phenylephrine-hydrochloride and Abscess

Isolated nasal bone fractures are the most common injuries of the central midface. They can be divided into different fracture types, depending on the exposure and orientation of violence. It is essential to ensure that there is no septal hematoma or abscess, which would require an emergency surgical intervention. A closed reposition can be offered if misalignment of the nose can still be observed after the edema swelling has gone down. In case of insufficient aesthetic and functional results, rhinoplasty/septal reconstruction can be performed 6 to 12 months after the trauma at the earliest. In children the, the decision for repositioning should be taken carefully in order to protect the nasal growing zone.. Isolierte Nasenfrakturen sind die häufigsten Verletzungen des zentralen Mittelgesichts. Die Frakturtypen können in Abhängigkeit von der Gewalteinwirkung und -ausrichtung eingeteilt werden. Wesentlich ist zudem der Ausschluss eines Septumhämatoms oder -abszesses. Liegen diese vor, ist eine notfallmäßige chirurgische Entlastung indiziert. Ansonsten sollte das Begleitödem abgewartet werden und bei bestehender Schiefstellung eine geschlossene Reposition angeboten werden. Bei unzureichendem ästhetischem und funktionellem Ergebnis ist eine definitive rhinochirurgische Versorgung im Sinne einer Septorhinoplastik/Septumrekonstruktion frühstens 6–12 Monate nach Trauma möglich. Bei Kindern sollte zur Schonung der Wachstumszonen die Indikation zur Reposition zurückhaltend gestellt werden.

Topics: Abscess; Child; Humans; Nasal Bone; Nasal Septum; Nose; Nose Diseases; Rhinoplasty; Traumatology

To study the results of surgical treatment and sequelae in nasal septum injuries in children.. Between January 1990 and December 1997, 16 pediatric patients with septal haematoma and/or abscess were treated. Mean age was 5 years (range: 2-14 years). Thirteen were male (81.2%), and three were female (18.8%). In nine cases (56.2%) the disease was a consequence of a minor trauma. Only two children had nasal fracture associated (12.5%). Minimum follow-up after the first visit was 10 months (mean, 3 years).. All cases were surgically treated. Minor sequelae were observed in six cases (37.5%), and major ones in ten patients (62.5%). In this latter group, multiple reconstructive procedures were needed.. It is necessary to be aware of the possibility of haematoma and abscess of the nasal septum. Major sequelae can be also expected after cases following minor traumas.

Topics: Abscess; Adolescent; Child; Child, Preschool; Female; Fractures, Cartilage; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Diseases; Wounds and Injuries

This comprehensive article reviews some of the most common injuries to the ear, nose, and throat, and in addition reviews the relative anatomy of this area of the body. Particular attention is paid to the treatment of the patient with epistaxis, a common presentation to the Emergency Department.

Topics: Abscess; Ear; Ear Diseases; Emergencies; Epistaxis; Esophagus; Foreign Bodies; Humans; Larynx; Nose; Pharynx

Topics: Abscess; Anti-Bacterial Agents; Child; Female; Humans; Male; Nose; Orbital Cellulitis; Orbital Diseases; Retrospective Studies

Impacted teeth are one of causes of patients visits to maxillofacial surgeons or dental surgeons. They are often detected accidentally when diagnosing other diseases in area of the nose, paranasal sinuses or oral cavity. This paper presents the process of diagnostics and treatment of a rare case of a 53-year-old patient, who developed hard palate abscess as a result of caries of impacted tooth accompanied by lateral periodontal cyst and nasopalatine fistula located in jaw.

Topics: Abscess; Fistula; Humans; Middle Aged; Nose; Palate, Hard; Tooth, Impacted

Topics: Abscess; Aged; Anti-Bacterial Agents; Antirheumatic Agents; Diagnosis, Differential; Ear Auricle; Humans; Lymphohistiocytosis, Hemophagocytic; Male; Methotrexate; Neck; Nose; Polychondritis, Relapsing; Prednisone; Propionibacterium acnes; Tomography, X-Ray Computed; Treatment Outcome

We report a successful treatment of a subcutaneous abscess in a 24-year-old woman caused by hyaluronic acid injection in nasal dorsum augmentation using negative pressure drainage via nasal mucosal approach.

Topics: Abscess; Drainage; Female; Humans; Hyaluronic Acid; Injections; Negative-Pressure Wound Therapy; Nose; Young Adult

Spontaneous rupture of the esophagus is a rare but life-threatening thoracic emergency, with high rates of clinical misdiagnosis and mortality. This article summarizes our experience in the treatment of spontaneous esophageal rupture with transnasal thoracic drainage and temporary esophageal stent and jejunal feeding tube placement.. We retrospectively assessed the medical records of 19 patients with spontaneous esophageal rupture treated using our intervention protocol. Patients received local anesthesia and sedation prior to undergoing transnasal drainage catheter placement into the thoracic abscess cavity, followed by temporary esophageal stent and jejunal feeding tube placement. After the operation, abscess lavage, nutritional support, and anti-inflammatory treatment were given. The transnasal thoracic drainage catheter, esophageal stent, and feeding tube were removed after the healing of the abscess cavity.. In all, 19 covered esophageal stents were placed in 19 patients with spontaneous esophageal rupture. All operations were technically successful. After an average of 84.06 days, the stents were successfully removed from 17 patients. No cases of massive hemorrhage, esophageal rupture, or other complications occurred during stent removal. An 82-year-old patient died of heart failure 2 months after the operation. One patient died of sudden massive hematemesis and hematochezia 55 days after the operation. In one patient, the esophageal injury failed to heal completely.. Our treatment protocol is simple, minimally invasive, and efficacious and may be an alternative for patients who are not candidates for surgery, have a high risk of postoperative complications, or wish to undergo minimally invasive surgery.. Therapeutic study, level V.

