ro13-9904 and Abscess

Pyomyositis is an unusual bacterial infection but potential severe in children. Staphylococcus Aureus is the main caused of this disease (70-90%), following by Streptococcus Pyogenes (4-16%). Streptococcus Pneumoniae rarely caused invasive muscular infections. We describe a case of pyomyositis caused by Streptococcus Pneumonia in an adolescent 12-year-old female.. I.L. referred to our hospital for high fever associated with right hip and abdominal pain. The blood exams showed increase of leukocytes with prevalence of neutrophils with high level of inflammatory markers (CRP 46,17 mg/dl; Procalcitonin 25,8 ng/ml). The abdomen ultrasonography was unremarkable. The CT and MRI of the abdomen and right hip revealed pyomyositis of the iliopsoas, piriformis and internal shutter associated with collection of pus between the muscular planes (Fig. 1). The patient was admitted to our paediatric care unit, and she was initially treatment with intravenous Ceftriaxone (100 mg/kg/day) and Vancomycin (60 mg/kg/day). On day 2, a pansensitive Streptococcus Pneumoniae was isolated from the blood culture, and the antibiotic treatment was changed to only IV Ceftriaxone. She was successively treated with IV Ceftriaxone for 3 weeks, then continued with oral Amoxicillin for a total of 6 weeks of therapy. The follow up showed a complete resolution of the pyomyositis and psoas abscess after 2 months.. Pyomyositis associate with abscess is a rare and very dangerous disease in children. The clinical presentation can mimic symptoms of other pathologies like osteomyelitis or septic arthritis, so many times is hard to identify. The main risk factors include story of recent trauma and immunodeficiency, not present in our case report. The therapy involves the antibiotics and, if possible, abscess drainage. In literature there is much discussion about duration of antibiotic therapy.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Ceftriaxone; Child; Female; Humans; Pyomyositis; Streptococcus pneumoniae

We present the cases of two otherwise healthy adults, one with meningitis and another with a subdural abscess, with both conditions attributable to

Topics: Abscess; Adult; Aged; Ceftriaxone; Humans; Male; Meningitis, Pneumococcal; Streptococcus pneumoniae; Vancomycin

Salmonella enterica subspecies arizonae is a rare pathogen but has been reported in the literature in immunosuppressed and rarely immunocompetent patients. Most disease states have been reported in animals and reptiles. Human exposure has resulted in a range of complications from skin and soft tissue infections to bacteremia and periprosthetic joint infections. Predisposing factors such as age, comorbidities, and use of Mexican folk healing practices increase the risk of developing an infection. S. arizonae has been associated with gastrointestinal infections in several parts of the country and on rare occasions have been isolated from skin and soft tissues, prosthetic joints, and empyema. Case: This is a unique case of a large de novo chest abscess that developed in a 59-year-old diabetic male from the Southwest region with cultures growing Salmonella enterica subspecies arizonae. This patient presented without predisposing factors and did not appear to be ill at the time of admission. He was treated successfully by aspirating the abscess along with a 2-week course of ceftriaxone intravenously.

Topics: Abscess; Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Diabetes Complications; Humans; Male; Middle Aged; New Mexico; Salmonella enterica; Salmonella Infections; Soft Tissue Infections; Thorax; Treatment Outcome

We describe an unusual case of a 58-year-old man with type 2 diabetes mellitus (T2DM) developing sepsis secondary to a prevertebral neck abscess. Following cross-sectional imaging, the patient underwent surgical drainage.

Topics: Abscess; Ceftriaxone; Ciprofloxacin; Diabetes Mellitus, Type 2; Drainage; Humans; Male; Metronidazole; Middle Aged; Neck; Salmonella enterica; Salmonella Infections; Sepsis; Treatment Outcome

Acute mastoiditis (AM) is a relatively rare complication of acute otitis media (AOM). The most common pathogens include Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus. Pneumococcal vaccination and changes in antibiotic prescribing recommendations for AOM may change the incidence of AM in the future. Diagnosis of AM can be made based on clinical presentation, but computed tomography of the temporal bone with contrast should be considered if there is concern for complicated AM. Both extracranial and intracranial complications of AM may occur. Previously, routine cortical mastoidectomy was recommended for AM treatment, but new data suggest that a more conservative treatment approach can be considered, including intravenous (IV) antibiotics alone or IV antibiotics with myringotomy. [Pediatr Ann. 2016;45(5):e176-e179.].

Topics: Abscess; Acute Disease; Anti-Bacterial Agents; Ceftriaxone; Female; Humans; Infant; Mastoid; Mastoiditis; Otitis Media with Effusion; Periosteum; Periostitis; Pneumococcal Infections; Streptococcus pneumoniae; Tomography, X-Ray Computed

Lemierre syndrome is a rare but serious illness that associates throat infection and thrombosis of the internal jugular vein (IJV) or one of its tributaries with subsequent distant septic emboli. The purpose of our study was to review the pathogenesis, clinical presentation, and treatment of this disease.. Patients with confirmed Lemierre syndrome were included in our retrospective monocentric study. All patients had bacteriologic analyses as well as radiologic imaging.. There were 11 patients in our study (from 1998-2012). Fusobacterium necrophorum was responsible for the infection in 45% of cases. Surgical drainage of pharyngeal, cervical, or mediastinal abscesses was carried out in 8 cases. All patients received broad-spectrum antibiotics. Six patients were admitted to the intensive care unit (ICU). One patient (9%) died.. Treatment with broad-spectrum antibiotics is the primary choice of treatment of Lemierre syndrome. Surgery is indicated in case of abscess formation.

Topics: Abscess; Adolescent; Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Ceftriaxone; Cellulitis; Drainage; Female; Humans; Intensive Care Units; Lemierre Syndrome; Length of Stay; Male; Mediastinitis; Metronidazole; Middle Aged; Retrospective Studies; Tonsillitis; Young Adult

Salmonella ovarian abscess in a patient with rheumatoid arthritis (RA) is reported here. A 33-year-old nulliparous woman with a 16-year history of RA who had been treated with corticosteroid and immunosuppressive drugs was diagnosed as having a non-typhoidal Salmonella ovarian abscess which might have been preceded by an occurrence of endometriotic cyst. Multidisciplinary therapy including surgical intervention was required to complete the eradication of infection. Although Salmonella ovarian abscess is rare, it may cause a serious complication in the ovary harboring endometriotic cyst through sustained presence of Salmonella bacteraemia.

Topics: Abscess; Adult; Anti-Bacterial Agents; Arthritis, Rheumatoid; Ceftriaxone; Female; Humans; Lincomycin; Ovarian Diseases; Salmonella enteritidis; Salmonella Infections

Transrectal ultrasound guided biopsy (TRUSB) of the prostate directly contaminates the prostate with rectal flora. Patients commonly receive fluoroquinolone (FQ) antibiotics to prevent infection. Infectious complications following TRUSB are increasing. The most common offending organism is Escherichia coli (E. coli), with isolates of this bacteria showing growing resistance to FQs. We present to our knowledge the first reported case of seminal vesicle abscess formation after TRUSB. The abscess was initially not seen on computed tomography and eventually treated with percutaneous drainage by a transgluteal approach. We review literature on infectious complications following TRUSB with implications for future antibiotic prophylaxis.

Topics: Abscess; Aged; Anti-Bacterial Agents; Buttocks; Ceftriaxone; Drainage; Escherichia coli; Escherichia coli Infections; Humans; Image-Guided Biopsy; Levofloxacin; Male; Nitrofurantoin; Prostate; Seminal Vesicles; Treatment Outcome; Ultrasound, High-Intensity Focused, Transrectal

Actinomycosis is an uncommon chronic granulomatous infection that cause formation of abscesses and cutaneous fistula. In mandibular actinomycosis the alveolar bone and mandibular body are usually not involved and the pathogenetic mechanisms of the actinomycotic infiltration is unknown. The patients usually report pain at the alveolar arch with development of a purplish-red swelling firmly attached to the mandibula; the fibrous tissue produces the continued development of new cutaneous fistulas with oncoming pus-secretion. An uncommon case of actinomycotic osteomyelitis with a double pathological fracture of mandibula is reported. Ortopanoramic X-ray and computed tomography scan of the mandibula are effective and relevant diagnostic procedures to quantify the entity and site of the osteolitic areas and to define the precise position of fractures. In association with the intravenous infusion of benzilpenicillina, daily local irrigations of rifamicina have been performed. Moreover, the patient underwent surgical drainage of abscesses with accurate curettage of osteomyelitic lesions and several biopsies of the trabecolar bone and fistulas were taken. It has been also necessary to perform a mandibular blockage using a resinal plaque anchored on premolars. To reach a precise diagnosis, an histopathological examination togheter with batterioscopic-coltural examination is needed. Antibiotic therapy alone is not a sufficient therapeutic approach and surgical treatment must be quickly performed with clean up of the osteomyelitic lesions and contention of fractures by alveolar blockage for at least 40 days.

