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PubMed1991

[A goal-oriented local approach to the prevention of postoperative suppurative complications].

A goal-oriented local approach to the prevention of postoperative purulent complications includes the use of compression suture devices to establish intestinal anastomoses and a complex of measures aimed at preventing surgical wound suppurations. To form compression anastomoses, use was made of the original AKA-2, AKA-4, IZhKA and SPTU devices fitted with compression clamps and of magnet facilities. The complex of measures to prevent postoperative wound suppurations includes optimal methods of laparotomy wound suture and the use of antibacterial suture materials, bathing of the wound by pulsed douche under pressure, local antibacterial prophylaxis by new dosage forms, preventive aspiration lavage and drainage of the wounds. Comparative clinical investigations carried out in more than 3,000 patients have demonstrated the effectiveness of the preventive methods under consideration and a decrease of the rate of postoperative wound suppurations from 11.7 to 2.3%. The rate of anastomosis failure amounted to 2.7%.

Anastomosis, Surgical↗
PubMed1986

[Efficacy evaluation of aztreonam for suppurative otitis media].

Preclinical and clinical studies were performed to evaluate usefulness and safety of aztreonam (AZT) in the treatment of acute otitis media, acute exacerbation of chronic otitis media and chronic otitis media and the following results were obtained. MICs for P. aeruginosa, P. mirabilis and P. inconstans isolated from the patients with suppurative otitis media were 1.56 micrograms/ml, less than or equal to 0.025 micrograms/ml and less than or equal to 0.025 micrograms/ml respectively in their peaks. In the intravenous injection of 1 g, AZT concentration in the mastoid cell mucosa was 7.52 micrograms/g on average and serum concentration 51.6 micrograms/ml sufficiently suggesting clinical efficacy of AZT. In the clinical trial by administering AZT 1-2 g/day for the patients with suppurative otitis media, effective rates were 2/3 (66.7%) for acute otitis media, 16/22 (72.7%) for acute exacerbation of chronic otitis media, 21/34 (61.8%) for chronic otitis media and 6/7 (85.7%) for cholesteatoma of the middle ear. Elimination rate of single Gram-negative pathogens was 82.1% in the bacteriological studies of AZT. As for abnormal laboratory findings, 7 cases showed GOT, GPT elevations. However, they were in minor degree and transient. Side effect was not noted except 1 case of flushing with itching. It was considered from the above results that AZT is a highly useful antibiotic for suppurative otitis media.

Adult↗
PubMed1986

Differential diagnosis of granulomatous meningoencephalomyelitis, distemper, and suppurative meningoencephalitis in the dog.

Clinical differences were determined between granulomatous meningoencephalomyelitis, distemper, and suppurative meningoencephalitis in the dog. Dogs with granulomatous meningoencephalomyelitis had "head" signs on examination, which progressed to profound caudal fossa abnormalities, changes in mental status, and tetraparesis. Dogs with distemper had a gradual onset of posterior paresis; tetraparesis and occasional vestibular signs developed later in the course of disease. Dogs with suppurative meningoencephalitis had lethargy and anorexia at the time of examination, which progressed to nuchal rigidity, mental depression, tetraparesis, and profound alterations in consciousness. Analysis of cerebral spinal fluid was useful in distinguishing suppurative meningoencephalitis from the other 2 diseases. Twenty-seven cases of inflammatory disease of the CNS in dogs were reviewed. Comparisons of history, results of physical and neurologic examinations, ancillary data, and response to treatment were made. It appeared that certain clinical and neurologic features contributed to the diagnosis of these diseases.

Animals↗
PubMed1985

Esophageal carcinoma masquerading as recurrent acute suppurative thyroiditis.

A 61-year-old woman had clinical features of acute suppurative thyroiditis that was recurrent and refractory to antibiotic therapy. The diagnosis of acute suppurative thyroiditis was established by a fine-needle aspiration biopsy procedure, yielding suppurative material from which anaerobic and aerobic bacteria grew. Subsequent investigation with a barium swallow study followed by esophagoscopy and biopsy confirmed extensive esophageal carcinoma with a fistulous tract extending into the perithyroidal region.

Carcinoma↗
PubMed1985

[Prevention of wound infection after pulmonary resection of acute suppurative disease].

The appearance of suppuration of the operation wound is real after resection of lungs for a restricted and spread gangrene despite prophylactic use of antibiotics and washing of the wound with antiseptics. Early diagnosis of local suppuration of the wound, effective drainage of the focus and increase of non-specific resistance give a way out of the situation. Choice of diagnostic criteria of suppuration and a method of correction of healing the thoracotomic wound are presented.

Combined Modality Therapy↗
PubMedDate not supplied

[Some aspects of current medical treatment of bronchopulmonary suppurations].

