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Unexplained Fever In Infectious Diseases: Section 2: Commonly Encountered Aerobic, Facultative Anaerobic, And Strict Anaerobic Bacteria, Spirochetes, And Parasites
Published in Benedict Isaac, Serge Kernbaum, Michael Burke, Unexplained Fever, 2019
The diagnosis of chronic brucellosis is often difficult to establish. The condition may persist for months or years giving rise to many “functional” symptoms (pain, sweating, asthenia, depression) and apart from mild splenomegaly, no abnormal physical findings. Febrile episodes may reappear intermittently. Suppuration may occur in the liver, spleen or kidneys and extensive investigation is required for detection and eradication. In fact, chronic forms are rare. Are they really chronic or are they re-infections? It is not always easy to tell. Laboratory tests are often helpful in determining the phase of the disease. The pathogen should be isolated either from the blood, or occasionally, from biopsy material such as lymph node, bone marrow, liver, or a metastatic focus.
Skin and Organs with Epidermoid Mucosae
Published in George W. Casarett, Radiation Histopathology, 2019
With severe and deep damage to subepidermal supporting tissues and larger blood vessels, necrosis may involve not only epidermal and subepidermal tissue, but the whole of the dermis as well, and even deep hypodermal connective tissue, muscle and bone, or other underlying structures, causing relatively intractable lesions which do not heal well, may become gangrenous, and which are at best healed by scars. The wound remains stationary at first. The ulceration, although usually infected from the start, gives rise to only a moderate suppuration. Repair, largely by secondary intention, often takes months or even years. Cicatrization occurs slowly from the edges of the wound. Any epidermal regrowth which may be attempted often undergoes abortive periods of cessation and regression. Healing is usually inadequate and the state of the region remains precarious, with necrosis recurring fairly often even years after cicatrization.
Practising on principle: Joseph Lister and the germ theories of disease
Published in Christopher Lawrence, Medical Theory, Surgical Practice, 2018
Christopher Lawrence, Richard Dixey
Suppuration, per se, is not an unhealthy action, nor is pus itself always an injurious substance; but when the process can be prevented by union by the first intention so much the better for the patient; for, wherever pus or effused blood exist, there is more or less the danger of their becoming decomposed, absorbtion taking place, and the system being poisoned by them. If freely exposed stumps heal up most readily and well, it must be at once apparent that those which do so when most elaborately swathed in carbolised wrappings, do so rather in spite of, than as a consequence of the treatment.
Best management of patients with an acute sore throat – a critical analysis of current evidence and a consensus of experts from different countries and traditions
Published in Infectious Diseases, 2023
Ronny K. Gunnarsson, Mark Ebell, Robert Centor, Paul Little, Theo Verheij, Morten Lindbæk, Pär-Daniel Sundvall
A sore throat can occasionally lead to suppurative complications, such as peritonsillar abscess (quinsy) and in rare cases otitis media, sinusitis and sepsis [25]. Skin infections may also occur, predominantly in low-income settings. Suppurative complications are primarily linked to GAS but also to F. necrophorum in adolescents and young adults with quinsy [25]. The most feared, but rare, complication associated with F. necrophorum is the Lemierre Syndrome characterised by internal jugular suppurative thrombophlebitis with metastatic emboli mostly commonly to the lung [26]. Streptococcus dysgalactiae subsp. equisimilis is less frequently linked to suppurative complications compared to GAS and F. necrophorum [25]. Clinical scoring such as Centor scores [27,28], McIsaac scores [27,29,30] or FeverPain scores [17,31] do not reliably predict acute suppurative complications [32].
Cat at home? Cat scratch disease with atypical presentations and aggressive radiological findings mimicking sarcoma, a potential diagnostic pitfall
Published in Acta Orthopaedica, 2021
Florian Amerstorfer, Jasminka Igrec, Thomas Valentin, Andreas Leithner, Lukas Leitner, Mathias Glehr, Jörg Friesenbichler, Iva Brcic, Marko Bergovec
Treatment of CSD frequently includes surgery and antibiotic therapy. Up to one-third of cases develop suppuration of the affected lymph nodes and evacuation of the pus is indicated (Wang et al. 2009). Lymphadenectomy is not advised due to the possibility of the development of fistulas (Baranowski and Huang 2020). In our study, even though B. henselae infection was confirmed in 2 cases, lymphadenectomy was performed due to imaging findings suspicious of malignancy. 1 patient (case number 4) was free of local postoperative complications and in the second patient (case number 9) histology showed granulomatous inflammation with synchronous metastasis of the malignant melanoma. This case illustrates that only histologic analysis can rule out malignant diseases, and if the findings are inconclusive, the biopsy should be repeated.
Pattern of Childhood Uveitis in Egypt
Published in Ocular Immunology and Inflammation, 2019
Eiman Abd El Latif, Wahib Fayez Goubran, Emad El Din M. El Gemai, Ahmed E. Habib, Ahmed M. Abdelbaki, Hatem Ammar, Mouamen Seleet
Children diagnosed with presumed parasitic anterior uveitis had yellowish-white or creamy-colored nodules, in the inferior part of the anterior chamber, rising between the iris and the cornea, with a variable accompanying anterior chamber reaction. The nodules had a tendency to heal by scarring in response to topical steroids (Figure 1). We could not ascertain conjunctival nodules in any of the enrolled children. Seven eyes with large “fleshy” nodules underwent surgical excision of the lesions under general anesthesia and a strictly aseptic technique, followed by histopathological examination of the specimen. The specimens revealed a nonspecific mixed inflammatory reaction in which lymphocytes, macrophages, polymorphic nuclear leukocytes, and eosinophils were detected. Three of the seven specimens revealed islands of suppuration. No parasite could be identified in any of the specimens.