phenylephrine-hydrochloride and Brain-Abscess

We report a child with misdiagnosed nasal dermal sinus and frontonasal dermoid cyst, that was complicated by brain abscess. Familiarizing physicians with this peculiar clinical picture may allow prompt recognition of this malformation, with subsequent imaging study, and surgical treatment, aimed to preventing fatal infectious complications.

Topics: Brain Abscess; Child, Preschool; Dermoid Cyst; Humans; Male; Nose

We report the first case of a transnasal penetrating intracranial injury in Hong Kong by a chopstick. A 49-year-old man attempted suicide by inserting a wooden chopstick into his left nose and then pulled it out. The chopstick caused a transnasal penetrating brain injury, confirmed by contrast magnetic resonance imaging of the brain. He was managed conservatively. Later he developed meningitis without a brain abscess and was prescribed antibiotics for 6 weeks. He enjoyed a good neurological recovery. This case illustrates that clinician should have a high index of suspicion for penetrating intracranial injury due to a nasally inserted foreign body, even though it had already been removed. In such cases moreover, brain magnetic resonance imaging is the imaging modality of choice, as it can delineate the path of penetration far better than plain computed tomography.

Topics: Brain Abscess; Brain Injuries; Cooking and Eating Utensils; Foreign Bodies; Humans; Magnetic Resonance Imaging; Male; Meningitis; Middle Aged; Nose; Wounds, Penetrating

Endonasal endoscopic skull base surgery (ESBS) is perceived as having a high risk of infection because it is performed through the sinuses, which are not sterile.. To identify the bacteriological characteristics, incidence, mortality, and risk factors for intracranial infection after ESBS.. A retrospective analysis of the first 1,000 ESBS procedures performed at the University of Pittsburgh Medical Center from 1998 to 2008.. In 18 cases (1.8%), the patient developed meningitis. In 2 cases, the patient died within 2 months after surgery, of noninfectious causes. In 11 cases, cerebrospinal fluid (CSF) cultures had positive results. There were no predominant pathogens. Male sex (odds ratio [OR], 3.97 [95% confidence interval {CI}, 1.21-13.03]; P = .02), history of a craniotomy or endonasal surgery (OR, 4.77 [95% CI, 1.68-13.56]; P = .02), surgery with higher levels of complexity (OR, 6.60 [95% CI, 1.77-24.70]; P = .003), the presence of an external ventricular drain or ventriculoperitoneal shunt at the time of surgery (OR, 6.38 [95% CI, 1.07-38.09]; P = .005), and postoperative CSF leak (OR, 12.99 [95% CI, 4.24-39.82]; P < .001) were risk factors for infection.. The incidence of infection of 1.8% in ESBS is comparable to that in open craniotomy. The most important risk factor was a postoperative CSF leak. All patients recovered from their infection.

Topics: Adolescent; Adult; Aged; Brain Abscess; Confidence Intervals; Cross Infection; Endoscopy; Female; Humans; Male; Meningitis; Middle Aged; Nose; Pennsylvania; Postoperative Complications; Retrospective Studies; Risk Factors; Skull Base

Topics: Aged; Brain Abscess; Humans; Male; Nose; Paranasal Sinuses; Postoperative Complications

Topics: Brain Abscess; Child, Preschool; Humans; Male; Neural Tube Defects; Nose

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

Topics: Adult; Brain Abscess; Child; Frontal Lobe; Humans; Male; Methods; Nose; Paranasal Sinuses; Punctures

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: Brain; Brain Abscess; Humans; Neck; Nose; Pharynx

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