odontogenic origin].

Five cases are presented, of suppurated cervico-mediastinitis developed after acute suppurated apical parodontitis of a lower molar tooth. In two cases the severity and the extension of the lesions resulted in a fatal outcome. In one of the cases the patient also had pericarditis, pleurisy and purulent meningitis, and in the second case the necrotizing mediastinitis extended to the pleural and pericardic cavities, and was associated to bilateral bronchopneumonia. In three cases the patients were cured following cervical mediastinotomy, efficient mediastinal aspiration of the anterior and of the posterior mediastinum, in association with antiinfectious and resuscitation therapy. Since the prognosis of these major complications is still severe the risk of diffusion of odontogenic suppurations should not be ignored or minimized since in all the cases iatrogenic factors have occurred over the evolution of the patients. Knowledge of stomatologists should be improved and they should be aware of the risks of odontogenic suppuration involving parapharyngeal and cranio-encephalic extension, or the risk of cervico-mediastinal diffusion.

Adult↗
PubMed1989

[Suppuration of the postcholecystectomy wound].

In 212 patients after elective cholecystectomy, the bacteriologic study was performed. Bile infection was revealed in 43 (20.3%) patients, wound suppuration--in 28. Of them in 20, pathogenic microflora was cultured. In 16 patients, the microorganism in the bile and wound were identical. Escherichia coli was the main microorganism cultured from the wound and bile. The incidence of wound suppuration after cholecystectomy with the common bile duct revision is higher than after cholecystectomy alone. Changes in the gallbladder function (excluded gallbladder), or cholangiography didn't increase the risk of wound suppuration. Microorganisms cultured from the bile were the most sensitive to gentamycin and cephalosporin. Prophylactic use of antibiotics for reduction of the incidence of wound suppuration is recommended.

Adult↗
PubMed2003

Evaluation of topical povidone-iodine in chronic suppurative otitis media.

OBJECTIVES: To evaluate if povidone-iodine (PVP-I) can be used topically in the treatment of chronic suppurative otitis media-tubotympanic disease and to compare it with ciprofloxacin hydrochloride ear drops. DESIGN: Prospective double-blind randomized study. SETTING: Academic tertiary medical center. PATIENTS: Forty patients with chronic suppurative otitis media were randomized into 2 groups. INTERVENTION: One group (19 patients) received 5% PVP-I ear drops, while the other group (21 patients) received 0.3% ciprofloxacin ear drops. Both were administered topically, 3 drops 3 times daily for 10 days. These patients were followed up at weekly intervals for up to 4 weeks after commencing therapy. RESULTS: Clinical improvement at the end of study was 88% in the PVP-I group and 90% in the ciprofloxacin group. The most commonly isolated organism was Pseudomonas aeruginosa. In vitro resistance to ciprofloxacin was seen in 17% of organisms, while no resistance was seen for PVP-I. CONCLUSIONS: To our knowledge, this is the first study to evaluate the efficacy of PVP-I as a topical agent in the treatment of chronic suppurative otitis media. The results show that clinically, topical PVP-I is as effective as topical ciprofloxacin, with a superior advantage of having no in vitro drug resistance. Also, there is an added benefit of reduced cost of therapy.

Administration, Topical↗
PubMed1975

Suppuration of the submandibular salivary glands in the neonate.

Suppurative sialadenitis is rare in the neonate and usually involves the parotid glands. Two cases are reported of suppuration of the submandibular gland in the newborn. Diagnosis was made by clinical signs of infection, appearance of a unilateral, erythematous submandibular mass, and expression of pus from the orifice of Wharton duct under the tip of the tongue. Gram stain, culture, and antibiotic sensitivity studies were done on the purulent material. Staphylococcus aureus grew in both cases and was sensitive to treatment with methicillin sodium. This report discusses the management of these cases, with speculation about the possible cause. To my knowledge, these are the only two cases found in the literature of suppurative submandibular sialadenitis occuring as an isolated lesion in the neonatal period.

Humans↗
PubMed1996

Aerobic and anaerobic microbiology of superficial suppurative thrombophlebitis.

OBJECTIVE: To study the aerobic and anaerobic microbiologic characteristics of superficial suppurative thrombophlebitis. DESIGN: Retrospective review of microbiologic and clinical data. SETTING: Navy Hospital in Bethesda, Md. RESULTS: Sixty-one isolates, 36 aerobic and 25 anaerobic, were isolated from samples obtained from 42 patients. Aerobic bacteria only were found in 26 (62%) patients; anaerobic only, in 11 (26%); and mixed aerobic and anaerobic bacteria, in five (12%). The predominant aerobic bacteria were Staphylococcus aureus (n = 9), Escherichia coli (n = 7), Pseudomonas aeruginosa (n = 4), and Klebsiella sp (n = 3). The most frequently recovered anaerobic bacteria were Peptostreptococcus sp (n = 8), Propionibacterium acnes (n = 6), Bacteroides fragilis group (n = 5), Prevotella intermedia (n = 3), and Fusobacterium nucleatum (n = 3). Propionibacterium acnes and Peptostreptococcus sp were associated with cannula-related superficial suppurative thrombophlebitis; B fragilis and Enterobacteriaceae, with abdominal surgery or pathology; and S aureus and P aeruginosa and Citrobacter sp, with burns. CONCLUSION: These data illustrate the importance of anaerobic bacteria in superficial suppurative thrombophlebitis.

Adult↗
PubMed1986

Percutaneous biliary drainage in acute suppurative cholangitis.

One hundred and sixteen percutaneous drainage procedures of the biliary system were performed in a 2-year period. Eight of 9 acutely ill patients with the diagnosis of acute suppurative cholangitis were successfully treated nonoperatively. They represented 26% of all patients with benign or postsurgical obstruction referred for biliary decompression. Conversely, acute suppurative cholangitis only occurred in 2.3% of patients with underlying malignant disease. These observations are considered most relevant in predicting the purulent nature of the disease, with further implications for patient management. Early recognition and prompt decompression of the biliary system are mandatory, along with the appropriate antibiotic coverage. Our experience compares favorably with surgical results and the procedure is proposed as the method of choice for the initial treatment of acute suppurative cholangitis.

Acute Disease↗