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.

SourceResearch connectionFrom yearThrough year

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

At least 1,099 records · Page 61Linked to original sources

PubMedDate not supplied

A rat model of unilateral utero-tubo-ovarian abscess.

Unilateral (utero-tubo-ovarian) abscesses were produced in rats with Bacteroides fragilis in pure culture. One horn of the rat's bicornuate uterus was ligated, and the inoculum of B. fragilis was placed in the uterine horn above the point of ligation. The 50% infecting dose (ID50) of B. fragilis was approximately 10(5) colony forming units (cfu). When harvested the abscesses contained up to 10(8) cfu of B. fragilis in pure culture as well as many white blood cells. Abscesses were 2-3 cm in length and contained 0.5-1.5 ml of purulent material. The oxidation-reduction potential (Eh) of the abscesses ranged from -230 to -323 millivolts. Abscess formation was comparable in all four phases of the estrous cycle. In rats treated with depoestradiol (to create a high-estrogen state), the rate of growth and size of the abscesses (3-5 cm in length and 2-3 ml of purulent material) were greater than in untreated rats.

Abscess↗

PubMed1999

Spinal epidural abscess associated with epidural catheterization: report of a case and a review of the literature.

We describe a 53-year-old man who developed a catheter-related epidural abscess 8 days after left upper lobectomy for lung cancer. Methicillin-resistant Staphylococcus aureus (MRSA) was detected in a culture of the epidural pus. Magnetic resonance imaging was essential for the diagnosis of epidural abscess and for determining the extent of spread. The patient was treated by laminectomy and administration of appropriate antibiotics, with almost complete recovery, except for urinary retention. A literature search yielded 29 additional cases of catheter-related epidural abscess. The median duration of catheterization was 4 days and the median time to onset of the clinical symptoms after catheter placement was 8 days. Eleven of the 30 patients had some underlying disorders, including malignancy or herpes zoster, or were receiving steroids. Nine of the 10 patients with thoracic epidural abscess had persistent neurological deficits, whereas 12 of the 15 patients with lumbar epidural abscess showed a full recovery after treatment. Surgical decompression was not required in six patients without significant neurological deficits, who recovered following antibiotic treatment (four patients) or percutaneous drainage (two patients). Thoracic catheters are associated with a disproportionately high incidence of epidural abscess and persistent neurological sequelae following treatment.

Abscess↗

PubMed2004

IL-1 and TNF-alpha play a pivotal role in the host immune response in a mouse model of Staphylococcus aureus-induced experimental brain abscess.

Brain abscesses represent a significant medical problem despite recent advances made in detection and therapy. Using an established Staphylococcus aureus-induced brain abscess model, we have sought to define the functional importance of interleukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), and IL-6 in the host anti-bacterial immune response using cytokine gene knockout (KO) mice. Previous studies from our laboratory revealed that these cytokines are among the main proinflammatory mediators produced during the acute stage of brain abscess development. The results presented here demonstrate that although they share many redundant activities, IL-1 and TNF-alpha are important for containing bacterial infection in evolving brain abscesses as evident by increased mortality and bacterial burdens in IL-1 and TNF-alpha KO mice compared to wild type (WT) animals. In contrast, IL-6 was not found to be a major contributor to the host anti-bacterial immune response. Microarray analysis was used to evaluate the downstream consequences originating from the lack of IL-1 on subsequent proinflammatory mediator expression in brain abscesses from IL-1 KO and WT animals. Although numerous genes were significantly induced following S. aureus infection, only IL-1beta and 2 chemokines, CCL9 (macrophage inflammatory protein-1 gamma/MIP-1gamma) and CXCL13 (B lymphocyte chemoattractant/BLC), were differentially regulated in IL-1 KO versus WT animals. These results suggest that IL-1 and TNF-alpha play a pivotal role during the acute stage of brain abscess development through regulating the ensuing anti-bacterial inflammatory response.

Animals↗

PubMed2002

Bacterial brain abscess: microbiological features, epidemiological trends and therapeutic outcomes.

