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Detection of metastases especially intracranial metastases signals a poor prognosis in a patient with cancer. Solitary cystic metastasis is often difficult to differentiate from intra-cerebral abscess which can also occur in these patients. However, the co-existence of an abscess within a CNS metastasis is a rare event. At surgery, a purulent exudate within discrete metastatic tumours was identified. Pathological and microbiological examinations confirmed the coexistence of an abscess within a metastatic carcinoma. This case highlights the importance of considering intratumoral abscesses.

Accidental hydrocarbon poisoning encountered in children is often a cause of pneumonia without complications or sequelae. We report a new case of pneumonitis hydrocarbons complicated parenchymatous lung abscess in a child of 3 years following accidental ingestion. The particularity of this clinical case is the scarcity of previous study.

Abscess of the liver ligaments is extremely rare, and abscess of the falciform ligament has been sporadically reported. We report the case of a 3 years old male who presented with a three days history of right upper quadrant abdominal pain, fever and nausea. The ultrasound and CT scan showed an abdominal wall abscess located anterior to the liver. The patient underwent surgery. Abscess of the falciform ligament secondary to a ruptured liver abscess was found. Excision of the falciform ligament including the abscess was performed. Although pathology of the falciform ligament is rare, it should be included in the differential diagnosis of acute abdomen.

Liver abscess of oropharyngeal origin in an immunocompetent patient is a rare condition. Furthermore, microbiologic diagnosis of liver abscess can be challenging due to the tremendous diversity of the microorganisms implicated and culture difficulties under laboratory conditions. In this manuscript, we report a case of a previously healthy 23-year-old male, who presented multiple liver abscesses, attributed to aggregatibacter aphrophilus, an obligatory oral gram-negative microorganism, that normally is a component of the commensal oral microbiota and non-virulent. The etiopathogenic microorganism was identified after needle aspiration of a liver abscess cavity. Treatment with broad-spectrum antimicrobials and percutaneous catheter drainage under computed tomography guidance of both abscesses, resulted in full recovery. A. aphrophilus represents a rare entity of liver abscess in healthy individuals and suggests that a pathogen of oropharyngeal origin should be suspected when an overt source of infection cannot be documented.

Thyroid abscess is a very rare disease due to its anatomical position and the physiology of the gland. It most often occurs in the immunosuppressed population. The diagnosis is easy and is based on ultrasound. However it is often unrecognised. Bacteriological examination allows to identify the germ responsible for this condition. We report the case of a Mauritanian patient living in the said country presenting with painful cervical swelling associated with fever. The diagnosis was based on ultrasound and confirmed by fluid examination. Bacteriological assessment didn't identify the cause of this condition. Patient's outcome was marked by regression of symptoms under antibiotic therapy, with normalization of the gland structure after two months. [ABSTRACT FROM AUTHOR]

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Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Pyogenic liver abscess is characterized by a collection of pus in a neoformed cavity of the hepatic parenchyma. The most common complication is the rupture in the peritoneal, pleural or pericardial cavities. We describe a rare case of pyogenic liver abscess complicated by inferior vena cava thrombosis and bile duct compression. This is a 54-years-old patient, smoking, and alcoholic, who was received for pain of the right hypochondrium evolving for a month secondarily associated with jaundice. Examination of the abdomen found painful hepatomegaly with swelling of the right hypochondrium. The CT scan showed a segment II and IV abscess with compression on the superior biliary confluent with moderate dilatation of the intrahepatic bile ducts (Figure 1). There was also partial thrombosis of the inferior vena cava probably extended to the bilateral iliac and femoral veins confirmed by venous Doppler ultrasonography of the lower limbs. Drainage guided by ultrasonography with antibiotherapy and curative anticoagulation was initiated. The initial evolution was unfavorable towards death on the third day by probable pulmonary embolism. The abscess of the liver is a serious pathology. The occurrence of vena cava thrombosis with compression of the bile ducts is rare. Early diagnosis improves the prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Médecine et Santé Tropicales is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: Amoebic liver abscess (ALA) is the fourth cause of mortality by parasitic infection. This study aimed to assess clinical, radiological and therapeutic characteristics of patients admitted for amoebic liver abscess compared to pyogenic abscess in a French digestive tertiary care-centre., Material and Method: The charts of patients hospitalized for a liver abscess between 2010 and 2020 were retrospectively assessed then separated in two groups: amoebic liver abscess and pyogenic liver abscess from portal underlying cause. Clinical and radiological data were collected for univariate comparison., Results: Twenty-one patients were hospitalized during the time of the study for ALA, and 21 patients for pyogenic liver abscess with a portal mechanism. All patients hospitalized for ALA lived in and/or had travelled recently in an endemic area. In comparison with patients hospitalized for pyogenic abscess, patients admitted for ALA were younger (44years old vs. 63years old, P<0.001), had less comorbidities (5% vs. 43% of patients with at least one comorbidity, P<0.01), a longer median duration of symptoms (10days vs. 3days, P=0.015), abdominal pain (86% vs. 52%, P=0.019), and a slighter leucocytosis (9600G/L vs. 15,500G/L, P=0.041) were more frequent. On the abdominal tomodensitometry, density of ALA was higher (34 vs. 25 UH, P<0.01), associated with a focal intra-hepatic biliary dilatation and less often multiloculated., Conclusion: While rare in western countries, amoebic liver abscess care should not be underestimated. The presence of a solitary liver abscess of intermediate density on computed tomography, occurring on a patient returning from an endemic zone should lead the physician to a possible diagnosis of ALA., (Copyright © 2023 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.)