Topics: Abscess; Actinomycosis; Adult; Anti-Bacterial Agents; Biopsy; Ceftriaxone; Combined Modality Therapy; Cutaneous Fistula; Drainage; Drug Therapy, Combination; Fractures, Spontaneous; Humans; Male; Mandibular Fractures; Osteomyelitis; Penicillin G; Radiography, Panoramic; Rifamycins; Surgical Wound Infection; Tomography, X-Ray Computed; Tooth Extraction

By culturing for N gonorrhoeae in cases of neonates and children with conjunctivitis, vaginitis, urethritis, proctitis, sepsis, and arthritis, gonococcal infections can be identified easily. They are then treated with ceftriaxone. In neonates, the mother and her sexual contacts also should be treated. In children, a full evaluation for sexual contacts, with the assistance of other professionals, if necessary, will almost always identify a sexual contact. Appropriate action then can be taken to protect the child from further sexual contact. .

Topics: Abscess; Ceftriaxone; Child; Child, Preschool; Conjunctivitis; Female; Gonorrhea; Humans; Infant; Infant, Newborn; Male; Mouth Diseases; Ophthalmia Neonatorum; Pelvic Inflammatory Disease; Pharyngeal Diseases; Proctitis; Scalp Dermatoses; Urethritis; Vaginitis

Appendicitis is the most common emergency condition in children. Historically, a 3-drug regimen consisting of ampicillin, gentamicin, and clindamycin (AGC) has been used postoperatively for perforated appendicitis. A retrospective review at our institution has found single day dosing of ceftriaxone and metronidazole (CM) to be a more simple and cost-effective antibiotic strategy. Therefore, we performed a prospective, randomized trial to compare efficacy and cost-effectiveness of these 2 regimens.. After internal review board approval (IRB no. 04 12-149), children found to have perforated appendicitis at appendectomy were randomized to either once daily dosing of CM (2 total doses per day) or standard dosing of AGC (11 total doses per day). Perforation was defined as an identifiable hole in the appendix. The operative approach (laparoscopic), length of antibiotic use, and criteria for discharge were standardized for the groups. Based on our retrospective analysis using length of postoperative hospitalization as a primary end point, a sample size of 100 patients was calculated for an alpha of .5 and a power of 0.82.. One hundred patients underwent laparoscopic appendectomy for perforated appendicitis. On presentation, there were no differences in sex distribution, days of symptoms, temperature, or leukocyte count. There was no difference in abscess rate or wound infections between groups. The CM group resulted in significantly less antibiotic charges then the AGC group.. Once daily dosing with the 2-drug regimen (CM) offers a more efficient, cost-effective antibiotic management in children with perforated appendicitis without compromising infection control when compared to a traditional 3-drug regimen.

Topics: Abscess; Administration, Oral; Adolescent; Antibiotic Prophylaxis; Appendectomy; Appendicitis; Ceftriaxone; Child; Cost-Benefit Analysis; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug Therapy, Combination; Female; Follow-Up Studies; Gentamicins; Hospital Costs; Humans; Infusions, Intravenous; Male; Metronidazole; Multivariate Analysis; Probability; Prospective Studies; Treatment Outcome

The significance of C-reactive protein (CRP) in assessing the treatment of pelvic inflammatory disease (PID) was established and compared with body temperature (BT), erythrocyte sedimentation rate (ESR) and serum leukocyte concentration (L).. In 51 patients with PID, 20 (39%) of them with tubo-ovarial abscess (TOA), measurement of BT and laboratory investigations were carried out on admission and during treatment on days 3-4, 6-8 and 18-21. The changes in these values were compared with the changes in clinical condition.. Prior to treatment, the majority--49 patients or 96.1%--had increased CRP values. In successful treatment, the CRP values decreased significantly in PID patients without TOA on day 3-4, in patients with TOA on day 6-8 and reached normal values in both groups on day 18-21. Changes in clinical condition were most concurrent with changes in CRP.. In assessing PID treatment, the determination of CRP has precedence over L, ESR and BT as the percentage of patients with increased CRP is higher and because the changes in value follow the changes in clinical condition more reliably.

Topics: Abscess; Adult; Blood Sedimentation; Body Temperature; C-Reactive Protein; Ceftriaxone; Clindamycin; Drug Administration Schedule; Drug Therapy, Combination; Female; Gentamicins; Humans; Oophoritis; Pelvic Inflammatory Disease; Prognosis; Prospective Studies; Salpingitis; Sensitivity and Specificity; Severity of Illness Index; Tetracycline

Two hundred and forty adults undergoing acute appendicectomy were randomised to receive either cefoxitin or ceftriaxone 1 g intravenously at induction of anaesthesia. Patients were monitored daily while in hospital, and at least 4 weeks after discharge for evidence of wound, urinary or lower respiratory tract infection. We evaluated 167 patients at follow up and found no significant difference in infection rates between the two antibiotic groups. Thirty-four had normal appendices and 1 of 16 (6.3%) given cefoxitin and 2 of 18 (11.1%) given ceftriaxone developed wound infections. Ninety-seven had acute appendicitis and 3 of 48 (6.3%) given cefoxitin and 3 of 49 (6.1%) given ceftriaxone developed infections including 2 wound infections in each group. Thirty-six had gangrenous perforated or abscessed appendices: 31 were given additional antibiotics postoperatively, and 4 of 18 (22.2%) in each prophylactic antibiotic group developed infections, including wound infection in 3 given cefoxitin and in 4 given ceftriaxone. None of the infections were serious. Sixty-one percent presented after discharge from hospital. The mean hospital stay was 4.6 days for each antibiotic group. Neither antibiotic caused adverse effects.

Topics: Abscess; Adolescent; Adult; Appendectomy; Appendicitis; Cefoxitin; Ceftriaxone; Humans; Intestinal Perforation; Middle Aged; Premedication; Random Allocation; Rupture, Spontaneous; Surgical Wound Infection

Topics: Abscess; Adult; Aged; Amoxicillin; Breast Diseases; Cefotaxime; Ceftriaxone; Clinical Trials as Topic; Doxycycline; Drug Combinations; Endometritis; Erythromycin; Female; Genital Diseases, Female; Humans; Metronidazole; Middle Aged; Postoperative Complications; Pregnancy; Puerperal Infection; Salpingitis; Urinary Tract Infections

During a 7 month trial for therapy of polymicrobial surgical sepsis, intravenous antibiotic treatment was randomized between gentamicin (1 mg/kg every 8 hours) plus clindamycin (8 mg/kg every 6 hours), and the cephalosporin, ceftriaxone (1 g every 12 hours) in 197 patients, of whom 99 were being treated for peritonitis, 93 for soft tissue sepsis, and 5 for other forms of infection. No significant differences were noted in patient demographics, type of sepsis, associated disease states, surgical procedure, or causative aerobic or anaerobic pathogens. Results demonstrated approximately equivalent efficacy, although cure rates obtained with ceftriaxone in patients with soft tissue sepsis or intraabdominal abscess were superior to those achieved with combination gentamicin and clindamycin. There were no significant side effects with ceftriaxone therapy, such as the renal failure noted in six of the patients treated with gentamicin and clindamycin. We conclude that single agent treatment with ceftriaxone is preferable because of the greater safety and the longer dosing intervals.

Topics: Abdomen; Abscess; Adolescent; Adult; Aged; Bacterial Infections; Cefotaxime; Ceftriaxone; Clindamycin; Clinical Trials as Topic; Drug Therapy, Combination; Female; Gentamicins; Humans; Kidney Diseases; Male; Microbial Sensitivity Tests; Middle Aged; Peritonitis; Postoperative Complications; Random Allocation; Recurrence

Gonococcal infection of the penile raphe is rarely encountered in the clinical setting. The study aimed to understand the incidence, sites, clinical manifestations, and treatment of gonococcal infection of the penile raphe.. We enrolled men with gonococcal infection of the penile raphe and men with urethral gonorrhea from January 2010 to December 2021. All patients' demographic data and clinical characteristics were recorded. All patients were treated with ceftriaxone. Incision and drainage were performed in patients with non-ruptured abscesses. Nodules and sinus tract-like lesions that did not resolve after 1 month of treatment were excised.. Among 2,736 men who presented with urethral gonorrhea from January 2010 to December 2021, 5 (0.18%) had accompanying gonococcal infection of the penile raphe. An additional two men presented with gonococcal infection of the penile raphe without urethritis. Thus, 7 (0.26%; confidence interval, 0.11-0.56%) of 2,738 men had urethral gonorrhea or gonococcal infection of the penile raphe confirmed both clinically and by laboratory testing. Lesions were present in the frenulum of the prepuce and at the median aspect, proximal end, distal end, and both the proximal and distal ends of the penile raphe. The lesions manifested as abscesses, ulcers, a nodule, and a nodule with a sinus-like lesion. All lesions exhibited tenderness. All seven patients were cured after treatment.. Gonococcal infection of the penile raphe is a rare, atypical type of involvement of the male urogenital tract by Neisseria gonorrhoeae. It may be a local complication of urethral gonorrhea or an independent primary infection. The proximal end, distal end, and median aspect of the penile raphe can be infected by N. gonorrhoeae. Cutaneous lesions present as abscesses, ulcers, nodules, and sinus-like lesions. Ceftriaxone is effective, but sinus-like lesions require surgery.