Due to their frequency, which is still significant in the frame of respiratory pathology, bronchopulmonary suppurations especially those of the secondary type, developing on previously existing lesions such as chronic bronchitis, bronchiectasis, bronchial asthma, bronchial carcinoma, aerial cysts, etc. rise bacteriological, therapeutical and epidemiologic difficulties for the general practitioner. An analysis is presented, of a group of 619 patients with suppurated bronchopneumopathies, hospitalized in 1980 in a department for lung diseases, of whom 116 had primary, and 503 secondary suppurations. In 177 cases (28.5%) monomorphous flora was identified, from the Ps. aeruginosa and Esch. coli strains, as well as Staphylococcus aureus. In 395 patients (64%) cultures remained sterile, and in 171 cases (27.6%) frequent fungal colonies of the Candida genus were evidenced. The medical treatment, which is sometimes difficult due to the severity and the variety of anatomo-clinical forms of the disease, includes, on an individualized basis, symptomatic therapy, anti-infectious and adjuvant therapy dominated by fluidifying drugs, by antibiotics adapted to the various microbial strains, as well as to particular conditions such as acute episodes or superinfections with anaerobic germs. There is an increased interest for re-establishing immunological balance by substitution medication or bio-stimulating preparations such as mono- or polymicrobial vaccines.

Anti-Bacterial Agents↗
PubMed1978

Amyloidosis secondary to drug abuse and chronic skin suppuration.

Amyloidosis has not been included in the wide spectrum of medical complications associated with drug abuse. Chronic visceral infection is a recognized cause of amyloidosis, but chronic suppuration of the skin is not a well-appreciated cause of this condition. Furthermore, to our knowledge, chronic skin suppuration secondary to parenteral drug abuse has not been reported as a cause for systemic amyloidosis. We report a case in which subcutaneous injections of narcotic tablets led to chronic skin suppuration and systemic amyloidosis.

Abscess↗
PubMed1981

Surgical approach to extensive suppurative thrombophlebitis of the central veins of the chest.

Suppurative thrombophlebitis is a potentially lethal intravascular infection associated with the usage of intravenous catheters. Conventional approaches to management include ligation and excision of involved venous structures. These measures may not be feasible in all situations. This paper describes the successful medical/surgical management of a patient with suppurative thrombophlebitis of the major vessels of the chest. When suppurative thrombophlebitis extends into the large central veins and antibiotic therapy fails, surgical intervention may be necessary.

Adolescent↗
PubMed1981

[Diagnostic value of the CT scan in suppurative abdominal lesions (author's transl)].

Computed tomography, a relatively non-aggressive method of radiological investigation, can establish diagnosis, and, more particularly, define the site of suppurative lesions in the peritoneal cavity, the retroperitoneal space, and in solid organs (liver, kidneys, spleen). This method was employed to explore the abdomen in 52 patients. Intraperitoneal suppurations were diagnosed in 15 cases after demonstration of a low density mass, which may contain clear pockets of gas or be limited by a higher density wall. In 4 cases, a retroperitoneal lesion was detected (psoas or perinephric abscess). A parenchymatous abscess was present in 6 cases, 4 in the liver, one in the kidneys, and one in the spleen. Using the angioscan technique, after a bolus injection of an iodised contrast medium, improved definition of the limits of the abscess can be obtained. Differential diagnosis of intraperitoneal suppurative lesions in cases of developing haematomas, or in the presence of an intrahepatic abscess, which may be confused with necrotic metastases or post-traumatic ischaemic foci, may be difficult.

Abscess↗
PubMed1981

[Acute suppurative cholangitis].

1) Acute suppurative cholangitis is the most severe clinical form of bacterial biliary infection. 2) During a 14 year period, 29 patients were treated at the General Surgery Division A, of the Cosme Argerich General Hospital. 3) Patients were divided in two groups; a) acute suppurative cholangitis with (n:100 or b) without (n:19) evidence of biliary obstruction. In the former group, in addition to Charcot's triad, we found mental confusion and septic shock among clinical signs. 4) Gall stones were the most common cause of obstruction, followed by pancreatic and biliary carcinoma. 5) Diagnosis on admission was correct in 40% of patients. Charcot's triad was present in 19 of the 29 patients. 6) All 22 operated patients survived whereas 7 non operated patients died. 7) The high mortality observed was similar to that reported in other publications and could be partly due to delayed diagnosis, and the high frequency of multiple liver abscesses found at autopsy. 8) Newer diagnostic procedures have improved the differential diagnosis of obstructive jaundice. It is hoped that they will help in the earlier recognition of acute suppurative cholangitis and decrease the incidence of severe complications.

Adult↗
PubMed1980

[Prevention of suppurative complications of appendiceal peritonitis (author's transl)].

