ro13-9904 and Fistula

Topics: Anti-Bacterial Agents; Ceftriaxone; Cerebrospinal Fluid; Cerebrospinal Fluid Rhinorrhea; Cerebrospinal Fluid Shunts; Community-Acquired Infections; Dexamethasone; DNA, Bacterial; Drug Therapy, Combination; Female; Fistula; Humans; Magnetic Resonance Imaging; Meningitis; Middle Aged; Respiratory Tract Fistula; Ribotyping; Sphenoid Sinusitis; Streptococcal Infections; Streptococcus; Subarachnoid Space; Tomography, X-Ray Computed

Bilateral, spontaneous cerebrospinal fluid rhinorrhoea is extremely rare, with only one previous case report (this patient developed contralateral cerebrospinal fluid leakage four years after successful endoscopic repair). We present the first English-language report of simultaneous, bilateral, spontaneous cerebrospinal fluid rhinorrhoea.. To recommend a simple alternative endoscopic technique for simultaneous closure of bilateral, spontaneous cerebrospinal fluid rhinorrhoea.. A 47-year-old woman presented with recent onset of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, a recent history suggestive of meningitis, and a past history of pneumococcal meningitis. Bony defects on both sides of the cribriform plate were closed endoscopically in the same anaesthetic session, via a uninasal, trans-septal approach, enabling both leakage sites to be sealed simultaneously.. In cases of bilateral, spontaneous cerebrospinal fluid rhinorrhoea, uninasal, trans-septal endoscopic repair is a simple and effective technique for simultaneous closure of cerebrospinal fluid leakage.

Topics: Anti-Bacterial Agents; Ceftriaxone; Cerebrospinal Fluid Rhinorrhea; Endoscopy; Ethmoid Bone; Female; Fistula; Humans; Magnetic Resonance Imaging; Meningitis, Bacterial; Middle Aged; Minimally Invasive Surgical Procedures; Nasal Cavity; Nasal Surgical Procedures; Postoperative Care; Rare Diseases; Tomography, X-Ray Computed; Treatment Outcome

A 62-year-old man with adenocarcinoma underwent complete resection with a right upper lobectomy and en-bloc resection of the chest wall, with metallic clips applied to the vertebral nerve roots. A sudden deterioration in neurological status occurred due to pneumocephalus and ascending bacterial meningitis resulting from a subarachnoid-pleural fistula. The neurological status normalized after thoracoplasty and ceftriaxone treatment.

Topics: Adenocarcinoma; Adenocarcinoma of Lung; Anti-Bacterial Agents; Brain Diseases; Ceftriaxone; Fistula; Humans; Iatrogenic Disease; Lung Neoplasms; Male; Meningitis, Pneumococcal; Middle Aged; Pleural Diseases; Pneumocephalus; Pneumonectomy; Reoperation; Respiratory Tract Fistula; Streptococcus pneumoniae; Subarachnoid Space; Thoracoplasty; Tomography, X-Ray Computed; Treatment Outcome

Cervical adenophlegmon is frequently encountered in children. We report on a case of an exceptional direct communication between a retropharyngeal abscess and a cervical adenophlegmon, observed in a 25-month-old child. Treatment comprised double antibiotic therapy and retropharyngeal drainage, which led to the subsidence of the laterocervical abscess. The progression was uncomplicated.

Topics: Anti-Bacterial Agents; Ceftriaxone; Child, Preschool; Drainage; Drug Therapy, Combination; Fistula; Glucocorticoids; Humans; Lymphadenitis; Male; Neck; Oxacillin; Retropharyngeal Abscess; Treatment Outcome