Topics: Abscess; Ceftriaxone; Gonorrhea; Humans; Male; Neisseria gonorrhoeae; Ulcer

Recent studies are discordant regarding postoperative use of piperacillin/tazobactam (PT) versus ceftriaxone/metronidazole (CM) for pediatric complicated appendicitis. Some argue that the broader spectrum PT decreases intraabdominal abscess formation; however, antibiotic stewardship, and once-a-day dosing favor CM. We aim to compare outcomes of postoperative antibiotic utilization using a large administrative database.. We queried the Pediatric Health Information System for patients 2-18 years old who underwent laparoscopic appendectomy for complicated appendicitis between 2016 and 2021. Patients were grouped into PT, CM, or other using the first postoperative day antibiotics. Adverse events and antibiotic use trends were evaluated.. We included 29,015 children from 45 hospitals. CM was used in 51.9% and 31.3% received PT. Wide variation was seen among hospitals with PT use decreasing over the years. Overall rate of abscess was 9.2%. On multivariable regression, PT was associated with higher risk for abscess formation (RR 1.35, 99% CI 1.04-1.75) and readmission (RR 1.38, 99% CI 1.13-1.68) compared to the CM group. However, following adjustment for hospitals with high CM prevalence, these associations were no longer significant.. Postoperative use of PT for complicated appendicitis is associated with higher rates of readmissions and intraabdominal abscess when compared to CM. However, this effect is mitigated when adjusting for common practice patterns.. Level III.. Retrospective Comparative Study.

Topics: Abdominal Abscess; Abscess; Adolescent; Anti-Bacterial Agents; Appendectomy; Appendicitis; Ceftriaxone; Child; Child, Preschool; Humans; Metronidazole; Piperacillin, Tazobactam Drug Combination; Postoperative Complications; Retrospective Studies; Treatment Outcome

To investigate the incidence, clinical manifestations, and treatments of gonococcal tysonitis in men. We enrolled men with gonococcal tysonitis and men with gonococcal urethritis from January 2000 to December 2020. Demographic data, interval from non-marital sexual contact to the onset of symptoms of gonococcal tysonitis, occurrence sites, and manifestations were recorded for all patients. Ceftriaxone (1 g) was injected intramuscularly once daily for 5 days in patients with lesions comprising abscesses or nodules. A single dose of ceftriaxone (1 g) was injected intramuscularly in patients with sinus-like lesions. Incision and drainage were performed in patients with non-ruptured abscesses. Fifteen patients with gonococcal tysonitis (0.29%; 95% confidence interval: 0.15-0.44%) were observed among 5087 patients with gonococcal urethritis. The mean age was 38.64 years (range, 17-74 years). The mean gonococcal tysonitis incubation period was 6.02 ± 1.37 days (range, 2-11 days). Lesions were present in the right side of the preputial frenulum in seven patients (46.67%), in the left side of the preputial frenulum in six patients (40%), and in both sides of preputial frenulum in two patients (13.33%). The lesions manifested as abscesses in 7 patients (46.67%), nodules in six patients (40%), and sinus-like lesions in two patients (13.33%); all lesions exhibited tenderness. All 15 patients were cured after treatment. Gonococcal tysonitis is a rare local complication of gonorrhea. Gonococcal urethritis with concurrent gonococcal tysonitis was less common than gonococcal urethritis with concurrent paraurethral gonococcal infection or gonococcal urethritis with concurrent gonococcal epididymitis. Gonococcal tysonitis lesions manifest as abscesses, nodules, and sinus-like lesions. Treatment with ceftriaxone is effective for gonococcal tysonitis.

Topics: Abscess; Adult; Ceftriaxone; Female; Gonorrhea; Humans; Male; Urethritis

Inappropriate antibiotic prescriptions contributed to a global issue of antimicrobial resistance. This study aimed to assess the prevalence of bacterial pathogens and antimicrobial resistance isolated from maxillofacial infections (MIs). Two hundred and twenty-two patients with different MIs were included in this study. Swab samples were taken from the site of infections. Samples were cultured, and isolated bacteria were identified using various biochemical tests. Antimicrobial resistance patterns of isolates were assessed by the disk diffusion method. The mean age of the patients was 50.8 years. The male-to-female ratio was 127/95 (P<0.05). Smoking and alcohol consumption were found in 60.36% and 37.38% of patients, respectively. Most patients had a ≤1-week infection duration (P<0.05). Abscess lesion was the most predominant infection type (P<0.05). The prevalence of aerobic bacteria among abscess, pus localization, and deep facial infections was 59.33%, 64.28%, and 46.66%, respectively. The prevalence of anaerobic bacteria among abscess, pus localization, and deep facial infections was 40.66%, 23.80%, and 53.33%, respectively.

Topics: Abscess; Ampicillin; Anti-Bacterial Agents; Anti-Infective Agents; Azithromycin; Bacteria; Bacterial Infections; Ceftriaxone; Drug Resistance, Bacterial; Female; Gentamicins; Humans; Linezolid; Male; Microbial Sensitivity Tests; Middle Aged; Penicillins; Surgery, Oral; Tetracyclines

A 16-year-old man was hospitalised with a painful space-occupying lesion in his posterior neck involving muscles, soft tissues, C1 cervical vertebra and vital cervical blood vessels. The true-cut biopsy showed inflammatory tissue. The microbiological analysis, which combined classical bacteriological and molecular methods, yielded at least four different anaerobic species. The patient was treated successfully with a prolonged course of ceftriaxone and metronidazole.

Topics: Abscess; Adolescent; Ceftriaxone; Cervical Vertebrae; Humans; Male; Neck; Osteomyelitis

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Cough; Diagnosis, Differential; Drainage; Dyspnea; Female; Fever; Humans; Middle Aged; Point-of-Care Testing; Radiography, Thoracic; Salmonella; Salmonella Infections; Splenic Diseases; Ultrasonography

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; Drainage; Female; Humans; Laryngoscopy; Magnetic Resonance Imaging; Tomography, X-Ray Computed; Tongue Diseases

Topics: Abscess; Administration, Oral; Aged; Anti-Bacterial Agents; Ceftriaxone; Diabetes Mellitus, Type 2; Diagnosis, Differential; Humans; Klebsiella Infections; Klebsiella pneumoniae; Male; Prostatic Diseases; Prostatic Hyperplasia; Tomography, X-Ray Computed

Gradenigo's syndrome is defined by the classic clinical triad of ear discharge, trigeminal pain, and abducens nerve palsy. It has become a very rare nosological entity after the introduction of antibiotics, so that has been defined as the "forgotten syndrome." However, the underlying pathological process (apical petrositis) still represents a life-threatening condition that shall be immediately recognized in order to address the patient to the proper therapy. The therapy itself may be an argument of discussion: on a historical background ruled by surgery, reports of successful conservative antibiotic treatment have risen in recent years.. We reported a case of Gradenigo's syndrome in a child with an abscess of the left petrous apex and initial involvement of the carotid artery. After multidisciplinary evaluation, we decided to encourage conservative treatment, until complete regression was observed.. The available literature of the last 10 years was reviewed, with particular attention to the presence of an apical abscess and the therapeutic approach. The principles of management with regard to conservative therapy versus surgical indications are therefore examined and discussed.

Topics: Abscess; Anti-Bacterial Agents; Anti-Inflammatory Agents; Ceftriaxone; Child; Drug Therapy, Combination; Humans; Male; Methylprednisolone; Metronidazole; Otitis Media; Petrositis; Petrous Bone; Teicoplanin

Spinal intramedullary abscesses are rare and potentially devastating lesions. Infection is mostly caused by staphylococci. Anaerobes are rare and often polymicrobial. We report an unusual case of spinal cord intramedullary abscess in a 7-month-old infant with monomicrobial infection due to Finegoldia magna. She was found to have a missed congenital thoracic dermal sinus. The patient was treated with metronidazole and ceftriaxone for 8 weeks, and improvement of the infection was documented. Clinical awareness of patients at risk is crucial for early diagnosis and intervention. As detection methods continue to improve for Finegoldia magna, it is important to increase awareness of the pathogenic role of this organism.

