Anorectal Abscess
Laurence R. Sands, Dana R. Sands in Ambulatory Colorectal Surgery, 2008
Symptoms depend on the site of the abscess and the extent of the infection. The classic symptoms of acute suppuration—a tender erythematous swelling—often accompany perianal abscess due to its superficial location. In this case, the inflammatory mass will be present outside the anal verge and fluctuance might not be present. In the other types of anorectal abscesses that are located deep within the pelvic tissue, a mass may not be easily evident on physical examination, or it may only be palpated or visualized during a rectal exam or anoscopy (Fig. 1) (43). If present, it may be located on the upper part of the anal canal or the lower part of the rectum. Because of the location, the patient may recount a history of prolonged symptoms (pain, fever), and is more likely to have systemic symptoms such as fever and leukocytosis compared to a superficial perianal abscess. An ischiorectal abscess, if swelling and erythema are involved, will appear medially at the buttock, lateral to the anal verge (Fig. 2). A deep postanal abscess can be associated with severe rectal discomfort, pain radiating to the sacrum, coccyx, or buttocks, and may be confused for coccydynia. An intersphincteric abscess is usually associated with severe pain and frequently requires an evaluation under anesthesia (EUA). Pain associated with an anorectal abscess is often exacerbated by or appears after evacuation.
Complications related to neurogenic bladder dysfunction I: Infection, lithiasis, and neoplasia
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
This is also a catheter-related infection. It is usually caused by spread of infection from the urethra or bladder, which reaches the epididymis via the vas deferens in a retrograde manner. The most common cause of epididymitis in NBD patients, therefore, is due to the organisms that cause urethritis. These include Neisseria gonorrhoeae, Escherichia coli, and Chlamydia trachomatis.22 Acute epididymitis is a clinical syndrome consisting of pain, swelling, and inflammation of the epididymis of less than 6 weeks. In neurologically affected patients, pain is usually absent because they do not have adequate sensation. The only clinical sign is swelling and flare. Fever may be detected in the acute stage. Treatment is by specific antibiotics according to culture results. Quinolones can be given until the result of culture appears. In rare conditions, in neglected cases, infection may reach the testicle and cause orchitis, with the eventual formation of abscess. Treatment should include abscess drainage plus strong antibiotics. Sometimes, if the testis is found damaged, orchiectomy becomes the solution.22
Central nervous system viral infections complicating immunosuppression
Avindra Nath, Joseph R. Berger in Clinical Neurovirology, 2020
Patients with primary and secondary tumors represent up to 25% of all CNS infections, mostly bacterial, in cancer patients. Poor wound healing is a risk after steroids, radiation therapy, vascular endothelial growth factor (VEGF) inhibitors, and repeat craniotomies, particularly those involving shunting or Ommaya reservoir placement. Abscesses can occur within days or up to many years after treatment. S. aureus remains the most common postoperative pathogen for brain abscess, but other cause of abscesses include Toxoplasma gondii, Taenia solium, Aspergillus species, and Nocardia asteroides. Thus, viral infections are not usually associated temporally with neurosurgery. There is however, one syndrome specific to cranial radiotherapy, reactivation of herpes simplex 1 virus. (See Sec. 24.5.1.)
Treatment of lactational breast abscesses with cavity diameter larger than 5 cm via combined ultrasonography-guided percutaneous catheter placement and hydrostatic pressure irrigation
Published in Journal of Obstetrics and Gynaecology, 2022
Zhihui Du, Lei Liu, Xing Qi, Peisen Gao, Shumin Wang
Overall, US-guided interventional treatment is considered effective and safe for early-stage lactational breast abscesses with a diameter <5 cm and has even been suggested as the primary method for small and early-stage breast abscesses (Lam et al. 2014). Nevertheless, Eryilmaz et al. (Eryilmaz et al. 2005) believe that US-guided interventional treatment is unlikely to succeed in the case of breast abscesses with a cavity diameter >5 cm and that conventional drainage with surgical incision or suction drainage should be used as the treatment. According to Suthar et al (2013), the failure rate of US-guided aspiration therapy is 12.5% in lactational breast abscesses smaller than 5 cm and 55.5% in those larger than 5 cm. The aim of our study was to irrigate and drain the pus from such abscesses more thoroughly. We tried to use this method to increase the cure rate of US-guided minimally invasive treatment for large abscesses. The results showed that all patients were cured successfully, requiring no further surgical intervention. Moreover, no complications occurred, and no patients developed sequelae. The average hospital stay length was six days, and the patients did not stop breastfeeding during the treatment period. The cosmetic results were satisfactory, and no recurrence was observed.
Parabacteroides distasonis: intriguing aerotolerant gut anaerobe with emerging antimicrobial resistance and pathogenic and probiotic roles in human health
Published in Gut Microbes, 2021
Jessica C. Ezeji, Daven K. Sarikonda, Austin Hopperton, Hailey L. Erkkila, Daniel E. Cohen, Sandra P. Martinez, Fabio Cominelli, Tomomi Kuwahara, Armand E. K. Dichosa, Caryn E. Good, Michael R. Jacobs, Mikhail Khoretonenko, Alida Veloo, Alexander Rodriguez-Palacios
Abscesses are a prime hotspot for numerous infectious bacteria to manifest and thrive. Clinical studies have reported finding culturable P. distasonis isolates in abscesses. Clinical studies and case reports have implied a possible role for P. distasonis in abscess formation in various tissues, including the spleen,120,121 liver,122 and wounds.33 For example, Gunalan et al.120 reported a case of splenic abscess in a 40-year-old man presenting to the hospital with fever, left-side abdominal pain, altered sensorium, and vomiting. After the patient received antimicrobial therapy and underwent a splenectomy, it was discovered that pus aspirated from the splenic abscess grew P. distasonis. Gunalan et al.120 noted that this is one of only a few recorded cases of P. distasonis causing splenic abscess in humans; nonetheless, such a finding is alarming and supportive of a pathogenic role of P. distasonis in human infections.120 Furthermore, CD4+ T-cells were shown to play a key role in the formation of P. distasonis-induced intra-abdominal abscesses in rodent models.123
Group A streptococcal brain abscess in children: two case reports and a review of the literature
Published in Infectious Diseases, 2018
Guy Hazan, Eyal Kristal, Michael Gideon, Vadim Tzudikov, Yuval Cavari, Yariv Fruchtman, Shalom Ben-Shimol, Eugene Leibovitz, Isaac Lazar, Rimma Melamed
Brain abscesses arise through direct extension of infection from neighbouring structures, by haematogenous spread or may follow head or skull trauma or surgery [1,2]. Most abscesses are bacterial and many may contain multiple species (mixed infection). Staphylococcus aureus and Streptococcus spp. (mostly S. viridans group) are the most common aerobic species involved [1–4]. Recently, in a series of 31 children diagnosed with brain abscesses caused by various bacterial agents in Turkey during 2000–2015, 24 (77.4%) had predisposing factors, 17 (54.8%) had an unfavourable outcome and 2/31 (6.4%) died [4]. Surgical procedures were performed in 26 (83.9%), including aspiration (19 patients, 61.3%), resection (5, 16. 1%) and aspiration plus resection (2, 6.5%). In this series, Glasgow coma scale <12 (12 patients, 38.7%) and presence of focal neurologic deficits (17 patients, 54.8%) were independent risk factors for unfavourable neurologic outcome [4].
Related Knowledge Centers
- Carbuncle
- Cyst
- Hair Follicle
- Parasitism
- Pus
- Tissue
- Ultrasound
- Boil
- Pathogenic Bacteria
- Methicillin-Resistant Staphylococcus Aureus