BACKGROUND: Despite the advent of modern neurosurgical techniques, new antibiotics, and powerful imaging technologies, brain abscess remains a potentially fatal central nervous system infection. AIM: To determine the epidemiological trends, prognostic factors, and outcomes of bacterial brain abscess, to improve the therapeutic strategy for this disease. DESIGN: Retrospective hospital-based epidemiology study. METHODS: Over a period of 15 years (1986-2000), 123 patients were retrospectively identified as having brain abscesses at Kaohsiung Chang Gung Memorial Hospital. To compare changes over time, the appearance of disease among our patients was divided into two time periods: 1986-1993 and 1994-2000. RESULTS: The prevalence rate of brain abscesses caused by Gram-negative organisms significantly increased in the second study period. Viridans streptococci and Klebsiella pneumoniae were the two prevalent pathogens associated with haematogenous spread. Metastatic septic abscess, a devastating complication of K. pneumoniae septicaemia, frequently occurs in diabetic patients, with a high mortality rate. Viridans streptococci were the most prevalent pathogens from infection in paranasal sinusitis, but no fatality occurred. In recent years, head trauma and/or post-neurosurgical states have become important predisposing factors, and nosocomial infections also play an important role. DISCUSSION: Despite the availability of new antibiotics and the development of better neurosurgical techniques, therapeutic outcomes of brain abscess showed no significant change when comparing the two study periods, and only the presence of septic shock influenced outcome.

Adolescent↗

PubMed1997

Epidemiological aspects of liver abscesses in children in the Western Cape Province of South Africa.

A high incidence (28 per 100,000 admissions) of liver abscesses is reported in children from the Western Cape Province of South Africa. Of a total of 84 childhood hepatic abscesses over a 10-year period, 51 per cent (43 patients) were primary pyogenic, 30 per cent (25 patients) amoebic, 2 per cent (two patients) Ascaris, and 17 per cent (14 patients) were culture negative. Protein calorie malnutrition was evident in 56 per cent of cases. Amoebic abscesses originated in patients from rural areas, whereas pyogenic abscesses occurred in patients from urban and periurban environments. Staphylococcus aureus was cultured in 85 per cent of pyogenic liver abscesses. Gram negative organisms were identified in four cases of amoebic hepatic abscess where secondary infection occurred. Co-existing parasites of Ascaris lumbricoides and Trichuris trichiura were identified in the stools of 31 per cent of patients. A low (4.8 per cent) mortality is reported for this series.

Chi-Square Distribution↗

PubMed1997

Spontaneous healing of pancreatic abscess after fistulization to the duodenal bulb.

A 70-year-old man was admitted to the hospital because of sudden, upper abdominal and back pain. Laboratory and image data indicated acute pancreatitis. Shortly after the admission, pancreatic and liver abscess with bacteremia developed. Antibiotic therapy seemed effective. A month later, spontaneous fistulization of the pancreatic abscess to the duodenal bulb was found by gastroduodenal fiberscopy. Injection of contrast medium into the duodenal orifice showed that the fistula was draining the abscess and that no other fistula formed from the abscess. Endoscopic retrograde cholangiopancreatogram indicated no fistula formation to the pancreatic duct. The pancreatic abscess became smaller and was not visible using computerized tomography and ultrasonography 3 months later and thereafter. Closure of the duodenal orifice was ascertained by the endoscopy. It is suggested that retrograde infection from the fistula was prevented by the single fistulization to the acidic duodenal bulb, which is not supposed to allow most bacterial growth. Pancreatic abscess usually necessitates operative treatment, even with fistulization to the alimentary tract. It seems likely that the single, small fistulization to the bulb, in addition to the lack of underlying disease and medical and nutritional support, facilitated the spontaneous healing process.

Abscess↗

PubMed1986

Factors contributing to fatal outcome after treatment of pancreatic abscess.

The authors analyzed 27 patients with pancreatic abscess treated since 1975 at hospitals affiliated with the University of Louisville School of Medicine. Treatment consisted of careful debridement, abscess drainage, and multiple antibiotics in all patients. Overall mortality was 33%; however, only three of 17 patients treated since 1980 have died. Patients who died were more likely to have bacteremia, a residual abscess, multiple organ system failure, and/or polymicrobial growth on culture of the abscess. The proper use of soft suction drains in a dependent position reduced the rate of residual abscess to 19% compared to 67% in patients not treated in this fashion. The results identify factors that are correlates of death in patients with pancreatic abscess and emphasize the importance of prompt diagnosis and proper treatment.