Topics: Abscess; Adult; Aged; Aged, 80 and over; Drainage; Enteral Nutrition; Esophageal Perforation; Female; Fluoroscopy; Humans; Jejunostomy; Male; Mediastinal Diseases; Middle Aged; Nose; Postoperative Complications; Retrospective Studies; Stents; Treatment Outcome

This study aimed to analyze the results of a modified continuous quilting sutures technique in a series of patients presenting with hematoma and/or abscess of nasal septum (HANS). Only patients with a confirmed diagnosis of HANS without co-morbid conditions (which could predispose to a bleeding tendency), were selected. Following incision and drainage, nasal septal flaps were coapted by applying continuous quilting sutures only. The success rate of this technique in terms of recurrence requiring re-exploration and drainage was 100%. Quilting sutures were generally well tolerated with few complaints. Saddle deformity was the most obvious complication of HANS, seen with septal abscess. Quilting sutures can be considered as an alternative treatment option for HANS. The modified technique employed in this study demonstrated impressive results and avoided the morbidity of nasal packing with fewer complications.

Topics: Abscess; Child; Child, Preschool; Drainage; Female; Hematoma; Humans; Infant; Male; Nasal Septum; Nose; Suture Techniques; Sutures

Perforated esophageal carcinoma with mediastinal abscess is a clinically life-threatening emergency. Herein, we summarize our experience with placement of transnasal drainage catheters and covered esophageal stents for the treatment of this condition.. We retrospectively assessed the medical records of 20 patients who were treated using our intervention protocol. Patients received local anesthesia and sedation prior to transnasal drainage catheter placement into the mediastinal abscess, which was followed by esophageal stent placement. Once the fluid was completely drained and the abscess was completely closed, the drainage catheter was removed.. The placement of the drainage catheter and stent was successful in all patients. The drainage catheter was successfully removed from the mediastinum after 7-60 days in 14 patients. During the follow-up of 1-18 months, six patients died from hemorrhage, eight from cancer progression or pulmonary infection, one from atrial fibrillation, and one from asphyxia caused by tracheal compression. The remaining four patients can eat normally.. Placement of transnasal drainage catheters and covered esophageal stents may be an appropriate palliative therapy for patients with perforated esophageal carcinoma with mediastinal abscess who are not candidates for surgery or have a high postoperative risk. J. Surg. Oncol. 2016;114:725-730. © 2016 Wiley Periodicals, Inc.

Topics: Abscess; Aged; Aged, 80 and over; Catheterization; Drainage; Esophageal Neoplasms; Esophageal Perforation; Female; Follow-Up Studies; Humans; Male; Mediastinal Diseases; Middle Aged; Nose; Palliative Care; Retrospective Studies; Stents; Treatment Outcome

To analyze the clinical and imaging characteristics of patients with cystic lesions in sella region and to describe the experience of endoscopic transsphenoidal surgery.. Fourty-six cases of cystic lesions in sella region confirmed by surgery and pathology between June 2003 and September 2013 were retrospectively analysed. The clinical features, imaging, surgical technique and postoperative recurrence in 46 cases were presented.. All lesions were resected through transsphenoidal endoscopic endonasal approach. Followed up lasted from 6 months to 6 years. Postoperatively, headache was recovered in 26 cases and wasn't recovered in 8 cases, visual was improved in 12 cases and wasn't improved in 2 cases, hypopituitarism was relieved in 18 cases and wasn't relieved in 15 cases, polyuria was disappeared in 8 cases and wasn't disappeared in 4 cases. Seven cases recurred, including 4 cases of craniopharyngioma, 2 cases of pituitary abscess, 1 case of cystic adenoma. There were no death and serious complication. The small age of onset, visual acuity and visual field symptoms, tumor in suprasellar, third ventricle compression was easy to occur in craniopharyngioma; cystic tumor, cavernous sinus invasion, the solid part homogeneous enhancement could be seen in cystic adenoma; Rathke cyst showed simple cystic, lighter clinical symptoms and a short course. Prone to diabetes insipidus, low multiple hormone level and the lesions of annular enhancement was more common in pituitary abscess.. The clinical features and imaging of cystic lesions in sella region feature overlap each other, but there are certain specificity. Transsphenoidal endoscopic endonasal approach for the surgery of cystic lesions in sella is effective and safe.

Topics: Abscess; Adenoma; Craniopharyngioma; Cysts; Endoscopy; Headache; Humans; Hypopituitarism; Neoplasm Recurrence, Local; Nose; Pituitary Diseases; Pituitary Neoplasms; Retrospective Studies; Sella Turcica

To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess.. Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded.. All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach.. Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

Topics: Abscess; Adolescent; Adult; Endoscopy; Female; Humans; Male; Middle Aged; Nose; Pituitary Diseases; Retrospective Studies; Sphenoid Sinus; Young Adult

The aim of the present study was to compare the external (EA), transnasal endoscopic (TEA), and combined (CA) external and transnasal approaches to drain orbital subperiosteal abscesses complicating pediatric ethmoiditis.. This retrospective study included 38 children consecutively operated in our center for an orbital subperiosteal abscess complicating an acute ethmoiditis. The distribution of surgical approaches used for our patients was the following: 12 TEA (32%), 21 EA (55%) and 5 CA (13%). All data were retrieved from patients' clinical charts.. No surgical complication was observed in the present study regardless of the approach. The percentage of surgical failures requiring additional drainage was almost twice as high after TEA (failure rate: 25%) than after EA (failure rate 14.3%), but this difference was not significant. Parameters which significantly influenced the risk of failure of TEA were the length and width of the abscess. The duration of postoperative hospitalization was significantly lower in the TEA group (3.1 days) than in the EA one (5.4 days). There were no failures in the CA group.. Failures of surgical drainage of orbital subperiosteal abscess complicating pediatric ethmoiditis are not rare and did not differ between external and transnasal endoscopic approaches in our study. The transnasal route is associated with a shorter postoperative duration of postoperative hospitalization. CA seems to be a viable surgical option combining the advantages of both endoscopic and external approaches.

