cefotaxime and Hematoma

De novo aneurysm formation is a rare entity of cerebral aneurysms. The authors describe a 19-year-old man presenting with spontaneous intracerebral hemorrhage of unknown etiology. The initial cerebral angiography revealed no identifiable vascular lesion. A few weeks following a surgical evacuation of the hematoma, a tiny saccular aneurysm was incidentally found on the distal posterior cerebral artery (PCA) remote from the site of the primary ictus. Several rationales indicated that it was compatible with a cerebral aneurysm of infective etiology. The aneurysm was successfully treated by antibiotic therapy alone. To the authors' knowledge, de novo aneurysm on the PCA has rarely been reported.

Topics: Anti-Bacterial Agents; Cefotaxime; Cerebral Hemorrhage; Cloxacillin; Hematoma; Humans; Incidental Findings; Intracranial Aneurysm; Male; Posterior Cerebral Artery; Radiography; Young Adult

An 11-month-old boy presented with a 2-day history of non-specific symptoms and a zygomatic haematoma. With aetiology uncertain after admission clerking and blood tests, a CT head scan was arranged for suspected traumatic injury and revealed a retropharyngeal abscess (RPA) with significant airway narrowing in the transverse plane. The patient received urgent intraoral abscess drainage and bilateral tonsillectomy in theatre. This case highlights the need for a high index of suspicion regarding RPAs. These abscesses have potentially fatal sequelae and are difficult to diagnose in the infant paediatric population.

Topics: Acetaminophen; Analgesics, Non-Narcotic; Anorexia; Anti-Bacterial Agents; Cefotaxime; Dexamethasone; Drainage; Hematoma; Humans; Infant; Male; Metronidazole; Postoperative Care; Retropharyngeal Abscess; Tomography, X-Ray Computed; Tonsillectomy; Tonsillitis; Treatment Outcome; Vomiting

Bacterial infection of a cephalhaematoma is rare and has been associated with needle aspiration of the haematoma, placement of scalp electrodes and systemic sepsis. Clinical diagnosis of infected cephalhaematoma is difficult without obvious evidence of local infection. The role of imaging in differentiating infected from non-infected cephalhaematoma has not been clearly established. Needle aspiration is considered mandatory for suspected cases. In this report, we present the magnetic resonance imaging (MRI) findings of a 23-day-old neonate with an infected cephalhaematoma. Cephalhaematoma is a subperiosteal accumulation of blood, thus the diagnosis of infected cephalhaematoma was made as the MRI showed an accumulation of blood under thick, contrast-enhancing periosteum in the presented case. Without a diagnostic puncture, the decision for surgical intervention was made before complicating osteomyelitis developed. Early intervention with simple incision and drainage resulted in prompt improvement.

Topics: Anti-Bacterial Agents; Cefotaxime; Escherichia coli; Escherichia coli Infections; Head; Hematoma; Humans; Infant, Newborn; Magnetic Resonance Imaging; Male; Suction

A 52-year-old man with a gastric signet-ring cell carcinoma but without acute symptoms was admitted for reconstructive surgery of the gastrointestinal tract.. Before the present surgery all functional and radiological tests merely confirmed the previously known disease. Except for mild anemia and abnormal electrolytes all laboratory tests were within normal limits. COURSE, DIAGNOSIS AND TREATMENT: The patient underwent reconstructive surgery of the gastrointestinal tract, namely an ascending sigmoidostomy and resection of an enterocutaneous fistula. For a few days the postoperative development was as expected and the drain, placed during surgery, was removed at the expected time. 9 days postoperatively the patient developed signs of an infection (fever up to 38.8 degrees C, increased WBC and raised C-reactive protein levels). Computed tomography (CT) of the abdomen revealed an epigastric tumor measuring 6 x 5 cm. CT-guided needle aspiration of this lesion showed macroscopic signs of an infected hematoma. A pigtail catheter was successfully implanted for continuous drainage. Both the fluids obtained from CT-guided aspiration and the pigtail drain grew Aeromonas veronii biovar sobria when cultured on standard blood agar. Administration of both cefotaxim and metronidazole for 10 days produced a decrease in the inflammatory parameters. The abdominal CT at that time showed a noticeable regression of the epigastric mass so that the patient was discharged from hospital 3 weeks after surgery.. This case emphasizes the importance of adequately dosed antibiotic therapy, also for unusual bacteria such as species of Aeromonas.

Topics: Aeromonas; Anti-Bacterial Agents; Carcinoma, Signet Ring Cell; Cefotaxime; Gram-Negative Bacterial Infections; Hematoma; Humans; Male; Metronidazole; Middle Aged; Postoperative Complications; Stomach Diseases; Stomach Neoplasms; Treatment Outcome

Topics: Abdominal Muscles; Aged; Cefotaxime; Female; Hematoma; Humans; Muscular Diseases

In an eighteen-year-old boy with a high fever, an intra-hepatic infectious hematoma following blunt hepatic trauma was treated twice with intrahepatic arterial injection chemotherapy in an attempt to prevent conversion of the hematoma to an abscess. A decrease in body temperature occurred after the arterial injections, and the hematoma was gradually diminished in size. In selected patients with blunt hepatic trauma, intrahepatic arterial injection chemotherapy seems to be an effective treatment for prevention of liver abscess formation.

Topics: Adolescent; Cefmetazole; Cefoperazone; Cefotaxime; Cefotiam; Cephalothin; Cephamycins; Dibekacin; Hematoma; Humans; Injections, Intra-Arterial; Liver; Liver Abscess; Liver Diseases; Male; Wounds, Nonpenetrating