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Female; Firmicutes; Gram-Positive Bacterial Infections; Humans; Infant; Metronidazole; Spina Bifida Occulta; Spinal Cord Diseases; Treatment Outcome; Yemen

Topics: Abscess; Adult; Anti-Bacterial Agents; Biopsy; Ceftriaxone; Drainage; Female; Humans; Mastitis; Salmonella Infections; Salmonella paratyphi A; Ultrasonography

The ancient infectious diseases, Lemierre's Syndrome and Bezold's Abscesses are rare.. A 70-year-old Japanese woman with a 15-year history of Parkinson's disease was referred to our hospital due to fever, occipital headache and bilateral shoulder pain that had continued for three months. She had been prescribed prednisolone due to a diagnosis of polymyalgia rheumatica.. A blood culture revealed bacteremia of Streptococcus constellatus. In addition, computed tomography revealed Bezold's abscesses and Lemierre's syndrome.. We administered ceftriaxone for 31 days, followed by oral amoxicillin.. The patient recovered and the abscesses improved.. This case underscores the importance of blood culture tests and cross-referencing with radiological imagings in the diagnoses of these rare critical infectious diseases that mimic polymyalgia rheumatica.

Topics: Abscess; Aged; Amoxicillin; Anti-Bacterial Agents; Blood Culture; Ceftriaxone; Comorbidity; Female; Humans; Lemierre Syndrome; Streptococcal Infections; Streptococcus constellatus; Tomography, X-Ray Computed

A 70-year-old man with a history of hepatic cirrhosis presented with abdominal discomfort and distention. Physical examination revealed abdominal distention, positive fluid wave and abdominal tenderness. Due to concerns for spontaneous bacterial peritonitis (SBP), paracentesis was performed. Fluid analysis revealed 5371 total nucleated cells with 48% neutrophils. Ceftriaxone was then initiated for the treatment of SBP. Bacterial cultures of the fluid, however, grew

Topics: Abdomen, Acute; Abscess; Aged; Anti-Bacterial Agents; Ceftriaxone; Clostridioides difficile; Diagnosis, Differential; Drainage; Female; Humans; Male; Pelvic Infection; Peritonitis; Tomography, X-Ray Computed

When acute mastoiditis occurs in cochlear implant recipients, it can progress to subsequent retroauricular abscess due to the absence of the external mastoid cortex resulting from mastoidectomy performed for cochlear implantation. The management goal is to control infection while preserving the implanted device. A 2-year-old boy with cochlear implants developed acute mastoiditis and a subsequent retroauricular abscess. The patient underwent a surgical intervention based on the diagnosis made utilizing gray-scale and power Doppler sonography. This case illustrates the diagnostic usefulness of sonography in this rare situation. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:515-519, 2017.

Topics: Abscess; Acute Disease; Anti-Bacterial Agents; Ceftriaxone; Child, Preschool; Cochlear Implants; Ear; Ear Diseases; Humans; Male; Mastoid; Mastoiditis; Ultrasonography

Orbital cellulitis is a serious sight threatening and potentially life threatening condition which can be complicated by orbital abscess formation. Posterior subtenon (PST) injection of corticosteroid is commonly used in the treatment of posterior segment inflammation including post-operative macular oedema. We report a case of orbital abscess formation as a late complication of PST triamcinolone acetonide and discuss the presentation, diagnosis and management.

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Drug Therapy, Combination; Floxacillin; Glucocorticoids; Humans; Infusions, Intravenous; Injections, Intraocular; Macular Edema; Magnetic Resonance Imaging; Male; Metronidazole; Middle Aged; Orbital Cellulitis; Tenon Capsule; Triamcinolone Acetonide

Topics: Abscess; Animals; Anti-Bacterial Agents; Ceftriaxone; Cicatrix; Humans; Hydronephrosis; Inflammation; Kidney; Kidney Function Tests; Male; Mice, Inbred C3H; Pyelonephritis; Treatment Outcome

There have been various reports concerning Helicobacter cinaedi infections. However, few reports have examined central nervous system infections.. A 52-year-old man was transferred from the local hospital because of a persistent headache and suspected intracranial subdural empyema. Neurosurgical drainage was performed via burr holes. Gram staining and results from abscess cultures were negative. The blood culture yielded H. cinaedi. He was given an antibiotic regimen consisting of 2 g of ceftriaxone twice a day, but the size of the abscess was not reduced in size at all after 3 weeks of treatment. Neurosurgical drainage was performed again, and the antimicrobial regimen was switched to 2 g of meropenem 3 times a day. The size of the abscess was reduced after 2 weeks of the second drainage and antimicrobial drug change to meropenem. After 4 weeks treatment with meropenem, the patient was discharged, and his symptoms had completely resolved.. H. cinaedi infection should be considered in the differential diagnosis of subdural empyema cases for which Gram staining and abscess culture results are negative. Meropenem can be a first-line drug of choice or an effective alternative treatment for H. cinaedi central nervous system infections.

Topics: Abscess; Anti-Bacterial Agents; Anti-Infective Agents; Bacteremia; Ceftriaxone; Drainage; Empyema, Subdural; Helicobacter; Helicobacter Infections; Humans; Male; Meropenem; Middle Aged; Thienamycins; Treatment Outcome

Neisseria macacae is a Gram-negative diplococcus, found in the oropharynx of healthy Rhesus Monkeys. Infections caused by N. macacae in humans are extremely rare.. We present here the first case of N. macacae infective endocarditis in a 65-year-old man with a native aortic valve infection complicated by a peri-aortic abscess. N. macacae was isolated from blood culture and was found on the cardiac valve using 16S rDNA detection. Despite an appropriate antibiotic therapy, and aortic homograft replacement, and mitral repair, the patient died 4 days after surgery from a massive hemorrhagic stroke.

Topics: Abscess; Aged; Anti-Bacterial Agents; Aortic Valve; Ceftriaxone; Endocarditis, Bacterial; Fatal Outcome; France; Gentamicins; Gram-Negative Bacterial Infections; Humans; Male; Neisseria; RNA, Bacterial; RNA, Ribosomal, 16S

Topics: Abscess; Administration, Topical; Anti-Bacterial Agents; Ceftriaxone; Child, Preschool; Drug Therapy, Combination; Erythromycin; Exotropia; Eye Infections, Bacterial; Female; Humans; Infusions, Intravenous; Magnetic Resonance Imaging; Oculomotor Muscles; Ofloxacin; Ophthalmologic Surgical Procedures; Orbital Cellulitis; Staphylococcal Infections; Staphylococcus aureus

Topics: Abscess; Aged, 80 and over; Amikacin; Anti-Bacterial Agents; Brain Abscess; Ceftriaxone; Drug Therapy, Combination; Eye Infections, Bacterial; Humans; Magnetic Resonance Imaging; Male; Microbial Sensitivity Tests; Native Hawaiian or Other Pacific Islander; Nocardia; Nocardia Infections; Retinal Diseases; Trimethoprim, Sulfamethoxazole Drug Combination; Vitrectomy

Topics: Abscess; Ceftriaxone; Humans; Infant; Kingella kingae; Male; Neisseriaceae Infections; Osteomyelitis; Tibia

Topics: Abscess; Alkylating Agents; Anti-Bacterial Agents; Ceftriaxone; Collagen; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Glaucoma, Open-Angle; Glycosaminoglycans; Humans; Male; Mitomycin; Prostheses and Implants; Scleral Diseases; Staphylococcal Infections; Trabeculectomy; Vancomycin; Young Adult

Endocarditis due to Propionibacterium acnes is a rare disease. Scant data on treatment of these infections is available and is based on case reports only. If the disease is complicated by abscess formation, surgical intervention combined with an antibiotic therapy might improve clinical outcome. In some cases, cardiac surgeons are reluctant to perform surgery, since they consider the intervention as high risk. Therefore, a conservative therapy is required, with little, if any evidence to choose the optimal antibiotic. We report the first case of a successfully treated patient with P. acnes prosthetic valve endocarditis without surgery.. We report the case of a 29-year-old patient with a prosthetic valve endocarditis and composite graft infection with abscess formation of the left ventricular outflow tract due to P. acnes. Since cardiac surgery was considered as high risk, the patient was treated intravenously with ceftriaxone 2 g qd and rifampin 600 mg bid for 7 weeks and was switched to an oral therapy with levofloxacin 500 mg bid and rifampin 600 mg bid for an additional 6 months. Two sets of blood cultures collected six weeks after completion of treatment remained negative. The patient is considered to be cured based on absence of clinical signs and symptoms, normal laboratory parameters, negative radiology scans and negative blood cultures, determined at site visits over two years after completion of treatment.. To our knowledge, this is the first successfully managed patient with P. acnes prosthetic valve endocarditis with abscess formation of the left ventricular outflow tract who was treated with antibiotics alone without a surgical intervention. A six month treatment with a rifampin and levofloxacin combination was chosen, based on the excellent activity against stationary-phase and adherent bacteria.