Abscess↗

PubMed1995

Nosocomial bacteremia-induced increases in abscess formation correlate with in vitro upregulation of macrophage procoagulant activity.

OBJECTIVE: To evaluate the hypothesis that sublethal exposure to common nosocomial pathogens can alter the host response to a later, distant infectious insult (peritonitis and intraperitoneal abscess formation), and that these changes are related to the induction of macrophage procoagulant activity. DESIGN: A multiexperiment, randomized, controlled trial. SETTING: Animal research laboratory of a university medical center. SUBJECTS: One hundred sixty-five Balb/c mice, weighing 20 to 25 g, were used for in vivo experiments and as the source of peritoneal macrophages for in vitro experiments. INTERVENTIONS: Nine groups of mice (n = 10 to 18 per group) were twice systemically preexposed to sublethal amounts of live Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginosa, Staphylococcus epidermidis, Enterococcus faecalis, or Candida albicans, or to 2.5 or 5.0 micrograms E. coli lipopolysaccharide O26:B6. One week later, mice underwent the induction of mixed E. coli/Bacteroides fragilis peritonitis, leading to abscess formation. In parallel experiments in vitro, 10(6) mouse peritoneal macrophages were incubated with similar amounts of nosocomial pathogens or lipopolysaccharide to determine the induction of macrophage procoagulant activity. MEASUREMENTS AND MAIN RESULTS: The three Gram-negative bacilli tested significantly upregulated both abscess formation and macrophage procoagulant activity, with a strong linear correlation between abscess formation and procoagulant activity. These effects were not seen with the Gram-positive cocci or with C. albicans. Pre-exposure of mice to endotoxin alone did not alter later abscess formation, but did increase macrophage procoagulant activity. CONCLUSIONS: Sublethal exposure to some Gram-negative nosocomial pathogens can significantly alter a host's response to a later, distant, infection, even when caused by different bacteria. In the case of peritonitis and intraperitoneal abscess formation, these changes may be mediated by the upregulation of macrophage procoagulant activity. The presence of endotoxin alone does not completely explain these phenomena.

Abdominal Abscess↗

PubMed1992

Magnetic resonance imaging of abscesses using lipid-coated iron oxide particles.

RATIONALE AND OBJECTIVES: The authors investigated whether iron oxide particles can be used as a magnetic resonance imaging (MRI) contrast agent to image abscesses in a two-stage experimental design. METHODS: Human buffy coat was incubated with iron oxide particles of different sizes and coatings. Smears of the incubation mixture were made on a glass slide and stained for iron. The percentage of iron oxide uptake was determined by counting 100 neutrophils and monocytes and scoring the number of cells that contain iron. Subcutaneous abscesses were created in the flanks of 18 Sprague-Dawley rats by injecting them with 0.1 mL of turpentine. Iron oxide was given intravenously, and the animals were imaged by MRI (1.5 T) 12 to 24 hours later. Different iron oxide coatings and doses were compared. RESULTS: The four different types of coating (constant fragment [Fc] of IgG, bovine serum albumin [BSA], lipid [Ferrosome], and dextran) had an uptake of 72% +/- 5.3%, 61% +/- 6.2%, 30.5% +/- 6.8%, and 5% +/- 2.5%, respectively. Comparison of two particle sizes (mean, 90 versus 35 nm) showed the large particles to have higher uptake (61% +/- 6.2%) compared with the small particles (6% +/- 1.8%) (P less than .001). Post-contrast imaging of the rats showed a hypointense ring around the abscess only in the animals injected with the lipid-coated agent. The effect was discernible within 12 hours after contrast injection and at a dose of 25 mumols iron/kg. Histologic sections showed phagocytic cells with iron granules in the periphery of the abscess. No hypointense ring on MRI or iron granules on histologic sections was seen around the abscess of the control animals or those injected with BSA-iron oxide or Fc-iron oxide. CONCLUSIONS: Lipid-coated iron oxide particles can be used to image abscesses by virtue of their phagocytosis into surrounding inflammatory cells. Positive uptake of these particles by human phagocytes in vitro suggests that similar results may be applicable in humans.