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We report a case study on a patient who presented with low back and thigh pain of one month duration. He was eventually diagnosed with left thigh pyomyositis. Tissue from thigh grew Staphylococcus aureus. With commencement of antibiotics and surgical drainage, patient made recovery despite prolonged hospital stay. The underlying mechanism of the extensive abscess accompanied by lack of systemic symptoms; is related to relative immunocompromised state of having underlying diabetes mellitus.

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Résumé L’histoire de l’endocardite infectieuse (EI) est une parfaite illustration des progrès de la médecine. Initialement incurable, l’endocardite, lorsqu’on parvenait à la diagnostiquer, était souvent synonyme de décès. Après d’importants progrès diagnostiques, marqués notamment par Osler, les premières chirurgies et les substances antibactériennes ont permis quelques guérisons. Ce n’est qu’avec la découverte de Flemming et l’avènement des antibiotiques que l’EI va être fréquemment guérie. Le développement des techniques chirurgicales modernes jouera également un rôle majeur dans cette pathologie et ses possibilités de guérison. Néanmoins, l’extension paravalvulaire, décrite dès les premiers cas chirurgicaux d’EI, n’était pas sans poser des problèmes techniques. Aussi, dans la seconde moitié du 20 e siècle vont se développer de nombreuses procédures chirurgicales tentant de surmonter ces difficultés. Dans cette mise au point, nous rapportons l’histoire des EI sévères, notamment avec extension paravalvulaire, en soulignant les progrès médicochirurgicaux qui ont abouti à la prise en charge qu’on lui connaît actuellement. The history of infective endocarditis (IE) is a good example of medical progress. Initially incurable, endocarditis, when diagnosed, was synonym of death. After significant diagnostic progress, thanks to Osler's contribution especially, the first surgeries and antibacterial drugs obtained very few successful cures. We had to wait until Flamming's discovery to observe frequent cures thanks to antibiotics. Surgery manages to push possibilities of cure a bit further. However, paravalvular extensions, described since the first surgical case of IE, was a real technical matter. Thus, the second half of 20th century was devoted to overcoming this surgical challenge. In this historical review, we describe the story of severe IE, especially with paravalvular involvement, by highlighting major progress – clinical and surgical, that allows its current management. [ABSTRACT FROM AUTHOR]

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Copyright of Colon & Rectum is the property of Lavoisier and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Trochanteric tuberculosis is a rare disease (<2% of osteoarticular tuberculosis), even in high-endemic countries. It is characterized by insidious symptoms. For this reason, diagnosis is often delayed. The authors report a series of 9 cases, the diagnosis was made by bacteriological and histological examinations after imaging assessment (ultrasound, MRI, CT scan). The treatment of this disease is medical (anti-tuberculous antibiotic). Surgical treatment is usually reserved for complications and improves disease progression [ABSTRACT FROM AUTHOR]

Pharyngeal foreign bodies are quite common. Their diagnosis is usually easy. The risk of complications including retropharyngeal abscess and mediastinitis is rare and it depends mainly on the nature of the foreign body and the period of the therapeutic management. The occurrence of these complications darkens the prognosis of this affection usually benign. We report a 21 years old patient, without any significant history, admitted to the emergency for a high painful dysphagia and impaired general condition with fever 20 days after trauma in the posterior pharyngeal wall following a meal. The radiological assessment including cervico-thoracic CT scan had objectified the presence of a metallic foreign body in the retropharyngeal space associated with a retropharyngeal abscess and aggravated by a mediastinitis following the migration of the foreign body to the chest. Biological markers of infection were very increased. The therapeutic management consisted of a surgical drainage of the collections by a cervicotomy with removal of the foreign body. The outcome was favorable clinically and biologically. Pharyngeal foreign bodies are common and favorable when the diagnosis and extraction are made on time. The occurrence of complications, especially retropharyngeal abscess and mediastinitis is rare and burdened with a high morbidity and mortality.