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; Communicable Diseases; Endocarditis, Bacterial; Gram-Positive Bacterial Infections; Heart Valve Prosthesis; Humans; Levofloxacin; Male; Middle Aged; Propionibacterium acnes; Prosthesis-Related Infections; Rifampin; Treatment Outcome

We report a 60-year-old woman who presented with orbital cellulitis, restricted ocular motility, proptosis, and visual acuity of counting fingers in her left eye 3 days after strabismus surgery. Although she initially responded well to antibiotic and anti-inflammatory therapy, visual acuity in the left eye again decreased on postoperative day 5. Radiographic imaging revealed an intraconal orbital abscess, and she underwent left lateral orbitotomy with abscess drainage, with continued antibiotics and a tapering dose of steroids. To our knowledge, this is the first case of orbital cellulitis and intraconal abscess after strabismus surgery in an adult.

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Clindamycin; Drainage; Drug Therapy, Combination; Eye Infections, Bacterial; Female; Humans; Magnetic Resonance Imaging; Meropenem; Middle Aged; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Orbital Cellulitis; Strabismus; Streptococcal Infections; Thienamycins; Tomography, X-Ray Computed; Visual Acuity

Topics: Abscess; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftriaxone; Clindamycin; Diagnosis, Differential; Humans; Male; Neck Pain; Soft Tissue Infections; Streptococcal Infections; Streptococcus pyogenes; Thyroid Diseases; Thyroid Gland; Tomography, X-Ray Computed; Ultrasonography

Liquid injectable silicone has been used to increase volume in determined cutaneous districts, particularly in aesthetical reconstructive surgery. Although considered biologically inert for a long time this substance produced various complications as granulomatous foreign body reaction (siliconomas), secondary limphedema, tissue destruction and lethal embolism. A 35-year-old Caucasian woman came to our department with erithema and edema on the right leg, fever and chills. A thorough examination of the patient's history revealed injection of liquid silicone 7 years before for cosmetic volume increase of both legs. A closer observation revealed a small fistulous element from which came out white-yellow puruloid material. Antibiotic therapy and drainage of the abscess were undertaken. Within few days of treatment erithema and swelling essentially improved and the patient was discharged. After two months she came back to our department due to the same disease on her left leg that we treated with the therapy previously used. We highlight the long time, 7 years, elapsed between liquid silicone injection and onset of cutaneous symptoms.

Topics: Abscess; Adrenal Cortex Hormones; Adult; Anti-Bacterial Agents; Ceftriaxone; Cosmetic Techniques; Cutaneous Fistula; Drainage; Drug Therapy, Combination; Edema; Erythema; Female; Humans; Injections, Subcutaneous; Leg Injuries; Rifamycins; Silicones; Streptococcal Infections; Streptococcus agalactiae; Time Factors; Wound Infection

Uropathogenic E. coli (UPEC) strains are described as extraintestinal pathogenic E. coli with preference for the urinary tract. Bottone et al2 recently described the first documentation of a hypermucoviscous phenotype of a UPEC strain that displays a "stringing" phenomenon analogous to those produced by Klebsiella pneumonia strains known to invade the liver. The occurrence of this hypermucoviscous phenotype of UPEC strains causing urinary tract infection has not been well established. Following, we present a case report of two separate renal isolates from a patient with recurrent renal abscesses yielding the aforementioned hypermucoviscous phenotype of UPEC strains.

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Drainage; Escherichia coli Infections; Female; Humans; Kidney Diseases; Middle Aged; Phenotype; Tomography, X-Ray Computed; Urinary Tract; Urinary Tract Infections; Uropathogenic Escherichia coli

We report an immunocompetent 24-year-old man who presented with a severe, invasive non-typhoidal salmonella (iNTS) infection. He presented with lumbar back pain associated with fever and rigours, which had been preceded by diarrhoea. Blood cultures grew Salmonella enteritidis. An MRI scan of his pelvis and spine showed that he had a small gluteal abscess and sacroiliitis. His condition subsequently deteriorated due to the development of a secondary pneumonia and respiratory failure. He was managed conservatively with 2 weeks of intravenous ceftriaxone, followed by 6 weeks of oral ciprofloxacin. Detailed investigations did not reveal any predisposing factors or evidence of an underlying immunodeficiency. Follow-up showed complete resolution of symptoms with no long-term sequelae.

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Communicable Diseases, Emerging; Diagnosis, Differential; Humans; Immunocompromised Host; Infusions, Intravenous; Magnetic Resonance Imaging; Male; Pneumonia, Bacterial; Sacroiliitis; Salmonella enteritidis; Salmonella Infections; Young Adult

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Child, Preschool; Fever; Humans; Lymphatic Diseases; Male; Thymus Gland

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Bacterial Typing Techniques; Ceftriaxone; Combined Modality Therapy; Debridement; Female; Humans; Immunocompetence; Ofloxacin; Osteomyelitis; Salmonella; Salmonella Infections; Tibia

Salmonellosis continues to be a major public health problem, especially in developing countries. The formation of focal abscesses may occur following either hematogenous or lymphatic spread. There are large number of serious and life-threatening clinical manifestations of Salmonella spp., ranging from osteomyelitis to infective endocarditis and meningitis. However, even though Salmonella epidydimo-orchitis is a relatively rare clinical manifestion, it can present, most often in male babies and adolescent boys, following contact with nontyphoidal Salmonella. Here, we report a case of epididymo-orchitis due to Salmonella Paratyphi A that presented in an otherwise healthy 63-year-old man in order to highlight this organism's unusual clinical presentation. In countries such as India, where Salmonella infections are endemic, a high index of suspicion should be always be maintained and the possibility of a Salmonella infection at an aberrant site where it is hardly expected should not be ruled out.

Topics: Abscess; Administration, Intravenous; Administration, Oral; Ceftriaxone; Ciprofloxacin; Developing Countries; Epididymitis; Humans; India; Male; Middle Aged; Ofloxacin; Orchitis; Salmonella Infections; Salmonella paratyphi A; Treatment Outcome

Topics: Abscess; Aged; Anti-Bacterial Agents; Ceftriaxone; Coinfection; Combined Modality Therapy; Drainage; Humans; Klebsiella Infections; Klebsiella pneumoniae; Magnetic Resonance Imaging; Male; Peripheral Arterial Disease; Pyomyositis; Quadriceps Muscle; Streptococcal Infections; Viridans Streptococci

Tubo-ovarian abscess (TOA), a serious complication of pelvic inflammatory disease, unites the fallopian tube and ovary and, is rarely observed in sexually inactive adolescent girls. A pelvic mass, supposedly originating from the ovary, was detected in a 13-year-old sexually inactive girl suffering from abdominal pain and menstrual disorder. Pelvic ultrasonography pointed out a semisolid, hyperechogenic mass of 57x73 mm in the left adnexal area. Laparotomy revealed an unilateral TOA adhering to the bowel and omentum. Abscess drainage and adhesiolysis were performed and postoperative antibiotherapy was administered. TOA should be considered in the differential diagnosis of females with abdominal pain and adnexal mass whether sexual activity is present or not.

Topics: Abdominal Pain; Abscess; Adolescent; Anti-Infective Agents; Ceftriaxone; Diagnosis, Differential; Drainage; Fallopian Tube Diseases; Female; Humans; Metronidazole; Ovarian Diseases; Ovarian Neoplasms; Sexual Abstinence; Suction; Therapeutic Irrigation

We report a case of recurrent, multifocal Salmonella enterica serotype Paratyphi A breast abscesses, resistant to ciprofloxacin, which relapsed despite surgery, aspiration and multiple courses of antibiotics, including co-trimoxazole and azithromycin. The patient was cured after a prolonged course of intravenous ceftriaxone.

Topics: Abscess; Administration, Oral; Adult; Anti-Bacterial Agents; Azithromycin; Breast Diseases; Ceftriaxone; Ciprofloxacin; Drug Resistance, Bacterial; Female; Humans; Infusions, Intravenous; Paratyphoid Fever; Recurrence; Salmonella paratyphi A; Suction; Treatment Outcome; Trimethoprim, Sulfamethoxazole Drug Combination

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; Diagnosis, Differential; Gonorrhea; Humans; Male; Penile Diseases; Sebaceous Gland Diseases; Sexual Behavior; Sexually Transmitted Diseases; Travel; United States; Vietnam

Virtually all pediatric cases of Neisseria gonorrhoeae originate from contact with an infected adult. A cutaneous abscess caused by N. gonorrhoeae in a child is extremely rare, especially outside the genital area. We report a case of a 22-month-old boy with a gonococcal cutaneous abscess on the abdominal wall and suggest that N. gonorrhoeae should be included in the differential diagnosis of skin and soft tissue infections in children.

Topics: Abdomen; Abscess; Anti-Bacterial Agents; Azithromycin; Burns; Ceftriaxone; Diagnostic Errors; Drug Therapy, Combination; Emergency Shelter; Environmental Exposure; Gonorrhea; Humans; Infant; Male; Neisseria gonorrhoeae; Skin Diseases, Bacterial; Spouse Abuse

Thyroid abscess is a rare condition of the thyroid gland. The common causative organisms responsible for thyroid abscess are Staphylococci and Streptococci species. We described a case of thyroid abscess due to Klebsiella pneumoniae in an infant. The patient was successfully treated with open surgical drainage and appropriate antimicrobial agents.

