BACKGROUND AND OBJECTIVES: Clinical differentiation of peritonsillar abscess from peritonsillar cellulitis can be difficult and often relies on diagnostic needle aspiration that is invasive. The differential diagnosis of the two conditions is very important for the planning of treatment. This study is to evaluate the usefulness of gray scale image (GSI) and color doppler image (CDI) using intraoral ultrasonography in differential diagnosis of the peritonsillar abscess from peritonsillar cellulitis. MATERIALS AND METHODS: Twenty patients with suspected peritonsillar abscess were included in this study. GSI and CDI of the intraoral ultrasonography with 7-MHz curved linear array transducer were used. RESULTS: The peritonsillar abscess showed inhomogeneously hypoechoic or cystic space on GSI and rim-shaped color flow signal on CDI. The peritonsillar cellulitis showed homogeneously hypoechoic or striated textual appearance on GSI and diffusely increased color signal on CDI. The sensitivity of GSI for diagnosis of peritonsillar abscess and peritonsillar cellulitis was 91.7% and 77.8%, respectively, whereas the specificiy of CDI proved to be 100% for the diagnosis of both conditions. CONCLUSION: This study demonstrates that intraoral ultrasonography is a useful and noninvasive technique for diagnosis of peritonsillar abscess.
Cellulitis ; Diagnosis* ; Diagnosis, Differential ; Humans ; Needles ; Peritonsillar Abscess* ; Transducers ; Ultrasonography*

Diabetes mellitus (DM) can accompany many musculoskeletal (MSK) diseases. It is difficult to distinguish the DM-related MSK diseases based on clinical symptoms alone. Sonography is frequently used as a first imaging study for these MSK symptoms and is helpful to differentiate the various DM-related MSK diseases. This pictorial essay focuses on sonographic findings of various MSK diseases that can occur in diabetic patients.
Adult ; Cellulitis/ultrasonography ; Diabetes Mellitus, Type 2/*complications ; Diabetic Neuropathies/ultrasonography ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications/*diagnosis/ultrasonography ; Pyomyositis/microbiology/ultrasonography ; Tenosynovitis/microbiology/ultrasonography ; Vascular Diseases/ultrasonography

Most popliteal cysts are asymptomatic. However, cysts may rupture, resulting in pain and swelling of the leg that could also arise from other diseases, including deep vein thrombosis, lymphedema, cellulitis, and tear of a muscle or tendon. Therefore, it is difficult to diagnose a ruptured popliteal cyst based on only a patient's history and physical examination. Musculoskeletal ultrasound has been regarded as a diagnostic tool for ruptured popliteal cyst. Here, we describe a patient who was rapidly diagnosed as ruptured popliteal cyst by ultrasonography. Therefore, ultrasound could be used to distinguish a ruptured popliteal cyst from other diseases in patients with painful swollen legs before evaluation for deep vein thrombosis.
Cellulitis ; Humans ; Leg ; Lymphedema ; Physical Examination ; Popliteal Cyst* ; Rupture ; Tendons ; Ultrasonography* ; Venous Thrombosis*

PURPOSE: We report a case of endogenous endophthalmitis caused by Klebsiella pneumoniae, accompanied by orbital cellulitis and necrotizing scleral perforation secondary to liver abscess. METHODS: A fifty three year old woman patient who had received treatment for uveitis in local ophthalmic clinic for five days was referred to this ophthalmologic department in consultation for uncontrolled ocular pain and eyelid swelling accompanied by proptosis. Ten days before admission, she had already received antibiotic medication at internal medicine clinic for abdominal pain and fever. Since her ocular pain along with exophthalmos and eyelid swelling got worse, she received a whole body examination including blood culture, urine test, chest and abdominal radiologic examination to find out infectious focus. In addition, ultrasonography, computed tomography and aqueous culture for ophthalmic examination were performed. Then she was treated with antibiotic medication via systemic and topical route. RESULTS: The Klebsiella pneumoniae was cultured from vitreous in endogenous endophthalmitis accompanied by orbital cellulitis and necrotizing scleral perforation. Although the inflammation was improved with antibiotic medication, she lost her vision. CONCLUSIONS: From the fact that scleral perforation can be complicated by endogenous bacterial endophthalmitis, it is strongly urged that systemic work up such as radiologic examination and blood test be carried out with caution to detect infectious diseases.
Abdominal Pain ; Communicable Diseases ; Endophthalmitis* ; Exophthalmos ; Eyelids ; Female ; Fever ; Hematologic Tests ; Humans ; Inflammation ; Internal Medicine ; Klebsiella pneumoniae ; Klebsiella* ; Liver Abscess ; Orbital Cellulitis ; Thorax ; Ultrasonography ; Uveitis