The high incidence and severity of suppurative complications consecutive to appendiceal rupture in children can justify this review. Mixed colonic flora, with a predominance of "E. coli" among and "B. fragilis" among anaerobes, is constantly recovered from the original purulent exudate as well as from that of suppurative complications. It seems therefore wise to complete surgical treatment with an adequate early antibiotic association direction to the particular flora. Gentamycin and Clindamycin seem to fulfill satisfactorily these requirement. On the contrary, peritoneal irrigation either with antiseptic or antibiotic fluids seems to be practically useless, and so are drains exept when they are inserted to evacuate a localized purulent collection Delayed closure of the contaminated wound can be an additional factor in the prevention of suppurative complications.

Anti-Bacterial Agents↗
PubMed1994

Endoscopic nasobiliary drainage in acute suppurative cholangitis.

BACKGROUND: Acute suppurative cholangitis is associated with significant mortality. It is best managed by drainage of the biliary tree, endoscopic, percutaneous or surgical. AIMS: To study the effect of emergency endoscopic nasobiliary drainage (ENBD) in acute suppurative calculous cholangitis. METHODS: In 37 patients with calculous cholangitis, an endoscopic nasobiliary drain (7 F) was placed in the biliary tree above the site of obstruction to ensure continuous biliary drainage. RESULTS: Success rate was 100% and there was no mortality. ENBD was performed in 4 very sick patients without the aid of fluoroscopy. Cholangitis improved in 36 of 37 patients within 12-24 hours. When the clinical condition improved, all the 36 patients were taken up for elective biliary surgery or endoscopic sphincterotomy and stone extraction. CONCLUSIONS: Emergency endoscopic nasobiliary drainage is an effective method in managing patients with acute suppurative calculous cholangitis.

Acute Disease↗
PubMed1993

Ultrasonography and fine needle aspiration cytology of acute suppurative thyroiditis.

Although acute suppurative thyroiditis is a rare disorder, from January. 1985 to December 1991, we observed 11 cases of acute suppurative thyroiditis in our hospital. All patients underwent thyroid ultrasonography and fine needle aspiration biopsy and cytologic evaluation of the specimens. In eight cases, pus cultures were positive, four of them grew Gram negative bacteria. Ultrasonographic finding showed either local or diffuse low to a very low echo density on both lobes. However, a cystic lesion was also found. Polymorphonuclear cells were the main elements in the smears from the thyroid aspirates. In conclusion, thyroid ultrasound with fine needle aspiration and cytology can assist in confirming the early diagnosis of acute suppurative thyroiditis.

Acute Disease↗
PubMedDate not supplied

[Endoscopic biliary drainage in acute suppurative cholangitis].

Acute suppurative cholangitis is a life-threatening condition and prompt biliary decompression (BD) is essential for survival. The evolution of thirty-one patients (21 women and 10 men, mean age 64 years) with acute suppurative cholangitis attended from February 1989 to February 1994 treated by endoscopic cannulation and sphincterotomy for biliary drainage were retrospectively reviewed. The mean hospital stay was 18 +/- 12 days and during hospitalization there were 5 deaths, none related to biliary drainage. Sixteen patients had previous cholecystectomy, 12 patients had previous cholangitis in the last year, 23 patients had choledocholithiasis and an additional three patients pancreatobiliary neoplasias and common duct stones. Only 67.7% showed the classic Charcot's triad (fever, abdominal pain and jaundice). Total bilirubin, aspartate aminotransferase, alanine aminotransferase and total leukocytes decreased significantly (p < 0.05) after BD. Retroperitoneal perforation was the only complication is a safe and effective procedure for emergency biliary decompression in the treatment of acute suppurative cholangitis.

Acute Disease↗
PubMed2006

Six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei infection.

Melioidosis, an infection caused by Burkholderia pseudomallei, is endemic in Southeast Asia and northern Australia. It can have various presentations, ranging from acute septicaemia to chronic localized infection. Uncomplicated, localized infection usually involves skin or subcutaneous tissues. Suppurative lymphadenitis caused by melioidosis has been rarely encountered by clinicians practicing in endemic areas. We encountered six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei in adults who were admitted to hospital in Singapore from 1997 to 2000. The most striking difference between these patients and cases reported previously was the pattern of the lymph node involvement. In the majority of previously described patients the infected lymph nodes were in the head and neck region. By contrast, four patients in our study presented with unilateral, inguinal lymphadenitis. Another two patients presented with mediastinal lymphadenitis and prolonged fever. All patients had prompt and sustained response to therapy. Melioidosis should be considered in the differential diagnosis of suppurative, regional lymphadenitis, especially in patients who travelled to, or stayed in, an endemic area.