Topics: Abscess; Adolescent; Child; Child, Preschool; Drainage; Endoscopy; Ethmoid Sinusitis; Female; Humans; Infant; Male; Nose; Orbital Diseases; Retrospective Studies; Treatment Failure; Treatment Outcome

Human infection due to Nocardiopsis, an actinomycete, is rare and the majority of those infections are due to Nocardiopsis dassonvillei. This agent has been implicated in cutaneous, pulmonary, eye and disseminated infections. It has never been isolated from the nose or any nasal infection. We report here a rare case of nasal vestibular abscess due to N. dassonvillei in an adult diabetic patient. The bacterium was identified on the basis of morphological and biochemical characteristics, and confirmed by sequencing the 16S rRNA and hsp65 genes. The patient was successfully treated with clarithromycin and levofloxacin. Though N. dassonvillei infections may be rare, the study highlights that it may cause a wide spectrum of disease manifestations, and laboratories should take care to isolate and identify the easily treatable pathogen.

Topics: Abscess; Actinomycetales; Actinomycetales Infections; Bacterial Typing Techniques; Cluster Analysis; Diabetes Complications; DNA, Bacterial; Humans; Male; Middle Aged; Molecular Sequence Data; Nose; Phylogeny; Sequence Analysis, DNA

The objective of the study was to evaluate the demographic factors, trauma type, treatment, and long-term results in patients with nasal septal hematoma (NSH) and nasal septal abscess (NSA).. Between the years 2006 and 2010, subjects who received a diagnosis of NSA and NSH were included for the study. Demographic data, the surgical findings, and long term follow-up results were recorded.. Twenty-nine subjects were identified. Eleven subjects had a diagnosis of NSA, whereas 19 subjects were identified as having NSH. Eighteen subjects (62.1%) were male, whereas the remaining 11 subjects (38.9%) were female. Mean age of the subjects was 7.79 ± 3.99 years. The etiologies were fall in 26 subjects (89.6%) and blow in 3 subjects (10.4%). Four subjects were previously examined by a physician. In 9 subjects (31.1%), radiologic and clinical evidence of nasal fracture exists. Eighteen (72%) of 29 subjects experienced sequelae. No significant difference exists for clinical properties, demographic data, etiology, and so on, except mean duration; P > 0.05. Mean duration was significantly high in the NSA group than in the NSH group (8.40 ± 8.46 days vs 3.58 ± 3.64 days, P = 0.025).. This study demonstrated that both NSH and NSA have similar properties for demographic data, etiology, and sequelae.

Topics: Abscess; Chi-Square Distribution; Child; Combined Modality Therapy; Female; Hematoma; Humans; Male; Nasal Septum; Nose; Treatment Outcome; Turkey

The goal was to compare rectal and nasal Staphylococcus aureus colonization rates and S aureus pulsed-field types (PFTs) for children with S aureus skin and soft-tissue abscesses and normal control subjects.. Sixty consecutive children with S aureus skin and soft-tissue abscesses that required surgical drainage and 90 control subjects were enrolled. Cultures of the nares and rectum were taken in both groups. S aureus isolates from all sites were characterized through multiple-locus, variable-number, tandem-repeat analysis, pulsed-field gel electrophoresis, staphylococcal cassette chromosome mec typing for methicillin-resistant S aureus isolates, and determination of the presence of Panton-Valentine leukocidin genes.. S aureus was detected significantly more often in the rectum of children with abscesses (47%) compared with those in the control group (1%; P = .0001). Rates of nasal colonization with S aureus were equivalent for children with abscesses (27%) and control subjects (20%; P = .33). S aureus recovered from the rectum was identical to S aureus in the abscess in 88% of cases, compared with 75% of nasal isolates. PFT USA300, staphylococcal cassette chromosome mec type IV, and Panton-Valentine leukocidin genes were significantly increased in the S aureus isolates from children with abscesses compared with those from control subjects.. Skin and soft-tissue abscesses in the current epidemic of community-associated staphylococcal disease are strongly associated with rectal colonization by PFT USA300. Nasal colonization in children does not seem to be a risk factor.

Topics: Abscess; Child; Child, Preschool; Female; Humans; Infant; Male; Nose; Rectum; Staphylococcal Skin Infections

Methicillin-resistant Staphylococcus aureus (MRSA) has emerged as an important cause of skin and soft-tissue infections (SSTI). The understanding of the molecular epidemiology and virulence of MRSA continues to expand. From January 2005 to December 2005, we screened soldiers for MRSA nasal colonization, administered a demographic questionnaire, and monitored them prospectively for SSTI. All MRSA isolates underwent molecular analysis, which included pulsed-filed gel electrophoresis (PFGE) and PCR for Panton-Valentine leukocidin (PVL), the arginine catabolic mobile element (ACME), and the staphylococcal cassette chromosome mec (SCCmec). Of the 3,447 soldiers screened, 134 (3.9%) had MRSA colonization. Of the 3,066 (89%) who completed the study, 39 developed culture-confirmed MRSA abscesses. Clone USA300 represented 53% of colonizing isolates but was responsible for 97% of the abscesses (P < 0.001). Unlike colonizing isolates, isolates positive for USA300, PVL, ACME, and type IV SCCmec were significantly associated with MRSA abscess isolates. As determined by multivariate analysis, risk factors for MRSA colonization were a history of SSTI and a history of hospitalization. Although various MRSA strains may colonize soldiers, USA300 is the most virulent when evaluated prospectively, and PVL, ACME, and type IV SCCmec are associated with these abscesses.