Abscess↗

PubMed1978

Evaluation of abdominal abscess with computed tomography.

Computed tomography (CT) is valuable in providing a specific diagnosis of abdominal abscess and in determining its site and extent. Computed tomography is also capable of excluding an abscess with a high degree of certainty. In 31 of 34 patients with proven abdominal abscess, CT suggested the correct diagnosis and accurately defined the extent of involvement. In nine patients, the CT findings were specific for abscess. The CT appearance of abscess is diverse, largely depending on its location. The most common appearance is a low density mass often with higher density at the periphery. The presence of gas distributed within the mass or an extraalimentary air--fluid level allows an extremely confident diagnosis of abscess. Differential diagnostic possibilities are reviewed with emphasis on interpretive problems.

Abscess↗

PubMedDate not supplied

Tuberculous abscess in retromammary region: CT findings.

PURPOSE: Our goal was to evaluate CT findings of tuberculous abscess in the retromammary region of the breast. METHOD: Four patients with tuberculosis extending from the retromammary region to the pleura were examined by CT and the findings were evaluated. All cases were also examined with mammography and two cases were evaluated with sonography. Diagnosis was confirmed by acid-fast bacillus stain, culture, and histologic examination. RESULTS: Mammography showed relatively smoothly marginated, round mass density in two cases, nodular density in one, and focal bulging of the pectoral wall in one. A sonogram demonstrated in two cases a fistulous connection from the heterogeneous, fluid-containing lesion with floating internal debris in the retromammary region to the thoracic cavity. In all four cases, CT showed relatively smoothly marginated, inhomogeneous, hypodense lesions with surrounding rims of the cold abscess type. A direct fistulous connection from the retromammary lesion through the thoracic wall into the pleura was seen in two cases. Destroyed rib fragments within the abscess were noted in two cases. CONCLUSION: A tuberculous abscess in the retromammary region usually showed on CT a focal, smoothly marginated, inhomogeneous, hypodense lesion with a surrounding enhancing rim. A direct fistulous connection with the pleura or a destroyed rib fragment in the abscess as revealed by CT can be helpful in the differential diagnosis of other infectious types of retromammary abscess.

Abscess↗

PubMedDate not supplied

Abscesses in Crohn's disease: outcome of medical versus surgical treatment.

GOALS: To compare the long-term outcome of medical, percutaneous, and surgical treatment of abdominal and pelvic abscesses complicating Crohn's disease. STUDY: All patients with Crohn's disease and an abdominal abscess treated at one institution during a 10-year period were retrospectively identified. We reviewed hospital and outpatient records and contacted patients for telephone interviews. Outcome measures included abscess recurrence, subsequent surgery for Crohn's disease, and medications used at the time of most recent follow-up. RESULTS: Fifty-one subjects were identified, with a mean follow-up of 3.75 years. Fewer patients developed recurrent abscesses after initial surgical drainage and bowel resection (12%) than patients treated with medical therapy only or percutaneous drainage (56%) (p = 0.016). One half of the patients treated nonoperatively ultimately required surgery, whereas only 12% of those treated with initial surgery required reoperation during the follow-up period (p = 0.010). Most failures of nonoperative therapy occurred within 3 months. Medication use was similar between the treatment groups at the time of most recent follow-up. CONCLUSIONS: In this series, surgical management of abscesses in Crohn's disease was more effective than medical treatment or percutaneous drainage for prevention of abscess recurrence. However, nonoperative therapy prevented subsequent surgery in half of the patients and may be a reasonable treatment option for some patients.

Abdominal Abscess↗

PubMed1996

Endonasal endoscopic surgery for rhinogen intraorbital abscess: a report of six cases.

