amoxicillin-potassium-clavulanate-combination and Cutaneous-Fistula

Topics: Actinomyces; Actinomycosis; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cholecystectomy, Laparoscopic; Coinfection; Cutaneous Fistula; Escherichia coli; Escherichia coli Infections; Humans; Male; Penicillins; Pleural Effusion; Postoperative Complications; Respiratory Tract Fistula; Thoracic Wall; Tomography, X-Ray Computed

Topics: Acute Disease; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cutaneous Fistula; Dacryocystitis; Disease Susceptibility; Female; Fistula; Humans; Infant; Infectious Mononucleosis; Lacrimal Apparatus Diseases; Streptococcal Infections; Streptococcus pneumoniae

Osteopetrosis is a heterogeneous disorder characterized by abnormal bone remodeling and increased bone density primarily due to defective osteoclast resorption. The diagnosis is based on a history of numerous fractures and radiological findings indicative of osteosclerosis, usually sufficient for a definitive diagnosis. We present a quite rare case of osteopetrosis complicated by recurrent episodes of maxillomandibular osteomyelitis associated with cutaneous fistulization and purulent nasal discharge. We used intravenous antibiotic therapy and necrotic bone debridement that prevented the appearance of acute infections over a 3-year follow-up, but the complete healing of the case was not achieved.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Cutaneous Fistula; Debridement; Female; Follow-Up Studies; Humans; Infusions, Intravenous; Jaw Diseases; Nose Diseases; Osteomyelitis; Osteonecrosis; Osteopetrosis; Osteosclerosis; Recurrence

Actinomycosis with an extended pelvic abscess is an uncommon condition, which usually occurs coincident with the presence of an intrauterine contraceptive device (IUD) in the uterine cavity. The clinical picture of pelvic actinomycosis may vary between individuals, is often accompanied by complications, and is frequently misdiagnosed. Here, we report a case of pelvic actinomycosis, presenting as a huge pelvic mass and complicated by a vaginal fistula, a cutaneous fistula, and bilateral hydronephrosis, and we discuss the diagnosis and management of this patient.. A 35-year-old woman was referred to our hospital with a huge pelvic complex mass and progressively worsening low abdominal pain. The tumor workup, which included a computed tomography (CT) scan, revealed an extended pelvic abscess and bilateral hydronephrosis. Both cutaneous and vaginal fistulas were also noted. Endometrial curettage and biopsies of the skin and vaginal lesions confirmed the diagnosis of actinomycosis. The patient underwent conservative treatment and recovered well, although the skin lesion only healed after 12 weeks of oral antibiotic treatment. At the 1-year follow-up, a CT scan showed sequelae including a mildly atrophic left kidney and left hydronephrosis.. In patients presenting with a pelvic mass and an IUD in the uterine cavity, the diagnosis of actinomycosis should be seriously considered. A detailed workup, including a CT scan, endometrial curettage and biopsies where possible, should be performed before surgery. Once diagnosis has been confirmed, conservative medical treatment should be attempted before considering laparotomy, to reduce the risk of complications. Despite successful treatment with antibiotics, long-term sequelae such as hydronephrosis and renal atrophy are possible in cases of extended pelvic actinomycosis.

Topics: Actinomycosis; Adult; Amoxicillin-Potassium Clavulanate Combination; Atrophy; Cutaneous Fistula; Female; Humans; Hydronephrosis; Intrauterine Devices; Kidney; Penicillins; Tomography, X-Ray Computed; Vaginal Fistula