Introduction: Prevotella species (i. e. P. intermedia, P. nigrescens, P. pallens, P. oris) are usually responsible for abscesses of head and neck spaces after dental procedures. P. intermedia - related infective endocarditis has never been reported., Case Report: A 22-year-old man, with a history of aortic valve replacement 6 years ago, presented with fever and persistent retrosternal chest pain. An empirical antibiotic therapy was started on (cefotaxime, 2gx3 - gentamicin, 5mg/kilo). Five blood cultures were positive at Prevotella Intermedia. Metronidazole was introduced (500mg X 3 by day).The oro-pharyngeal spaces were normal. The evolution was marked by a hypotension, a third degree atrio-ventricular block, and a rapidly growing aortic root abscess complicated this case of Prevotella Intermedia infective endocarditis (IE). Aortic valve redux surgery was performed at day 5 of admission. Post-operative course was unremarkable., Conclusion: This first reported case of Prevotella Intermedia IE presented suggestive features of anaerobic IE as the patient developed both aortic-ring abscess, third degree atrio-ventricular block and hypotension., (Copyright © 2022 Elsevier Masson SAS. All rights reserved.)

Résumé: Nous rapportons une série de sept cas de dermohypodermite bactérienne de la face compliquant une injection de produit de comblement à visée esthétique, pris en charge dans un centre hospitalo-universitaire de 2005 à 2012. Il s’agissait de sept patientes âgées de 34 à 57ans. Deux patientes présentaient une collection profonde nécessitant un drainage chirurgical associé à une antibiothérapie. Cinq patientes ont été traitées par antibiothérapie seule. Dans deux cas, le germe retrouvé était un streptocoque A et dans un cas, Staphylococcus aureus. Une patiente a nécessité une hospitalisation en unité de soins intensifs. Seules les patientes ayant nécessité un traitement chirurgical ont présenté des séquelles esthétiques modérées. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to determine the incidence , clinical features , localization, and therapeutic aspects of the evolution of the brain abscess. Patients and Methods: This was a retrospective study included patients admitted for brain abscess Gabriel Touré Hospital in Bamako between January 2007 and September 2010. Results: We collected 17 patients. Fever was the predominant symptom in 14 patients and headache in 13 patients. The main clinical signs were hemiparesis ( 11 patients ) and vomiting (8 patients). The origin of infection was especially posttraumatic in 5 patients , locoregional by contiguity in 3 to 5 whose starting point sinus. All patients received triple antibiotic. The surgical management by trépanoponction was indicated in 16 patients. The clinical outcome was favorable in 14 patients. Three patients died. Conclusion: The brain abscess is a common disease in Mali. Despite improved diagnostics and treatment of patients, mortality remains high when the interest of prevention through early diagnosis and treatment of infectious ORL. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Surgical management of deep pelvic endometriosis may be responsible for various complications, such as infected pelvic haematic collection of the Douglas pouch. The aim of this study is to describe this unfavourable outcome and to estimate its frequency in the series of women managed by our team. Patients and methods: Retrospective study enrolling 163 women undergoing surgical removal of deep posterior endometriosis involving the vagina, from January 2008 to September 2011. We indentified women presenting with postoperative fever associated with computed tomographic findings suggesting an abscess of the Douglas pouch. Women characteristics, complication''s management and outcomes were analysed in each case. Results: Ten patients presented an inflammatory syndrome associated to hypothetical Douglas pouch abscess, revealed 6 days postoperatively on average. All women reported increasing pelvic pain, fever higher than 38.5°C, increased level of leucocytes and C reactive protein, and liquid collection of the Douglas pouch. Surgical management was carried out in nine women, revealing a pelvic collection of cloudy haematic liquid. Various bacteria were identified in six cases out of nine, suggesting liquid contamination through vagina opening. Postoperative outcome were immediately favourable. Discussion and conclusion: Inflammatory syndrome associated with infected haematic collection of the Douglas pouch is a postoperative complication of the surgical removal of deep endometriosis involving the posterior vagina. Surgical removal of the haematic collection allows rapid and definitive favourable outcomes. [Copyright &y& Elsevier]