Topics: Abscess; Bacterial Toxins; Carrier State; DNA Fingerprinting; DNA, Bacterial; Electrophoresis, Gel, Pulsed-Field; Exotoxins; Genotype; Humans; Leukocidins; Methicillin-Resistant Staphylococcus aureus; Military Personnel; Molecular Epidemiology; Nose; Risk Factors; Staphylococcal Infections; Staphylococcal Skin Infections; Surveys and Questionnaires; Virulence Factors

Complications of primary nasoplasty, at the time of definitive primary cheiloplasty, are underreported in the literature. This study endeavors to examine the occurrences of these complications at our cleft-craniofacial center, in an effort to identify causative factors and management strategies. A case series of patients with postoperative nasal complications after primary cleft lip nasal surgery is presented.. A retrospective chart review of primary cleft lip nasal repairs was conducted at our cleft-craniofacial center between January 2003 and December 2007. Consecutive cases of 3 staff surgeons were evaluated. Specific data points included number and type of complications, subsequent required interventions, and relevant history, with particular attention paid to the details of the primary nasoplasty.. Eighty-six primary cleft lip nasoplasties were completed between the years 2003 and 2007. Six complications (6.9%) related to the primary cleft lip nasoplasty were identified. Four patients (4.6%) experienced nasal tip infections; all 4 required surgical drainage. Twenty-four patients (27.9%) undergoing primary cleft lip and nose repair had postoperative nostril conformers placed, and 2 (8.3%) of them experienced complications deemed conformer related.. Postoperative nasal complications of primary cheiloplasty occur and are likely underreported. In this series, complications resulted from infection, often occurring late, and secondary to the use of nostril conformers. Surgeon awareness and caregiver education, to identify the early signs of postoperative nasal complications, are critical to the successful treatment of these occurrences. Although this study did not intend on examining antibiotic use, the significance of nasal tip infections might support the regular use of antibiotics in this population, and the use of postoperative nostril conformers must be followed closely.

Topics: Abscess; Cleft Lip; Drainage; Female; Follow-Up Studies; Haemophilus Infections; Haemophilus influenzae; Humans; Infant; Male; Nasal Cartilages; Nose; Nose Diseases; Plastic Surgery Procedures; Postoperative Complications; Retrospective Studies; Staphylococcal Infections; Surgical Fixation Devices; Surgical Wound Infection; Suture Techniques

Estimation of the treatment of the nasal septal hematoma and abscess after injury was performed.. In 1998-2005 in Department of Otolaryngology Children's Hospital in Warsaw 2500 children after nasal injury were examined. Nasal septal hematoma and abscess were diagnosed in 22 (0,9%). They were reviewed retrospectively and some of them were examined 1-8 years after.. In 22 children with nasal septal hematoma and abscess no complication were observed during treatment. In 12 children examined 1-8 year after treatment 1 child developed saddle nose deformity (qualified to observation) and 1 child developed nasal septum deformities with nasal obstruction (qualified to septoplasty).. Complex treatment of nasal septal hematoma, drainage of the hematoma with septoplasty and reduction of fracture of the nose, makes good functional and cosmetic effect. Drainage of the nasal septal abscess with antibiotic prevent the early complications but it isn't enough functional and cosmetic effect in the future.

Topics: Abscess; Adolescent; Child; Drainage; Female; Follow-Up Studies; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Diseases; Retrospective Studies

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Humans; Male; Nasal Septum; Nose; Nose Diseases; Treatment Outcome

Septal haematoma following nasal trauma is a complication that, if not diagnosed and treated early, may evolve into a nasal septal abscess. We present the case of a 10-year-old male who suffered nasal trauma with fracture and an undiagnosed septal haematoma that evolved into a septal abscess. During drainage of the abscess, necrosis of the quadrangular cartilage was noted. The patient later presented collapse of the nasal dorsum and deviation of the nasal septum. This sequela was corrected by means of an osteochondral costal graft. In the presence of any nasal trauma, it is important to explore the nasal septum correctly to discard the presence of a haematoma which, if not drained early, may evolve into an abscess due to compression of the quadrangular cartilage, leading to its necrosis in a few days and later collapse of the nasal dorsum as the child grows.

Topics: Abscess; Child; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose

Septal haematoma after nasal trauma is a complication that can lead to septal abscess if unrecognized or early intervention is not performed. It can cause compression and thereby necrosis that evolve to a septal abscess in which cultures reveal saprophyte bacteria. Cartilage necrosis and destruction can produce impaired breathing and aesthetic deformities with collapse of the dorsum and the tip of the nose. We present a 10 year old masculine infant, that suffered a nasal fracture with a septal haematoma that remained undiagnosed. The patient developed a septal abscess that required drainage and resulted in nasal sequelae with collapse of dorsum and cranial displacement of tip and columella. Functional and aesthetic reconstruction was performed using rib cartilage grafts. No complications occurred. Functional and aesthetic improvement was observed. Result after 2 months of follow-up is considered favourable.

