Publish in OALib Journal
APC: Only $99
Background: Conservative therapies of pelvic abscess are not highly effective and surgical treatment is usually required. This study reviewed cases of pelvic abscess treated at our hospital over a 3-year period to evaluate treatment efficacy. The medical records of 20 patients diagnosed with pelvic abscess and admitted to our hospital for treatment between November 2006 and December 2009 were retrospectively examined. Results: Mean age of the patients was 50 ± 16.6 years. Pelvic abscess occurred spontaneously in 13 patients and secondary to surgical manipulation in 7 patients. In the 13 patients with spontaneous abscess, 7 had undergone pelvic surgery and 2 had undergone insertion of an intrauterine contraceptive device. Concomitant endometriosis was present in 5 of the 13 (38.5%) patients. A positive bacterial culture from the abscess was obtained in 16 of 19 (84.2%) patients tested. Causative bacteria included 4 aerobic bacterial species detected in 7 patients and 11 anaerobic bacterial species detected in 10 patients. Although multiple antibiotics were administered in all cases, 19 of the 20 (95%) patients eventually required surgical intervention, which included total hysterectomy plus adnexectomy, drainage under laparotomy or drainage alone. Anaerobic bacteria were frequently detected as the causative bacteria. Conclusion: As treatment with antibiotics alone was ineffective in almost all cases, surgical treatment was required. Drainage might be the first-choice treatment for pelvic abscess to avoid invasive surgery.
Pott puffy tumor is almost always associated with an outward extension of suppurative acute frontal sinusitis. Pathogenesis includes osteomyelitis of the frontal bone with local spread of the infection to the outer cortex and termination of the suppurative process in a frontal subgaleal abscess. An unusual ectopic location of Pott puffy tumor is the tempo-parietal subgaleal space, located exterior to the squamous portion of the temporal bone. In this location, Pott puffy tumor is considered a suppurative complication of otomastoiditis. Reported here is a 4-year-old boy who developed amoxicillin-resistant acute otitis media, silent mastoiditis, temporal bone subperiosteal abscess, subgaleal abscess, and an epidural abscess. He had several fenestra of the tegmen mastoideum as a result of osteiitis of the temporal bone, which we believe permitted spread of the oto-mastoiditis to temporal bone, subgaleal space, and epidural space. Surgical specimens obtained from the middle ear and subgaleal abscess after 24-hours of intravenously-administered combination antibiotic therapy did not reveal any aerobic or anaerobic bacterial pathogens. This is only the second such pediatric case that we found during a careful search of the literature.
Nasal septal abscess is
an uncommon condition, yet presents as a rhinological emergency. Its symptoms
resemble upper respiratory tract infection and the diagnosis may be missed
leading to intracranial complication and cosmetic deformity. We present a
healthy patient with idiopathic nasal septal abscess who complained of acute
complete nasal obstruction, fever and nasal pain. Common aetiologies, causative
agents, complications and management of nasal septal abscess are discussed.
Spontaneous cholecystocutaneous fistula is a rare
complication of chronic
calculous cholecystitis, because
currently gallstones are diagnosed and treated at an early stage. This occurrence is possible even if it seems
actually to be rare. We report a case of spontaneous cholecystocutaneous
fistula of Anterior Abdominal Wall with subcutaneous gallstones admitted in the
medical oncology unit of HASSAN II University Hospital. An 64-year-old woman,
presented with a large subcutaneous abscess in the right subcostal area with
swelling. An abdominal computed tomography scan showed a subcutaneous gallstone
and communication between the abscess and the gallbladder. Cholecystectomy was
performed and the abdominal wall abscess was drained externally. This case
report demonstrates that maintaining a high degree of suspicion of this rare
entity is helpful in achieving correct preoperative diagnosis, and that
computed tomography scan should be performed in all cases of unexplained
abdominal wall suppuration.