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Abstract: Aseptic abscesses syndrome is a systemic disorder of unknown etiology involving polymorphonuclear neutrophil. Typical presentation of aseptic abscesses syndrome includes fever, abdominal pain and leukocytosis, and is characterized by the presence of intra-abdominal aseptic lesions consisting of neutrophils. The diagnosis relies on a combination of a typical clinical and radiological presentation, the pathological findings, and the exclusion of alternative diagnosis, especially infectious diseases. Antibiotics fail to achieve cure but there is a marked improvement with corticosteroids. Aseptic abscesses syndrome is either associated with another disease such as Crohn''s disease or relapsing polychondritis, or is idiopathic. It is often a relapsing condition and the PET may be an interesting diagnostic tool in the setting of recurrent and febrile abdominal pain. An immunosuppressive agent is required in almost half of the patients and anti-TNFα drugs may be used. Aseptic abscesses syndrome shares some features with other disorders such as inflammatory bowel diseases or neutrophilic dermatoses which suggests a genetic susceptibility and a relationship with auto-inflammatory disorders. Further studies on the pathways involved in aseptic abscesses will help to improve diagnosis and treatment. [Copyright &y& Elsevier]

Résumé: Un homme âgé de 72 ans souffrait de douleurs du rachis lombaire et des membres inférieurs évoluant depuis six mois. Dans les antécédents, on retenait une résection trans-urétrale d’un cancer de la vessie réalisée 12 ans auparavant, suivie par des instillations intravésicales répétées de BCG. L’imagerie du rachis dorsolombaire mettait en évidence une ostéolyse des vertèbres L3 et L4 avec atteinte du disque intervertébral L3-L4 et une volumineuse masse des parties molles dont les anomalies de signal étaient celles d’un abcès. Une biopsie guidée par scanner a mis en évidence une infection àMycobacterium bovis. Le traitement antibiotique a consisté en une trithérapie par isoniazide, rifampicine et éthambutol, administrée pendant 12 mois. Le traitement chirurgical a comporté le drainage de l’abcès et une arthrodèse vertébrale L2-L5 avec fusion et instrumentation. La BCG-thérapie intravésicale peut se compliquer d’une infection mycobactérienne tardive atteignant l’os et ce même plusieurs années après sa réalisation. En conséquence, les patients ayant eu une BCG-thérapie devrait être évalués avec précision compte tenu de la survenue possible d’une dissémination hématogène de la mycobactérie vers des sites à distance. [Copyright &y& Elsevier]

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Abstract: A 63-year-old woman living in a rural area presented in 2004 with a granulomatous necrotizing axillary lymphadenitis caused by Corynebacterium pseudotuberculosis, a Gram positive bacillus belonging to the group of Corynebacterium diphtheriae, which is found primarily in animal infections. In the human being, around 30 cases of infection due to C. pseudotuberculosis have been described, mainly among people working in contact with infected animals. For this reason, this infection, which induces exclusively lymphadenitis and abscesses with granulomatous necrotizing lesions, should be regarded as an occupational disease. In this patient, due to ignorance of the disease, this bacterium was considered to be merely saprophytic. The first treatment introduced was probabilistic antibiotherapy followed by a second course of antibiotics after aspiration. The trend confirmed that this was not the correct treatment and that surgery was the only way to achieve a cure. [Copyright &y& Elsevier]

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Abstract: Acute ethmoiditis are bacterial infections of ethmoid sinuses, which may spread to the orbital or the endocranial spaces. It is essential to fit the antibiotherapy to the bacteria responsible for these infections. Population and methods. – The charts of children hospitalized from 1995 to 2003 for an acute ethmoiditis were reviewed, particularly the results of bacterial exams and the antibiotics delivered. Results. – Over this 9-year period, 125 children (mean age 4.5 years) were hospitalized for acute ethmoiditis. Eighty were checked for blood cultures, which were sterile in 73 cases, and in the other cases, grew Staphylococcus, S. Pneumoniae or Streptococcus pyogenes. Seric soluble antigens were absent in the 5 cases where they were looked for. Ten children had a puncture of a subperiostal abscess: it was sterile in 5 cases, Staphylococcus was found in 4 cases, S. pneumoniae in the last case. Most children received an association of cefotaxim and fosfomycine for a mean duration of 5.6 days. Thirteen per cent of the children received 3 or 4 antibiotics. Discussion. – It is always difficult to found the bacteria responsible for an acute ethmoiditis. In our serie as in others, the most frequent bacteria were Staphylococcus, S. pneumoniae and S. pyogenes. Conclusion. – In view of the bacteria responsible for these infections and their antibiotic resistance, we suggest the association of cefotaxim and fosfomycin for the first line of treatment of acute ethmoiditis. [Copyright &y& Elsevier]

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Copyright of EMC-Medecine is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Extra-corporeal Shock Wave Lithotripsy (ESWL) is widely used to treat urinary calculi. With increasing numbres of ESWL, more patients prone to infectious complications. A 62-year-old man presented with cerebral abscess following ESWL. The authors discuss presenting conditions, risk factors and preventive measures. [Copyright &y& Elsevier]