Intraorbital abscess is a serious complication of sinusitis with the danger of permanent loss of vision and even the danger of life-threatening progress. The recommended surgical procedure in the literature for drainage of an intraorbital abscess is the external approach. We report on successful functional endonasal endoscopic surgery in a series of six sequential cases with intraorbital abscesses following sinusitis. The main advantages of this approach are the simultaneous treatment of causative disorders with surgery following the pathogenic route of the abscess formation and lack of trauma to further structures. The endoscope with 25- or 70-degree angled axis of vision enables the surgeon to explore and drain the abscess cavity, which often is located behind the bulbus, with minimal trauma. For the trained surgeon the field of vision is favorable as compared with the external approach when the abscess is located right in the axis of vision and one has to cut through healthy tissue and the intact skin, which, especially in children, can lead to long-lasting visible scars.

Abscess↗

PubMed2000

Otolaryngology consultation for peritonsillar abscess in the pediatric population.

OBJECTIVE: To assess clinical outcomes of children seen in consultation for peritonsillar abscess treated without the routine use of computed tomography or needle aspiration. STUDY DESIGN: Retrospective review of patients evaluated in the emergency department for possible peritonsillar abscess. Patient outcomes are reviewed with a statistical analysis of children grouped according to age. METHODS: A series of 102 patients, ages 8 months to 19 years, who were evaluated by the emergency department with otolaryngology consultation for possible peritonsillar abscess. All patients were admitted and given intravenous fluid replacement, antibiotics, and analgesia. Patients who responded to 24 hours of medical treatment were discharged, whereas patients who did not respond underwent elective tonsillectomy. MAIN OUTCOME MEASURE: Outcome of patients evaluated for peritonsillar abscess treated without immediate surgery, needle aspiration, or computed tomography. Outcomes are correlated with age and clinical findings. RESULTS: Fifty-two patients were discharged after initial medical therapy. Fifty patients underwent elective tonsillectomy; 40 of these patients were found to have abscesses at the time of surgery. When analyzed according to age, patients ages 8 months to 6 years were more likely to respond to medical treatment than children ages 7 to 12 and 12 to 19 (P = .023). Significant differences in the mean age of children requiring surgery (11.0 y) compared with those who responded to medical treatment (7.9 y) were observed (P = .003). Younger children who underwent tonsillectomy had a lower incidence of surgically confirmed abscess. CONCLUSIONS: A significant number of children presenting with odynophagia, malaise, pharyngotonsillar bulge, and decreased oral intake respond to medical therapy without radiological evaluation or surgical intervention. Additionally, younger children (1-6 y) are more likely to respond to medical treatment than older children. Pertinent clinical data, as well as advantages and disadvantages of this approach, are discussed.

Adolescent↗

PubMed2001

A unique case of Bezold's abscess associated with multiple dural sinus thromboses.

OBJECTIVES/HYPOTHESIS: Bezold's abscess and dural sinus thromboses are rare complications of otitis media in the era of antibiotics. Although potentially fatal, they are treatable. We present a unique case report of Bezold's abscess in association with multiple dural sinus thromboses. STUDY DESIGN: Single case report. METHODS: A young female patient's clinical course is presented and discussed. We review the anatomy, incidence, pathogenesis, and treatment of Bezold's abscess and dural sinus thrombosis. RESULTS: After mastoidectomy, neck exploration, broad-spectrum intravenous antibiotics, and anticoagulation therapy, the patient recovered fully and has remained asymptomatic since her discharge from the hospital at 12 months' follow-up. CONCLUSIONS: This is the first reported case of Bezold's abscess associated with a cavernous sinus thrombosis and the third reported case of Bezold's abscess associated with lateral sinus thrombosis. Despite its rarity, Bezold's abscess must be recognized and treated aggressively. Dural sinus thrombosis is relatively more common, and treatment of the underlying cause is essential. The diagnosis and rapid, aggressive treatment of these conditions are essential for an optimal clinical outcome.

Abscess↗

PubMed1996

Posttraumatic gas-containing brain abscess caused by Clostridium perfringens with unique simultaneous fungal suppuration by Myceliophthora thermophila: case report.