Topics: Abscess; Child; Fractures, Bone; Hematoma; Humans; Male; Nasal Bone; Nasal Septum; Nose

Streptococcus equi is the cause of strangles in horses. To improve diagnostic sensitivity, development and evaluation of DNA-based methods are necessary.. To evaluate diagnostic methods and observe the pattern of bacterial shedding during natural outbreaks.. Two herds with natural outbreaks of strangles were visited over a period of 15 weeks and 323 samples originating from 35 horses investigated. The diagnostic use of a nested PCR test was evaluated using a collection of 165 isolates of Lancefield group C streptococci (species specificity) and swabs from nasal passages or from abscesses from horses infected with S. equi (diagnostic sensitivity).. All 45 S. equi isolates tested positive in the nested PCR, whereas no amplicon was formed when testing the other 120 Lancefield group C isolates. A total of 43 samples were collected from 11 horses showing clinical signs of strangles during the study period. The diagnostic sensitivity for PCR test was 45% and 80% for samples from the nasal passages and abscesses, respectively; the corresponding diagnostic sensitivity for cultivation was 18% and 20%. The diagnostic sensitivity was significantly higher for PCR than for bacterial cultivation. Furthermore, the shedding of S. equi in 2 infected horse populations was evaluated. An intermittent shedding period of S. equi of up to 15 weeks was recorded in this part of the study. It was also shown that shedding of S. equi occurred both from horses with and without clinical signs.. The nested PCR test represents a species-specific and -sensitive method for diagnosis of S. equi from clinical samples. It may, however, be desirable in future to develop detection methods with high diagnostic sensitivity and specificity without the potential problems inherent in nested PCR.

Topics: Abscess; Animals; Denmark; Disease Outbreaks; DNA, Bacterial; Horse Diseases; Horses; Nose; Polymerase Chain Reaction; Reproducibility of Results; Sensitivity and Specificity; Species Specificity; Streptococcal Infections; Streptococcus equi

Methicillin-resistant Staphylococcus aureus (MRSA) is an emerging cause of infections outside of health care settings. We investigated an outbreak of abscesses due to MRSA among members of a professional football team and examined the transmission and microbiologic characteristics of the outbreak strain.. We conducted a retrospective cohort study and nasal-swab survey of 84 St. Louis Rams football players and staff members. S. aureus recovered from wound, nasal, and environmental cultures was analyzed by means of pulsed-field gel electrophoresis (PFGE) and typing for resistance and toxin genes. MRSA from the team was compared with other community isolates and hospital isolates.. During the 2003 football season, eight MRSA infections occurred among 5 of the 58 Rams players (9 percent); all of the infections developed at turf-abrasion sites. MRSA infection was significantly associated with the lineman or linebacker position and a higher body-mass index. No MRSA was found in nasal or environmental samples; however, methicillin-susceptible S. aureus was recovered from whirlpools and taping gel and from 35 of the 84 nasal swabs from players and staff members (42 percent). MRSA from a competing football team and from other community clusters and sporadic cases had PFGE patterns that were indistinguishable from those of the Rams' MRSA; all carried the gene for Panton-Valentine leukocidin and the gene complex for staphylococcal-cassette-chromosome mec type IVa resistance (clone USA300-0114).. We describe a highly conserved, community-associated MRSA clone that caused abscesses among professional football players and that was indistinguishable from isolates from various other regions of the United States.

Topics: Abscess; Adult; Clone Cells; Cohort Studies; Community-Acquired Infections; Disease Outbreaks; Electrophoresis, Gel, Pulsed-Field; Football; Gels; Humans; Hydrotherapy; Male; Methicillin Resistance; Microbial Sensitivity Tests; Nose; Retrospective Studies; Risk Factors; Skin; Staphylococcal Infections; Staphylococcal Skin Infections; Staphylococcus aureus; United States

Between 1 February and 15 April 2002, 95 patients were admitted to Gaston Bourret Territorial Hospital (New Caledonia, France) for drainage of community-acquired soft tissue abscesses. Staphylococcus aureus was detected in 68 cases (72%). Two-thirds of the patients with S. aureus infection had furuncles, which were located on the limbs in 82% of cases. The median interval between symptom onset and hospital admission was 5.7 days. Three-quarters of the patients were Melanesians living in tribes. Fifty-four S. aureus isolates were screened for toxin genes. Panton-Valentine leucocidin (PVL) genes were detected in 48 isolates (89%), the exfoliative toxin A gene was detected in 1 isolate, and no toxin genes were detected in 4 isolates. S. aureus nasal carriage was detected in 39.7% of patients with S. aureus infections. Two infecting S. aureus strains and two nasal carriage strains were resistant to methicillin. Comparative pulsed-field gel electrophoresis, performed in 16 cases, showed that five of six patients with PVL-positive nasal carriage strains were infected by the same strains. In contrast, 8 of 10 patients with PVL-negative nasal carriage strains were infected by PVL-positive strains. PVL genes thus appear to be a major virulence factor in both primary and secondary S. aureus skin infections.

Topics: Abscess; Adult; Bacterial Toxins; Carrier State; Community-Acquired Infections; Exotoxins; Female; Humans; Leukocidins; Male; Nose; Soft Tissue Infections; Staphylococcal Skin Infections; Staphylococcus aureus

Topics: Abscess; Drainage; Endoscopy; Humans; Male; Middle Aged; Nose; Orbital Diseases

Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen for which the prevalence, risk factors, and natural history are incompletely understood.. In this prospective observational study, we evaluated 812 US Army soldiers to determine the prevalence of and risk factors for CA-MRSA colonization and the changes in colonization rate over time, as well as to determine the clinical significance of CA-MRSA colonization. Demographic data and swab samples from the nares for S. aureus cultures were obtained from participants at the start of their training and 8-10 weeks later. Over this time period, participants were observed prospectively to monitor for soft-tissue infections. S. aureus isolates were characterized by in vitro examination of antibiotic susceptibilities, mecA confirmation, pulsed-field gel electrophoresis, and Panton-Valentine leukocidin (PVL) gene testing.. At the initial sampling, 24 of the participants (3%) were colonized with CA-MRSA, 9 of whom (38%) developed soft-tissue infections during the study period. In contrast, 229 participants (28%) were colonized with methicillin-susceptible S. aureus (MSSA), 8 (3%) of whom developed clinical infections during the same period (relative risk, 10.7; 95% confidence interval, 4.6-25.2; P<.001). At follow-up culture, the CA-MRSA colonization rate dropped to 1.6% without eradication efforts. Previous antibiotic use was a risk factor for CA-MRSA colonization at the initial sampling (P=.03). PVL genes were detected in 66% of 45 recovered CA-MRSA isolates, including all 9 clinical isolates available for analysis. Of subjects hospitalized, 5 of 6 had PVL-positive CA-MRSA infections.. CA-MRSA colonization with PVL-positive strains was associated with a significant risk of soft-tissue infection, suggesting that CA-MRSA may be more virulent than MSSA. Previous antibiotic use may play a role in CA-MRSA colonization.

Topics: Abscess; Adolescent; Adult; Anti-Bacterial Agents; Carrier State; Cellulitis; Community-Acquired Infections; Female; Humans; Male; Methicillin Resistance; Military Personnel; Nose; Prospective Studies; Risk Factors; Staphylococcal Infections; Staphylococcus aureus; Virulence Factors

A nasal septal abscess is usually the result of an infected hematoma of the septum. A secondary septal abscess may be the result of infections extending from any of the neighbouring tissues. The necrosis of septal cartilage may lead to nasal deformities and severe impairment of nasal patency and growth.. Assess if the drainage of the abscess and the immediate reconstruction of the destroyed nasal septum in the acute phase is the best treatment to prevent short- and long-term effect on nasal and midface growth.. Three pediatric patients treated with drainage and immediate implantation of homologous bank cartilage prior to 1990 and four treated with mosaic plastic using small pieces of residual septal cartilage assembled with fibrin glue.. No complication were observed in the follow-up and any deformities in the long-term controls.. The drainage and immediate reconstruction of the nasal septum are the golden standard in the treatment of the septum infected haematoma.

Topics: Abscess; Cartilage; Child; Child, Preschool; Drainage; Epistaxis; Female; Fever; Formaldehyde; Hemostatics; Humans; Male; Nasal Obstruction; Nasal Septum; Nose; Polyvinyl Alcohol; Transplantation, Homologous; Treatment Outcome

Collaborative care pathways (CCPs) provide a framework for multidisciplinary patient care. They provide guidelines and a mechanism for audit, and were first introduced at the Regional Unit, Walton Hospital, Liverpool, in November 1994. They have been designed for many surgical groups. Between August 1996 and 31 July 1997, 955 patients were admitted on to the nine established pathways: fractured mandible (n=213), fractured zygoma (n=117), minor oral surgery (n=244), abscess (n=18), examination under anaesthesia (n=73), nasal surgery (n=73), osteotomy (n=80), salivary (n=63), and temporomandibular joint (n=74). The purpose of this article is to report the introduction of CCP in a maxillofacial ward and give results from a one-year audit. CCP have proved to be an extremely useful tool and have several advantages over traditional documentation. They are more accurate, easily computerized, and facilitate audit. They promote the development of guidelines and standardized perioperative care, and this in turn facilitates training and raises standards of care.

Topics: Abscess; Anesthesia, General; Critical Pathways; Documentation; England; Humans; Mandibular Fractures; Medical Audit; Medical Records Systems, Computerized; Minor Surgical Procedures; Mouth Diseases; Nose; Oral Surgical Procedures; Osteotomy; Perioperative Care; Practice Guidelines as Topic; Salivary Glands; Surgery, Oral; Temporomandibular Joint; Zygomatic Fractures

A group of patients (n=86) suffering from superficial abscesses was recruited in the Khartoum Teaching Hospital, Sudan. Detailed clinical and socio-economic data were collected. It appeared that 83% of all patients were younger than 40. Labourers were most prevalent (28%), followed by students (23%) and housewives (16%). The head and neck were most often affected (22%), with hands being second (19%). In 92% of all pus cultures a microbial agents was identified, the large majority being Staphylococcus aureus (69%). Among patients, 47% were nasal carriers of S. aureus, similar to the carriage rate measured among controls, suggesting that nasal carriage is no risk factor for abscess development. Multivariate logistic regression analysis revealed that a history of abscess, recent traditional medical treatment, poor hygiene and low socio-economic status were significantly and independently associated with the occurrence of superficial abscesses.

Topics: Abscess; Adolescent; Adult; Age Factors; Aged; Child; Child, Preschool; DNA Fingerprinting; Female; Genotype; Humans; Hygiene; Infant; Male; Medicine, African Traditional; Middle Aged; Nose; Risk Factors; Skin Diseases, Bacterial; Socioeconomic Factors; Staphylococcal Infections; Staphylococcus aureus; Sudan

Topics: Abscess; Amoxicillin; Child; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Diseases; Penicillins; Staphylococcal Infections; Staphylococcus aureus

The exact incidence of orbital complications due to sinusitis in children is unknown. However, a medial subperiosteal orbital abscess is the most common serious complication to occur. Surgical intervention is mandatory whenever antibiotic treatment fails. Most authors prefer open surgical procedures such as external ethmoidectomy, while others recommend transnasal endoscopic drainage as the first attempt at sinus decompression. Five out of 12 children with proven subperiosteal orbital abscess and sinusitis on computed tomographic scans failed antibiotic treatment and required surgical drainage. Transnasal endoscopic drainage of the abscess was performed on four patients, while one child underwent external ethmoidectomy. Our experience with endoscopic surgery in these four cases is discussed, along with a brief review of the advantage of this procedure over external surgery.