Topics: Abscess; Anti-Infective Agents; Ceftriaxone; Drainage; Female; Humans; Infant; Klebsiella Infections; Klebsiella pneumoniae; Metronidazole; Thyroid Diseases; Thyroiditis, Suppurative; Treatment Outcome

We describe psoas abscess with concomitant septic hip arthritis in 2 infants, 3 and 7 months old. The common clinical features were a palpable mass in the inguinal region, irritable hip, and delayed treatment. The diagnosis of septic hip was delayed in one child, and they both had residual hip deformity at follow-up. It is possible that initial delay in diagnoses resulted in the concurrent pathologic condition because of spread of infection. These 2 cases demonstrate the first known reports of concurrent psoas abscess and septic hip arthritis in infancy. Magnetic resonance imaging is a valuable method to identify these concurrent pathologic conditions. A proposed etiologic mechanism is also discussed in the article.

Topics: Abscess; Anti-Bacterial Agents; Arthritis, Infectious; Casts, Surgical; Ceftriaxone; Combined Modality Therapy; Delayed Diagnosis; Drainage; Female; Femur; Fever; Hip Joint; Humans; Infant; Joint Deformities, Acquired; Magnetic Resonance Imaging; Male; Psoas Abscess; Shoulder; Staphylococcal Infections; Subcutaneous Tissue

Abscess of the prostate has become increasingly rare due to modern antibiotics and a decreasing incidence of gonococcal infections. It is still difficult to diagnose the disorder on clinical grounds. Diagnosis is often made after Ultrasound examination. We report 2 cases of prostatic abscess and review etiopathogenic factors, clinical findings, diagnosis and treatment of this uncommon entity.

Topics: Abscess; Amikacin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Diagnosis, Differential; Dysuria; Humans; Male; Middle Aged; Prostate; Prostatic Diseases; Ultrasonography; Urinary Retention

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; Clindamycin; Coccidioides; Coccidioidomycosis; Humans; Laryngitis; Male; Pharyngitis; Soil Microbiology

Topics: Abscess; Anti-Bacterial Agents; Ceftriaxone; Drainage; Female; Focal Infection, Dental; Humans; Injections, Intravenous; Metronidazole; Middle Aged; Molar; Periapical Abscess; Treatment Outcome

A 67-year-old woman was admitted with aortic valve endocarditis and aortic wall thickening (AWT). Physical examination and laboratory findings yielded infective endocarditis. Echocardiography revealed several small vegetations on the aortic valve, leading to moderate aortic insufficiency together with a small ventricular septal defect. We also became aware of the AWT on and over the aortic root by transesophageal echocardiography (Figure 1). At the one month follow-up period, we also noticed an abscess formation originating from the AWT, which grew into a mature abscess form, day by day (Figure 2). The aortic valve endocarditis, with destruction of the aortic annulus and abscess formation, in this patient, is considered as a grave condition which, essentially, requires an aggressive combined surgical and medical approach. We would like to intimate here with this patient that AWT needs to be considered seriously important in aortic valve endocarditis and, even if the detected vegetations are small, a close follow-up for a possible abscess formation is essential.

Topics: Abscess; Aged; Anti-Bacterial Agents; Aortic Valve; Aortic Valve Insufficiency; Ceftriaxone; Endocarditis, Bacterial; Female; Gentamicins; Heart Valve Prosthesis Implantation; Humans; Penicillin G; Staphylococcal Infections; Streptococcus; Ultrasonography

We report the case of a 14-year-old girl who presented with an 8-week history of unilateral pansinusitis. In the course of the disease a right-side frontal swelling was observed, which disappeared following antibiotic treatment. Four weeks later, however, the swelling reappeared and was now diagnosed as recurrent Pott's puffy tumor. Interestingly, C-reactive protein levels were in the normal range throughout. Following functional endoscopic frontal sinusotomy, antibiotic treatment with ceftriaxone was administered over 3 weeks and led to complete remission of the lesion. Pott's puffy tumor is a subperiostal abscess of the frontal bone, usually presenting as localized swelling of the soft tissue in the overlying region of the forehead, and is associated with localized osteomyelitis and occasionally with intracranial epidural abscess. The entity has been known since 1768, although recurrent cases with normal inflammation parameters have not been published previously.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Ceftriaxone; Combined Modality Therapy; Endoscopy; Female; Frontal Bone; Humans; Osteomyelitis; Rare Diseases; Secondary Prevention; Treatment Outcome

A rare case of parapharyngeal abscess caused by Streptococcus pneumoniae presenting as neck abscess is reported. The patient had 20 days history of cough, fever and swelling behind right ear. He had not responded to multiple antibiotic treatments given earlier. On the basis of clinical examination and CT scan finding, he was diagnosed as having parapharyngeal abscess pointing in the neck. The abscess was drained and the patient was treated with injectable Ceftriaxone, due to identification of penicillin - resistant Streptococcus pneumoniae.

Topics: Abscess; Acute Disease; Aged; Anti-Bacterial Agents; Ceftriaxone; Combined Modality Therapy; Drainage; Humans; Male; Mastoiditis; Pharyngeal Diseases; Streptococcal Infections

A 35-year-old Chinese female has a large thigh abscess without a clear source. No underlying diseases were revealed in the patient. The combination of clindamycin and cefazolin or vancomycin was administered but without a clinical response. Eikenella corrodens and Streptococcus intermedius were isolated from puncture drainage. Then, ceftriaxone was administered and a surgery of incision and further draining was carried. Eventually, the patient recovered. To our knowledge, this is the first case of thigh abscess in a previous healthy adult.

Topics: Abscess; Adult; Anti-Bacterial Agents; Ceftriaxone; China; Eikenella corrodens; Female; Gram-Negative Bacterial Infections; Humans; Streptococcal Infections; Streptococcus intermedius; Thigh

To examine the incidence of acute otitis media (AOM) and mastoiditis in children after cochlear implantation (CI) and to evaluate the role of mastoidectomy in decreasing the rate of AOM in implanted children by comparing two surgical techniques: the Posterior tympanotomy approach (MPTA, with mastoidectomy) and the Suprameatal approach (SMA, without mastoidectomy).. A retrospective study was conducted on 234 children up to 16 years of age who underwent CI between 1993 and 2003 in our department. The children were divided into two groups according to the surgical technique that had been used for the implantation: the MPTA group and the SMA group.. Part of the children with a history of pre-implantation AOM (22 of 29 in MPTA group and 26 of 38 in SMA group) did not suffer from AOM post-CI (p=0.59), and an incidence of AOM after CI in children who did not have history of AOM prior to implantation (13 patients of MPTA group and 15 patients of SMA group) was unrelated to surgical approach (p=0.65). The incidence of pre-implantation AOM was similar for the two groups and declined after CI unrelated to performing of mastoidectomy in surgical technique. Overall, 47 children (20.1%) had post-CI AOM compared to 67 children (28.6%) who had pre-CI AOM. Mastoiditis developed in 11 children (4.7%), all 11 in the MPTA group. A subperiosteal abscess was incised and drained with the retroauricular approach in three of these children and the others were managed with intravenously administered ceftriaxone 50mg/kg/day for 3-5 consecutive days, followed by a course of oral cephalexin until there is complete clinical resolution of the effusion in the middle ear. The implants were preserved in all cases. Seven out of 11 children with mastoiditis had no history of AOM prior to implantation.. AOM and mastoiditis represent common complications of CI that can be successfully treated with the prompt use of antibiotics. However, the subperiosteal abscess could require surgical drainage. In our opinion, the decrease of incidence of AOM in implanted children is the result of natural history of otitis media and is unrelated to the surgical approach.

Topics: Abscess; Acute Disease; Adolescent; Anti-Bacterial Agents; Ceftriaxone; Cephalexin; Child; Child, Preschool; Cochlear Implantation; Drainage; Female; Humans; Infant; Israel; Male; Mastoiditis; Otitis Media; Retrospective Studies

Topics: Abscess; Adolescent; Anti-Infective Agents; Ceftriaxone; Drainage; Glomerulonephritis; Humans; Male; Mastoid; Metronidazole; Otitis Media, Suppurative; Sinus Thrombosis, Intracranial; Streptococcal Infections; Streptococcus milleri Group

Topics: Abscess; Anti-Bacterial Agents; beta-Lactamases; Ceftazidime; Ceftriaxone; Drug Therapy, Combination; Endophthalmitis; Female; Humans; Middle Aged; Moraxella; Moraxellaceae Infections; Retinal Diseases; Vancomycin; Vitreous Body

A 34-year-old man presented with a two-month history of intermittent fever and left loin pain. A large left suprarenal mass was detected on computed tomography and magnetic resonance imaging. Blood pressure, serum electrolytes, serum cortisol and urinary catecholamines were normal. Laparoscopic adrenalectomy was planned but the mass was found to be an isolated adrenal abscess due to Nocardiosis. He was later found to have AIDS. The clinical utility of various imaging modalities and management of adrenal cysts are reviewed.