OBJECTIVE AND IMPORTANCE: Gas-containing brain abscesses are rare, and the vast majority are caused by Clostridium perfringens. Significant simultaneous fungal infection in a bacterial abscess is even rarer. We present such a case and review the literature. CLINICAL PRESENTATION: A 21-month-old male patient sustained a penetrating head injury in a barnyard, developed a gas-containing left parietal brain abscess, and presented with high fever, galeal swelling, and seizure. INTERVENTION: The patient initially underwent debridement of his wound and then repeated aspirations. The initial cultures revealed pure growth of Clostridium perfringens. Despite appropriate antibiotic therapy, serial neuroimaging did not demonstrate a decrease in the size of the cavity. An excision had to be undertaken 6 weeks after the injury. The culture from the excised specimen revealed an unexpected growth of a saprophytic and opportunistic fungus, Myceliophthora thermophila. Antifungal treatment consisting of the administration of liposomal amphotericin B and itraconazole was then performed. The child was well and neurologically intact 6 months after the excision. CONCLUSION: Our review revealed 38 cases of clostridial brain abscess in the literature. Despite the reputation of the organism, the outcome with clostridial brain abscesses was relatively benign. The main characteristics of clostridial brain abscesses are highlighted, with reference to their optimal treatment. Our review also revealed that fungal infection after a penetrating head injury is extremely rare and often fatal. Our case seems to be the first in the medical literature with growth of M. thermophila as a causative agent for intracranial suppuration.

Amphotericin B↗

PubMed1997

Cerebellar abscess: the significance of cerebrospinal fluid diversion.

OBJECTIVE: Cerebellar abscesses that are often ominously silent have a significant mortality. Sudden total occlusion of cerebrospinal fluid (CSF) pathways makes an aggressive surgical approach mandatory. Our neurosurgical unit at Wentworth Hospital, Durban, South Africa, prospectively instituted a protocol for patients with cerebellar abscesses with reference to CSF diversion with the aim of improving outcome. Our 13-year experience with this approach to cerebellar abscesses is presented. METHODS: Since 1983, patients with cerebellar abscesses have been managed according to a standard protocol. In 1987, a policy of aggressive CSF diversion was prospectively instituted. This involved immediate CSF diversion in any patient with over or incipient hydrocephalus, even if fully conscious. The associated hydrocephalus was diagnosed on initial computed tomographic scans. CSF diversion was performed by means of a ventricular drain, inserted in the reception area under local anesthesia. The period from January 1983 to December 1995 was analyzed, and the impact of aggressive CSF diversion on patient outcome was evaluated. RESULTS: Seventy-seven patients with cerebellar abscesses during the 13-year period under review were studied. Thirty-four patients were treated before the introduction of the policy of aggressive CSF diversion. Of these patients, 10 died, resulting in a mortality of 29% and a morbidity of 21%. Forty-three patients were treated after the institution of the new policy of CSF diversion. Of these patients, five died, resulting in a mortality rate of 11.6% and a morbidity rate of 14%. CONCLUSION: Although surgical drainage of a cerebellar abscess and eradication of the primary septic source and appropriate antibiotic coverage are necessary, the management of hydrocephalus, or even incipient hydrocephalus, is of paramount importance.

Adolescent↗

PubMed1998

Abscess formation in invasive pituitary adenoma: case report.

OBJECTIVE AND IMPORTANCE: Pituitary abscess is rare, with few cases of secondary pituitary abscess reported. To our knowledge, only 14 cases of pituitary adenomas with abscess have been reported, and this is the first report to include a magnetic resonance image of a pituitary adenoma with abscess. CLINICAL PRESENTATION: A 22-year-old man presented with decreasing vision, headache, and vomiting. His higher functions were normal, with visual disturbance in both eyes. Computed tomographic scans and magnetic resonance images were suggestive of a sellar tumor with a cystic component. INTERVENTION: A right pterional craniotomy was performed, and the tumor was debulked, revealing an abscess in the center. Postoperatively, the patient received a regimen of antibiotics. CONCLUSION: Early surgical intervention plus follow-up antibiotic therapy are the mainstay of treatment for abscess formation in pituitary adenomas.

Abscess↗