PURPOSE: For the treatment of residual visible tributaries following minimally invasive saphenous vein ablation procedures such as endovenous laser treatment (EVLT) and radiofrequency ablation (RF), a variety of options including observation, sclerotherapy, ultrasonography-guided sclerotherapy, stab phlebectomy (SP) and additional laser therapy have been developed. We performed endovenous laser treatment combined with stab phlebectomy and we evaluated the early results to assess the efficacy and safety of this procedure. METHODS: Between February 2003 and February 2006, one hundred twelve venous insufficiencies of the lower limbs in 106 patients (46 men and 60 women; mean age: 51.7 years) were treated with EVLT combined with SP. According to the CEAP classification, 103 limbs were C2, and nine were C3/C4. 810-nm diode laser energy was delivered percutaneously into the saphenous veins (86 GSVs, 20 SSVs, 6 GSV+SSVs). All patients were followed up on an outpatient basis and duplex ultrasonography (US) was performed 3 months after operation. RESULTS: The mean follow-up period was 2.92 months. All the patients had symptomatic improvement and immediately returned to normal daily activities. The overall complication rate was 36.6% (41 cases), and most of them were minor problems including ecchymosis in 22, paresthesia in 8, induration in 5 and excessive pain in 2. Three cases of cellulitis or thrombophlebitis were present and this resolved with drainage and antibiotics. One case of foot drop developed, but this improved with active physiotherapy within a few months. No postprocedural symptomatic deep vein thrombosis occurred. The recurrence rate of tributaries at 3 months was 13.6%, but these were easily controlled by sclerotherapy if needed. The duplex US-confirmed saphenous vein recanalization rate at 3 months was 5.9%. CONCLUSION: EVLT combined with SP could be a novel minimally invasive modality for treating lower extremity varicose veins with an acceptable complication rate and a low recanalization rate of the saphenous veins. It could lessen the possibility of additional treatments for the residual visible tributaries and so improve the satisfaction index, along with the cosmetic and economic advantages. However, long-term follow up and postoperative duplex US with an additional objective index examination are required to confirm the effectiveness and durability of this operative procedure.
Anti-Bacterial Agents ; Catheter Ablation ; Cellulitis ; Classification ; Drainage ; Ecchymosis ; Extremities ; Female ; Follow-Up Studies ; Foot ; Humans ; Laser Therapy ; Lasers, Semiconductor ; Lower Extremity* ; Male ; Outpatients ; Paresthesia ; Recurrence ; Saphenous Vein ; Sclerotherapy ; Surgical Procedures, Operative ; Thrombophlebitis ; Ultrasonography ; Varicose Veins* ; Venous Insufficiency ; Venous Thrombosis

Plesiomonas shigelloides with positive reactions of oxidase and indole production is a species of facultative anaerobic gram-negative bacilli. It is an inhabitant of fresh surface water and has been isolated from surface water, fresh water fish, oysters, and various animals. It is not considered to be a part of normal human intestinal flora. In human, P. shigelloides has been associated with gastroenteritis and extraintestinal infection. There have been no previous reports of extraintestinal disease due to P. shigelloides in Korea. Rare extraintestinal infections include neonatal meningitis and septicemia, cellulitis pyometra and acute cholecystitis. The patients may take fatal courses even though they receive antiboiotic therapy. We report a case of sepsis caused by P. shigelloides in a 60-year-old male with diabetes mellitus who had undergone subtotal gastrectomy 8 years before. The patient presented with diarrhea, abdominal cramps, high fever and jaundice. Enlargement of the gallbladder was noted in an abdominal ultrasonogram. He had a history of drinking surface water 5 days ago. P. shigelloides was isolated from his blood, but he recovered after cephalosporin and aminoglycoside infusion and supportive therapy. To our knowledge, this is the first report of septicemia due to P. shigelloides in Korea.
Animals ; Cellulitis ; Cholecystitis, Acute ; Colic ; Diabetes Mellitus ; Diarrhea ; Drinking ; Fever ; Fresh Water ; Gallbladder ; Gastrectomy ; Gastroenteritis ; Humans ; Jaundice ; Korea ; Male ; Meningitis ; Middle Aged ; Ostreidae ; Oxidoreductases ; Plesiomonas* ; Pyometra ; Sepsis* ; Ultrasonography ; Water

No abstract available.
Acupuncture Therapy ; Ampicillin/pharmacology/therapeutic use ; Ankle/ultrasonography ; Anti-Bacterial Agents/pharmacology/therapeutic use ; Cellulitis/complications/diagnosis/drug therapy/*microbiology ; Diabetes Mellitus, Type 2/complications ; Gram-Negative Bacterial Infections/complications/diagnosis/drug therapy/*microbiology ; Humans ; Hypertension/complications ; Magnetic Resonance Imaging ; Male ; Microbial Sensitivity Tests ; Middle Aged ; Prevotella nigrescens/drug effects/*genetics/isolation & purification ; RNA, Ribosomal, 16S/*analysis ; Sulbactam/pharmacology/therapeutic use ; Tomography, X-Ray Computed