Topics: Abscess; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefuroxime; Cephalosporins; Child; Child, Preschool; Drainage; Drug Therapy, Combination; Endoscopy; Ethmoid Bone; Ethmoid Sinusitis; Female; Frontal Sinusitis; Humans; Male; Maxillary Sinusitis; Nose; Orbital Diseases; Periosteum; Sinusitis; Tomography, X-Ray Computed; Treatment Failure

Nasal septal abscess is a rare complication of septal haematoma. Nasal obstruction and, less frequently, pain are the usual presenting features. We report a case of a nasal septal abscess in a 21-year-old female patient who developed a naso-oral fistula. To our knowledge this is the first report of such an unusual presentation of a septal abscess. The aetiology, pathogenesis and management of septal abscesses are discussed.

Topics: Abscess; Adult; Female; Fistula; Humans; Nasal Septum; Nose; Nose Diseases; Oral Fistula; Streptococcal Infections; Wounds, Nonpenetrating

The development of the nose and the growth of the midface has been followed in a pair of identical twins. One of them (twin A) had nasal septum destruction after septal haematoma and abscess at the age of 7 years, and was treated by immediate implantation of homologous septal cartilage from a tissue bank. From 7-17 years of age the growth and development of the nose and face were followed. Lateral cephalograms, photographs, acoustic rhinometry and rhinoscopy were performed. Twin B presented a normal nasal and facial growth and served as control. Twin A developed a saddle nose, an upward displacement of the anterior part of the maxilla, diminished vertical development of the nasal cavity, and a retrognathically positioned maxilla due to decreased anteroposterior maxillary growth. This case report seems to indicate that the cartilaginous nasal septum is an important factor influencing vertical and sagittal growth of the maxilla.

Topics: Abscess; Airway Resistance; Cephalometry; Child; Hematoma; Humans; Longitudinal Studies; Male; Maxillofacial Development; Nasal Septum; Nose; Twins, Monozygotic

To evaluate the clinical characteristics and treatment outcome of hematoma and abscess of the nasal septum (HANS) in children.. Retrospective case series.. Pediatric tertiary care facility.. Consecutive series of 20 children (age, 2 months to 15 years; mean age, 7 years) who were admitted to the hospital for treatment of HANS after nasal trauma during an 18-year period.. In addition to receiving antibiotics, all patients underwent general anesthetic for incision and evacuation of the collection of blood and pus together with nasal packing.. All patients had a history of nasal trauma. The HANS was a consequence of child abuse (2 patients younger than 2 years), minor nasal trauma (14 patients aged 1 to 10 years), and sports injury (4 patients older than 10 years). The diagnosis was made 1 to 14 days (mean, 5.9 days) after the episode of trauma. Nasal obstruction was the most common symptom found and was present in all but 1 patient. Pain, rhinorrhea, and fever occurred in 50%, 35%, and 25% of patients, respectively. Nasal fracture was present in 3 children. Abscess was found at surgery in 12 patients and was universally associated with septal cartilage destruction. Hematoma was present in 8 patients and associated with cartilage destruction in 2 patients. Organisms cultured were Staphylococcus aureus, Streptococcus pneumoniae, and group A beta-hemolytic streptococcus and were obtained from all 12 patients with septal abscess and from 1 patient with septal hematoma. Corrective nasal surgery has been performed in 5 patients, 4 of whom had a history of septal abscess.. The diagnosis of HANS must be considered in all children who have acute onset of nasal obstruction and a history of recent nasal trauma to minimize the risk of nasal deformity and prevent the development of septic complications.

Topics: Abscess; Adolescent; Cartilage Diseases; Child; Child, Preschool; Drainage; Female; Hematoma; Humans; Infant; Male; Nasal Septum; Nose; Retrospective Studies

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Clindamycin; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Diseases; Staphylococcal Infections

Injuries to the nasal septum may occur as a result of injuries to the nose. A case of nasal septal abscess, an unusual complication of nasal trauma, is presented. The pathophysiology, clinical course, and treatment of this disorder are discussed. This case demonstrates the need for careful evaluation of the nasal septum in all cases of nasal trauma.

Topics: Abscess; Adult; Drainage; Humans; Male; Nasal Septum; Nose; Nose Diseases

Postnatal nasal injury occurring before full growth results in certain changes in the development of the nose and of the face. An assessment of the role of the cartilaginous nasal septum in this growth has been attempted by observing adults who had dissolution of the cartilaginous septum in childhood. The immediate management of long term follow up care of patients so afflicted is discussed. Also observed into adult life were several patients on whom lateral, medial or transverse osteotomies or combinations of these had been performed in childhood to determine if such procedures interfered with growth of the nose and face.

Topics: Abscess; Child; Child, Preschool; Diseases in Twins; Female; Follow-Up Studies; Humans; Male; Maxillofacial Development; Nasal Septum; Nose; Nose Deformities, Acquired; Nose Diseases; Osteotomy; Rhinoplasty

The long term results of our two first cases of septal reconstruction in the acute phase of a septal abscess in childhood are described. Follow-up periods were 19 and 17 years respectively. The development of the nasal pyramid was normal apart from a slight to moderate sagging of the cartilaginous dorsum. Length, width and prominence developed within normal limits and nasal function remained undisturbed. Reconstruction of the septum in the acute phase of a septal abscess seems also on the long term effective in preventing the well known disturbance of growth, form and function of the nose.