Adolescent↗
PubMed1997

Non-suppurative myocarditis in piglets associated with porcine parvovirus infection.

The involvement of porcine parvovirus (PPV) in the aetiology of non-suppurative myocarditis in sucking piglets was investigated by a polymerase chain reaction (PCR), designed to assess the presence of viral genome in formalin-fixed paraffin wax-embedded tissue of diseased animals. Myocardium and lung of stillborn piglets with a confirmed PPV infection were used to set up the PCR amplification method. Subsequently, 20 myocardia with inflammatory lesions were examined in parallel with 20 myocardia without lesions, from age-matched control piglets. Tissues were first tested for the presence and the integrity of porcine DNA by amplifying a sequence encoding the highly conserved nuclear protein histone H4. Tissue from 15 out of 20 animals with myocarditis contained amplifiable histone H4 DNA and in 12 of the 15 histone H4-positive samples, PPV DNA was detected. It proved possible to amplify histone H4 DNA in all 20 negative controls (without myocarditis), and PPV DNA was detected in three cases. In-situ hybridization with a digoxigenin-labelled probe homologous to PPV was performed in four PCR-positive cases of non-suppurative myocarditis. In two animals several positively stained nuclei were observed in the myocardium, within or close to the mild inflammatory cellular infiltrates. These results strongly suggest that PPV can cause non-suppurative myocarditis in sucking piglets.

Animals↗
PubMed2005

[Lung transplant therapy for suppurative diseases].

OBJECTIVE: Lung transplantation is a valid therapeutic approach for patients with bronchiectasis. The objective of the present study was to evaluate our experience with bronchiectasis patients and compare the results in patients with cystic fibrosis to results in those with bronchiectasis caused by other processes. PATIENTS AND METHOD: We carried out a retrospective study of bronchiectasis patients treated by lung transplantation in order to analyze demographic, functional and microbiological characteristics before and after transplantation, and survival. RESULTS: From 1991 to 2002 lung transplants were performed on 171 patients, 44 of whom had suppurative lung disease (27 had cystic fibrosis and 17 had bronchiectasis caused by other processes). There were no significant differences in the demographic variables between the 2 groups. At transplantation, lung function variables showed severe bronchial obstruction (mean [SD] forced expiratory volume in 1 second of 808 [342] mL and forced vital capacity of 1,390 [611] mL) and respiratory insufficiency (PaO2 at 52 [10] mm Hg and PaCO2 at 48 [9] mm Hg). Only PaO2 was significantly lower in patients with bronchiectasis from causes other than cystic fibrosis. Airway colonization was present in 91% of the patients; Pseudomonas spp germs were detected in 64% of the cases and were multiresistant in 9%. In the early postoperative period germs were isolated in 59% of the cases, half of which involved the same germ as had been isolated before transplantation. One year after lung transplantation, 34% of the patients continued to have bronchial colonization. Survival at 1 year was 79% and at 5 years, 49%, with no significant difference between the patients with cystic fibrosis and those with other suppurative diseases, nor between the patients with and without Pseudomonas colonization. Only 2 patients had died of bacterial pneumonia at 1 month after transplantation. CONCLUSIONS: Although airway colonization in patients with suppurative diseases complicates postoperative management, the results in terms of survival are good.

Adult↗
PubMed2003

Does the addition of endoscopic sphincterotomy to stent insertion improve drainage of the bile duct in acute suppurative cholangitis?

BACKGROUND: The treatment of patients with bile duct stones and acute suppurative cholangitis is emergent biliary decompression either by endoscopic sphincterotomy, nasobiliary drainage, or stent insertion. The aim of this retrospective study was to determine whether endoscopic sphincterotomy, in addition to an internal endoprosthesis, improves outcome for patients with acute suppurative cholangitis. METHODS: A total of 74 patients with acute suppurative cholangitis and bile duct stones were included in the study; 37 had endoscopic sphincterotomy before insertion of plastic stent (Group 1), and 37 had a plastic stent inserted through an intact papilla (Group 2). RESULTS: The success rates for stent insertion in Groups 1 and 2 were, respectively, 89.2% and 86.5% (p = 1.000). The complication rates in Group 1 and Group 2 were, respectively, 10.8% and 2.7% (p = 0.358). The median (interquartile range 25th-75th percentile) durations of hospital stay for patients in Group 1 and Group 2 were, respectively, 6.5 (4-11) days and 7 (5-12) days (p = 0.614). The median (interquartile range) lengths of time for resolution of jaundice in Group 1 and Group 2 were, respectively, 3 (2-6) days versus 4 (2-5) days (p = 0.981). CONCLUSIONS: Endoscopic sphincterotomy, in addition to biliary stent insertion, is not required for successful biliary decompression in patients with severe acute cholangitis.

Acute Disease↗