Topics: Abscess; Adrenal Gland Diseases; Adrenal Gland Neoplasms; Adult; Ceftriaxone; Humans; Male; Nocardia Infections; Trimethoprim, Sulfamethoxazole Drug Combination

Salmonella septic arthritis in healthy individuals is a rare phenomenon in the United States. This case report chronicles the clinical course of a 41-year-old male farmworker who presented with a 3-week history of fever, chills, night sweats with pain, and swelling and redness of his left ankle. He had an open fracture of the ankle 2 years earlier that healed and was asymptomatic despite prior radiographic evidence of avascular necrosis of the talar dome. One month before presentation, he had an ipsilateral periungual abscess of the great toe that he opened and drained himself. Joint cultures were positive for Salmonella enteritidis that was successfully treated with a 6-week course of i.v. ceftriaxone.

Topics: Abscess; Adult; Ankle Joint; Anti-Bacterial Agents; Arthritis, Infectious; Ceftriaxone; Humans; Male; Nail Diseases; Salmonella enteritidis; Salmonella Infections; Toes

Renal abscesses in patients with end stage renal disease are quite rare, and misdiagnosis or delaying in diagnosis is frequent. This report examines a case of renal abscess in a patient with end stage renal disease on maintenance hemodialysis and diabetes mellitus, which presented with a prolonged fever. An infected diabetic foot was impressed initially. Purulent urine, pyuria, bacteriuria, and bacteremia were noted after admission. Renal abscess was diagnosed by percutaneous needle aspiration under computerized tomography guidance. The patient was treated with parenteral antibiotics and percutaneous aspiration of the abscess. Follow-up ultrasonography showed renal abscess resolution. This case demonstrated that nephrectomy was not required in selected uremic patients with renal abscess.

Topics: Abscess; Aged; Anti-Bacterial Agents; Biopsy, Fine-Needle; Ceftriaxone; Diabetes Mellitus, Type 2; Drainage; Female; Gentamicins; Humans; Kidney; Kidney Failure, Chronic; Renal Dialysis; Staphylococcal Infections; Tomography, X-Ray Computed

To present an unusual case of actinomycosis abscess of the thyroid gland as well as review the history, etiology, pathogenicity and treatment of actinomycosis infections of the head and neck.. Case study.. A report of a 39 year-old female status post tooth extraction that developed an actinomycosis abscess of the thyroid.. After a thyroid actinomycosis abscess was suggested by physical exam, ultrasound, CT scan and needle aspiration, an otolaryngology consult was obtained. The patient successfully was managed with thyroidectomy and intravenous ceftriaxone.. Although Actinomycosis soft tissue infections of the head and neck are relatively uncommon, the head and neck surgeon must include it in the differential diagnosis when clinical presentation raises suspicion. Early biopsy is necessary for appropriate identification of the organism with the appearance of sulfur granules lending a clue to the diagnosis. Debridement and/or excision are often necessary for antibiotics to be used successfully. Antimicrobial therapy should be used for six to twelve months to completely eradicate the disease and prevent recurrence.

Topics: Abscess; Actinomycosis; Adult; Biopsy, Needle; Ceftriaxone; Female; Humans; Injections, Intravenous; Postoperative Complications; Thyroid Diseases; Thyroidectomy; Tomography, X-Ray Computed; Tooth Extraction

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.

Topics: Abscess; Adult; Aortic Valve; Aortic Valve Insufficiency; Bacteremia; Ceftriaxone; Cephalosporins; Endocarditis, Bacterial; Erysipelothrix Infections; Heart Valve Diseases; Heart Valve Prosthesis Implantation; Humans; Male

Renal absceeses in childhood are rare and require hospitalization, antibiotic therapy and drainage.. Two cases of renal abscess in childhood are described. In both cases there was no history of either antecedent skin infection or urinary tract infection or reflux. Flank pain and fever had a sudden onset.. The diagnosis was made in the first case by ultrasound and gadolinium-enhnaced magnetic resonance, in the second case ultrasound and computerized axial tomography were used. The patients were successfully treated at home with antibiotic therapy but without drainage.. Renal abscesses must be suspected in children with loin pain, fever and leukocytosis. They may heal even without hospitalization and drainage.

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Ceftriaxone; Child; Drainage; Female; Hospitalization; Humans; Kidney; Kidney Diseases; Male; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Radiography; Staphylococcal Infections; Ultrasonography

Topics: Abscess; Adolescent; Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Cephalosporins; Drainage; Female; Gonorrhea; Hand; Humans; Neisseria gonorrhoeae; Staining and Labeling

A pelvic abscess occurred in an infertile woman with an endocervical gonococcal infection after hysterosalpingographical examination. The pelvic abscess was not cured despite rigorous antimicrobial chemotherapy until two intra-abscess ceftriaxone injections were administered. This shows that antibiotics administered systemically may not reach therapeutic concentration in an abscess and an intra-abscess antibiotic injection may help to cure it.

Topics: Abscess; Adult; Ceftriaxone; Cephalosporins; Female; Gonorrhea; Humans; Injections, Intralesional; Neisseria gonorrhoeae; Pelvic Inflammatory Disease; Ultrasonography

Topics: Abscess; Adolescent; Ceftriaxone; Cephalosporins; Follow-Up Studies; Humans; Male; Salmonella Infections; Salmonella typhi; Splenic Diseases; Treatment Outcome

To establish some characteristics of patients with periurethral gland abscess, its microbiological profile, and response to treatment.. The patients were seen at the Khami Road Clinic, Bulawayo, a municipal STD referral clinic, serving an urban population. Twenty consecutive men with periurethral abscesses were studied. Demographic data and a sexual history were obtained from each patient. Aspirates from the abscess cavities and urethral swabs were collected for microbiology, and blood samples taken for syphilis and HIV serology. The patients were treated by aspiration of the abscess cavities, followed by a single injection of kanamycin 2.0 g followed by a 1 week course of oral doxycycline 100 mg twice daily.. Neisseria gonorrhoeae was cultured from three aspirates and five urethral specimens. Chlamydia trachomatis was found in two aspirates and three urethral specimens. Other organisms isolated included Gram negative and anaerobic bacilli. HIV antibody was detected in 13 of 18 patients tested. The response to initial treatment was good, but the abscesses ruptured in two patients, one of whom developed a urinary fistula. One patient required treatment with an alternative antimicrobial regimen.. This study demonstrated a role for N gonorrhoeae and possibly for C trachomatis in the aetiology of periurethral abscess. The prevalence of HIV infection in these patients was high. The results of treatment of periurethral abscess by aspiration of pus and followed by antimicrobial therapy covering both N gonorrhoeae and C trachomatis were acceptable.

Topics: Abscess; Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Ceftriaxone; Cephalosporins; Chlamydia Infections; Chlamydia trachomatis; Erythromycin; Gonorrhea; Humans; Male; Urethral Diseases

Topics: Abscess; Adult; Analgesia, Epidural; Anti-Bacterial Agents; Catheters, Indwelling; Ceftriaxone; Cephalosporins; Drug Therapy, Combination; Epidural Space; Female; Humans; Lumbar Vertebrae; Magnetic Resonance Imaging; Spinal Diseases; Vancomycin

Treatment of fecal peritonitis includes administration of antibiotics, physical removal of contaminants, and restoration of gastrointestinal integrity. The temporal relationship of parenteral antibiotics and peritoneal irrigation with varied antibiotic solutions was studied in a peritonitis model. Antibiotics in high concentrations may actually inhibit host immune cells; therefore, dilute solutions used were MIC (minimum inhibitory concentration) (micrograms per millimeter) equivalent to usually achieved standard therapeutic blood levels. Sprague-Dawley rats were given a quantitative intraperitoneal challenge of 2 x 10(10) CFU/kg Escherichia coli and 10 mg autoclaved rat feces. Rats were randomized to receive 30 mg/kg intramuscular ceftriaxone (CTRX) either at the time of challenge (T = 0) or 2 hr later (T = 2). Two hours after peritonitis, rats received peritoneal irrigation with 30 cc of (1) normal saline, (2) dilute (10 mg/liter) CTRX solution, or (3) concentrated (1000 mg/liter) CTRX solution or (4) no irrigation. Survival and intraperitoneal pathology were then assessed. Parenteral CTRX given concurrently with peritoneal contamination improved survival (67%) compared with parenteral administration given 2 hr later (33%) (P < 0.05). Intraperitoneal CTRX irrigation improved survival (100%) in animals that received parenteral CTRX concurrently with contamination; this beneficial effect was present with both dilute and concentrated solutions and was significantly better than saline irrigation alone. Parenteral antibiotics given early after contamination of the peritoneum associated later with peritoneal lavage with antibiotic solutions improved survival.