Topics: Abscess; Child; Female; Follow-Up Studies; Humans; Male; Maxillofacial Development; Nasal Septum; Nose; Nose Deformities, Acquired; Nose Diseases; Rhinoplasty

Nasal septal abscesses are uncommon. Sixteen cases from the Massachusetts Eye and Ear Infirmary were reviewed retrospectively and are presented. The diagnosis, bacteriology, and pathophysiology are discussed. Immediate therapy is indicated to avoid cosmetic deformity or intracranial infection. Treatment is based on diagnostic needle aspiration, antibiotic coverage and surgical drainage.

Topics: Abscess; Adolescent; Adult; Anti-Bacterial Agents; Child; Child, Preschool; Drainage; Female; Humans; Male; Nasal Septum; Nose; Nose Diseases; Staphylococcal Infections

Topics: Abscess; Age Factors; Child; Fractures, Cartilage; Hematoma; Humans; Nasal Septum; Nose; Nose Deformities, Acquired; Nose Diseases; Respiration; Rhinoplasty

Topics: Abscess; Anti-Bacterial Agents; Blepharoptosis; Blindness; Cellulitis; Conjunctiva; Cornea; Diagnosis, Differential; Edema; Ethmoid Bone; Eye Diseases; Eyelids; Face; Hypesthesia; Lacrimal Apparatus; Neuralgia; Nose; Ophthalmic Nerve; Ophthalmoplegia; Optic Neuritis; Orbit; Papilledema; Periosteum; Prednisone; Pupil; Sinus Thrombosis, Intracranial; Sinusitis

Topics: Abscess; Animals; Arteries; Brain; Brain Abscess; Cattle; Cattle Diseases; Corynebacterium Infections; Corynebacterium pyogenes; Exophthalmos; Lung; Male; Nose; Orbit

Topics: Abscess; Administration, Intranasal; Administration, Oral; Animals; Culture Media; Fluorescent Antibody Technique; Lymphadenitis; Nose; Palatine Tonsil; Streptococcal Infections; Streptococcus; Swine; Swine Diseases; Time Factors

Topics: Abscess; Animal Feed; Animals; Carrier State; Germ-Free Life; Lymphadenitis; Nose; Palatine Tonsil; Soil Microbiology; Streptococcal Infections; Streptococcus; Swine; Swine Diseases

Topics: Abscess; Animals; Fish Diseases; Fishes; Microscopy, Electron; Nose; Vibrio; Vibrio Infections

Six cases of infections in children with Bacteroides corrodens are reported. In five the infection was mixed but in one fatal extradural and subdural empyema the organism was found in pure culture. The bacteriological findings are presented. It is suggested that Bacteroides corrodens may assume a pathogenic role and the rarity of its isolation may be due to delay in the appearance of the colony.

Topics: Abscess; Adolescent; Bacteroides; Bacteroides Infections; Brain Abscess; Child; Child, Preschool; Colon; Craniotomy; Empyema; Female; Humans; Infant; Male; Mucous Membrane; Nose; Time Factors; Wound Infection

Topics: Abscess; Adolescent; Humans; Male; Nose; Tooth Eruption, Ectopic; Tooth, Supernumerary

Topics: Abscess; Animals; Bacteriophage Typing; Corynebacterium; Germ-Free Life; Lymphadenitis; Mouth; Nose; Serotyping; Streptococcal Infections; Streptococcus; Swine; Swine Diseases

Topics: Abscess; Air Microbiology; Anti-Bacterial Agents; Axilla; Bacteriological Techniques; Bacteriophage Typing; Black People; Corynebacterium; Drug Resistance, Microbial; Enterobacteriaceae; Enterococcus faecalis; Environment; Escherichia coli; Hand; Humans; Mining; Nose; Occupational Diseases; Perineum; Proteus; Pseudomonas aeruginosa; Soil Microbiology; South Africa; Staphylococcus; Streptococcus pyogenes; Water Microbiology; Wound Infection

Topics: Abscess; Adult; Bone Transplantation; Child; Female; Fractures, Bone; Hematoma; Humans; Male; Nasal Septum; Nose; Nose Deformities, Acquired

Topics: Abscess; Breast Diseases; Carrier State; Cross Infection; Eye; Female; Humans; Infant, Newborn; Nose; Pregnancy; Puerperal Infection; Staphylococcal Infections

Topics: Abscess; Adenoids; Foreign Bodies; Hematoma; Humans; Nasal Obstruction; Nasal Polyps; Nasal Septum; Nasopharyngeal Neoplasms; Nose; Nose Deformities, Acquired; Rhinitis; Rhinitis, Allergic, Seasonal; Rhinitis, Atrophic

Topics: Abscess; Anti-Bacterial Agents; Antibiotics, Antitubercular; Child; Edema; Eyelids; Humans; Nose; Orbit; Sinusitis

Topics: Abscess; Cellulitis; Humans; Infant; Nasal Septum; Nose; Orbit; Orbital Cellulitis

Topics: Abscess; Brain; Brain Abscess; Ear; Humans; Nose

Topics: Abscess; Duodenum; Face; Humans; Intubation, Gastrointestinal; Nose; Paranasal Sinus Diseases

Topics: Abscess; Fistula; Humans; Nose; Paranasal Sinuses; Sinusitis

Topics: Abscess; Humans; Nasal Septum; Nose; Sepsis; Tuberculosis

Topics: Abscess; Fistula; Nose; Paranasal Sinuses; Sinus Thrombosis, Intracranial

Topics: Abscess; Acute Disease; Disease; Ethmoid Sinus; Ethmoid Sinusitis; Humans; Nasal Septum; Nose; Paranasal Sinus Diseases; Sepsis