Topics: Abscess; Animals; Ceftriaxone; Escherichia coli; Escherichia coli Infections; Feces; Injections, Intramuscular; Male; Peritoneal Diseases; Peritoneal Lavage; Peritonitis; Random Allocation; Rats; Rats, Sprague-Dawley

Haemophilus paraphrophilus was recovered in pure culture from purulent material collected at surgery from a patient presenting with a spinal epidural abscess and a severe neurological deficit. This is the first report of such an occurrence.

Topics: Abscess; Aged; Ceftriaxone; Combined Modality Therapy; Epidural Space; Haemophilus; Haemophilus Infections; Humans; Male; Spinal Cord Diseases

Using a rat model of intraperitoneal abscess due to Bacteroides fragilis, we evaluated therapy with the combination of ceftriaxone plus the beta-lactamase inhibitor tazobactam in comparison with ceftriaxone or cefotaxime alone. When treatment was begun five hours after bacterial challenge, final bacterial counts within abscesses at 3.5 days of treatment were as follows (mean +/- S.D., log10 cfu/g): ceftriaxone plus tazobactam, 4.15 +/- 1.25; cefotaxime, 4.77 +/- 1.80; ceftriaxone alone, 5.68 +/- 1.04; untreated controls, 9.14 +/- 1.13. In spite of pharmacokinetic differences between the two drugs, coadministration of tazobactam significantly enhanced activity of ceftriaxone in this model.

Topics: Abdomen; Abscess; Animals; Bacteroides fragilis; Bacteroides Infections; Ceftriaxone; Disease Models, Animal; Drug Therapy, Combination; Male; Penicillanic Acid; Peritoneal Diseases; Rats; Rats, Sprague-Dawley; Tazobactam

Although rare in occurrence, the potential for congenital splenic cysts to enlarge, rupture, or become infected has been well documented. Presented is the case of a 13-year-old boy with an infected epidermoid cyst of the spleen, which presented as a solitary splenic abscess. The entity has traditionally been treated by splenectomy or, more recently, percutaneous drainage. However, given the inability of percutaneous drainage or sclerotherapy to permanently obliterate congenital splenic cysts, the authors managed this condition with percutaneous drainage and interval partial splenectomy. This achieves complete removal of the lesion while preserving splenic function.

Topics: Abscess; Adolescent; Ceftriaxone; Drainage; Epidermal Cyst; Humans; Male; Salmonella enteritidis; Salmonella Infections; Splenectomy; Splenic Diseases

Pulmonary infection complicating intra-abdominal sepsis is a major clinical problem. An experimental model for intra-abdominal sepsis was created with implantation of gelatin capsules, containing 3 x 10(8) cfu E. coli strain no. 2554, in the peritoneal cavity of 20 rats (10 animals received and 10 did not receive antibiotic therapy with ceftriaxone) in order to verify the role of the primary site of infection in the pathogenesis of pneumonia. Ten rats were sacrificed to determine the relative pulmonary weight and 10 were submitted to simple laparotomy and insertion of a germ-free capsule (sham-operated group). In this group of animals there was only one death (10%). All the rats that received antibiotic therapy survived until sacrifice while all the rats that did not receive ceftriaxone died, 7 within the 2nd and 3 on the 6th postoperative day. Pneumonia and peritonitis developed only in the animals that did not receive ceftriaxone. Bacteriological findings of material obtained from peritoneal and pleural cavities revealed the same strain of E. coli used for the experiment, suggesting that bacteria involved in the pleuro-pulmonary infections may originate in the primary site of infection and that antibiotic therapy started at the moment of contamination, can prevent this major complication.

Topics: Abdomen; Abscess; Animals; Ceftriaxone; Colony Count, Microbial; Male; Organ Size; Peritonitis; Pleural Effusion; Pneumonia; Rats; Rats, Sprague-Dawley

We describe a 19 year old woman with systemic lupus erythematosus on corticosteroid therapy, who developed bilateral, multiple, gas-forming Salmonella enteritidis leg abscesses and osteomyelitis mimicking deep vein thrombosis. The infection was treated successfully by a combination of surgical drainage and intravenous ceftriaxone, followed by prolonged oral pefloxacin. This rare case of gas-producing S. enteritidis emphasizes the difficulty in diagnosing such complications in active systemic lupus erythematosus.

Topics: Abscess; Adult; Ceftriaxone; Drainage; Female; Humans; Leg; Lupus Erythematosus, Systemic; Osteomyelitis; Pefloxacin; Salmonella enteritidis; Salmonella Infections

Topics: Abscess; Adult; Aged; Anti-Bacterial Agents; Ceftriaxone; Clinical Trials as Topic; Female; Half-Life; Humans; Male; Middle Aged; Soft Tissue Infections; Suppuration

A 21-year-old man presented to our emergency department with a two-day complaint of painful swelling and protrusion of the tongue, odynophagia, dysphagia, and difficulty with speech. A nonfluctuant area of tongue swelling was identified; needle aspiration of this site produced 5 mL of pus, with considerable amelioration of symptoms. Culture of the aspirate subsequently grew Hemophilus parainfluenzae, the first such reported case of this pathogen in a glossal abscess. Glossal abscess is a rare clinical entity that may result in airway compromise and disseminated infection to other systems. The presence of a glossal abscess should be considered in all cases of tongue swelling.

Topics: Abscess; Adult; Ceftriaxone; Cephalexin; Emergencies; Haemophilus Infections; Humans; Male; Tongue Diseases

Topics: Abscess; Bacteria; Ceftriaxone; Cholangitis; Female; Humans; Liver Abscess; Male; Middle Aged; Pancreatic Diseases; Pancreatitis; Peritonitis

Ceftriaxone (CTRX) was studied regarding its penetration into the adnexa uteri and uterine tissues, as well as its utility and safety in the treatment of patients with obstetric and gynecologic infections. The results obtained are summarized below. 1. When 1 g of CTRX was administered by intravenous bolus injection, Cmax in tissues of adnexa uteri and uterus ranged from 42.2 to 80.5 micrograms/g, Tmax ranged from 0.42 to 0.81 hour, and the AUC ranged from 314.9 to 606.9 micrograms.hr/g. Thus, drug penetration into these tissues was good. 2. Clinical efficacy of CTRX was evaluated in 29 obstetric and gynecological patients. The clinical efficacy was good in all cases. 3. Bacteriological effects of CTRX were very good, and 90% of the organisms isolated before treatment were eradicated. 4. Laboratory testing revealed an occurrence of mild eosinophilia in 1 case.

Topics: Abortion, Septic; Abscess; Adult; Bacterial Infections; Bartholin's Glands; Ceftriaxone; Endometritis; Fallopian Tube Diseases; Female; Genital Diseases, Female; Humans; Middle Aged; Obstetric Labor Complications; Ovarian Diseases; Pelvic Inflammatory Disease; Pregnancy

A 75-year-old man developed acute transient agranulocytosis. Hematologic data and course were suggestive of a toxic etiology. The patient had been admitted for pneumococcal septicemia and a polymicrobial abscess of the soft tissues of the left leg. At the time of diagnosis of the agranulocytosis, he had received 36 g ceftriaxone. The agranulocytosis resolved following discontinuation of ceftriaxone. This drug was, in all likeliness, responsible for the hematologic disorder. Renal failure occurred concomitantly with the agranulocytosis. Other similar cases have been reported. In view of these data, blood counts should be monitored in patients receiving prolonged courses of ceftriaxone.

Topics: Abscess; Acute Kidney Injury; Aged; Agranulocytosis; Ceftriaxone; Humans; Long-Term Care; Male; Pneumococcal Infections; Sepsis

The therapeutic efficacy of ceftriaxone and gentamicin was investigated in a foreign body induced abscess model in the rat by implanting a dialysis tube contaminated with Klebsiella pneumoniae into the subcutaneous tissue. Animals were treated for four days with ceftriaxone, gentamicin, and their combination starting immediately following or 48 h after the implantation. Peak free ceftriaxone and gentamicin abscess fluid levels were 4.3 and 2.6 mcg/ml, which were 7.3% and 37.5% of peak blood levels respectively. Both agents persisted longer in abscess fluid than in blood. Ceftriaxone inhibited the development of abscess formation when administered shortly after the implantation of the contaminated foreign body whereas gentamicin alone was without beneficial effect. When administered after 48 h ceftriaxone was less effective than immediately after implantation and gentamicin was again without any therapeutic effect. The effect of the combination of ceftriaxone and gentamicin was slightly better than ceftriaxone alone. Low oxygen tension may be an explanation for the lack of bactericidal effect of gentamicin. Ceftriaxone may be more suitable for the therapy of closed space infections caused by susceptible microorganisms than gentamicin.

Topics: Abscess; Animals; Cefotaxime; Ceftriaxone; Disease Models, Animal; Drug Evaluation, Preclinical; Drug Therapy, Combination; Female; Gentamicins; Kinetics; Klebsiella Infections; Klebsiella pneumoniae; Male; Rats; Rats, Inbred Strains