Brain tumors are manifest in a limited variety of ways, presenting with symptoms of increased intracranial pressure and of localized destruction or compression of nervous tissue. Two cases of brain tumor were reported, in which clinical manifestations resembled those of the meningitis, that is, clinical signs and symptoms, as well as cerebrospinal fluid pleocytosis, were consistent with the diagnosis of meningitis.
Brain Neoplasms* ; Brain* ; Cerebrospinal Fluid ; Diagnosis ; Intracranial Pressure ; Leukocytosis ; Meningitis*

Brain tumors are manifest in a limited variety of ways, presenting with symptoms of increased intracranial pressure and of localized destruction or compression of nervous tissue. Two cases of brain tumor were reported, in which clinical manifestations resembled those of the meningitis, that is, clinical signs and symptoms, as well as cerebrospinal fluid pleocytosis, were consistent with the diagnosis of meningitis.
Brain Neoplasms* ; Brain* ; Cerebrospinal Fluid ; Diagnosis ; Intracranial Pressure ; Leukocytosis ; Meningitis*

The anaerobic gram-positive bands, Actinomycosis israelii, are normal inhabitants of the oral cavity but upper intestinal tract of humans and rarely cause disease. Actinomycosis is an infrequent chronic suppurative infection which usually manifests as fistulas and sinuses or as a mass that simulates a pseudo-neoplastic formation. The cervicofacial region is the most common site of the disease, and the abdomen is the second. Abdominal involvement is traditionally often associated with right-sided infection. Herein, two cases of abdominal actinomycosis detected by the pathologist after a surgical operation, are reported. Before the operation, both patients presented with right lower quadrant pain, a palpable mass and leukocytosis. Preoperative abdominal computerized tomography (CT) was performed, followed by surgical intervention under the impression of a periappendiceal abscess. These cases demonstrate that abdominal actinomys should be included in the differential diagnosis when CT shows an infiltrative and inflammatory intraabdominal mass with localized tenderness.
Abdomen ; Abscess* ; Actinomycosis* ; Diagnosis, Differential ; Fistula ; Humans ; Leukocytosis ; Mouth

PURPOSE: Acute appendicitis is the most common disease requiring abdominal surgery, but for atypical clinical findings, a preoperative diagnosis is difficult and the frequency of a false positive and false negative diagnosis is high. The authors compared the diagnostic accuracy of a Technetium-99m-ciprofloxacin scan with that of the other diagnostic tools and evaluated its potential for clinical applications. METHODS: Seventeen patients were among those patients who visited the emergency room due to right lower quadrant (RLQ) pain were selected for this study. The decision for primary treatment was based on the clinical findings (RLQ pain, nausea, tenderness, rebound tenderness, leukocytosis, etc) and the radiological findings (abdominal ultrasonogram, abdominal computed tomography, etc). The 99mTc-ciprofloxacin scan was conducted regardless of the decision above. For the patients who underwent surgery, the final diagnosis of acute appendicitis was based on the pathologic result and for patients who did not undergo surgery, the final diagnosis was determined by the clinical course. RESULTS: Seventeen patients were enrolled in this study (7 males, 10 females). The patient's age ranged from 8 to 71 years and the average age was 29.2 years. The diagnostic accuracy of acute appendicitis is presented in order of the clinical findings, the radiological findings and the 99mTc- ciprofloxacin scan as follows: The sensitivity was 100%, 90.9% and 100%; the specificity rates was 33.3%, 50% and 67%; the positive predictive value was 87.5%, 90.9% and 93%; the negative predictive values was 100%, 50% and 100%; the false positive rate was 66.7%, 50% and 33.3%; the false negative rate was 0%, 9% and 0%. The respective p-values for the correlation between these results and the final diagnosis were 0.021, 0.049 and 0.002. CONCLUSION: A 99mTc-ciprofloxacin scan can decrease the false positive and the false negative rate and increase the diagnostic accuracy of acute appendicitis patients.
Appendicitis* ; Ciprofloxacin ; Diagnosis* ; Emergency Service, Hospital ; Humans ; Leukocytosis ; Male ; Nausea ; Sensitivity and Specificity ; Ultrasonography

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms

We reviewed 15 cases of necrotizing fascitis of the male genitalia. The clinical courses could be divided into two different types. In about one half of the patients the symptoms and signs progressed slowly within 122 weeks and in the remained they progressed rapidly. In the former, the prodromal signs were noted, usually low abdominal and inguinal pain. In 8 of fifteen patients, the locations of infectious focus were difficult to determine. The diagnosis were made after the development of scrotal necrosis in all of the cases. There were no differences in the causative pathogens comparing to 1hose of previous reports. The common underlying diseases were liver cirrhosis and diabetes. Hypoalbuminemia and leukocytosis were found in all. Of course, the strategy of treatment is same between two types, we would like to propose to use the term Fourier`s gangrene, a specific form of necrotizing fascitis, only to whose clinical course in acute and the location of primary infecious foci are obscure.
Diagnosis ; Fasciitis, Necrotizing* ; Gangrene ; Genitalia, Male* ; Humans ; Hypoalbuminemia ; Leukocytosis ; Liver Cirrhosis ; Male ; Male* ; Necrosis ; Prodromal Symptoms

The purpose of this study is to determine the value of serum concentration of C-reactive protein(CRP) in comparison with ESR and leukocyte as the tools for diagnosis and follow-up study of infection. For this study, thirty-one patients with head and neck infection and thirty-two patients performed the orthognathic surgery were selected for experimental and control groups each other. we analyzed the blood sample daily to measure CRP, ESR and leukocytosis. The results of this study are as the following : 1. Serum C-Reactive Protein levels in the experimental group were higher than control group and the pattern of CRP changes contin-ued to decline in both groups(P<0.001). 2. ESR changes in both groups were scattered without any special pattern. 3. Correlation between CRP and Leukocyte was higher than others(r=0.664, P<0.01). 4. In the Receiver Operating Characteristic(ROC) Curve of experimental group, rapid increase of CRP curve and Area under the curve(AUC) value, 0.774, indicate the high accuracy of estimation. 5. In experimental group, sensitivity of CRP, ESR, and Leukocytosis on recovery day were 83%, 17% and 71%. Based on the results of this study, we could conclude that determination of CRP is more useful method to diagnosis and follow-up study of infection than other commonly used variables in oral and maxillofacial region.
C-Reactive Protein* ; Diagnosis ; Follow-Up Studies ; Head* ; Humans ; Leukocytes ; Leukocytosis ; Neck* ; Orthognathic Surgery

Acute appendicitis is one of the most common diseases which need to surgical intervention. And it is one of the most perplexing diagnostic problems comfronting physicians, often present with atypical finding that make accurate preoperative diagnostic technique. This is a prospective study on 240 patients admitted with right lower quadrant pain and operated for suspected appendicitis at the Department of Surgery Chung-Ang University Hospital from March 1, 1996 to February 28, 1997. Each case was divided into two groups according to whether the pathologic diagnosis was appendicitis or non-appendicitis. And each group analysed by the clinical presentation of the physical findings and the results of preoperative routine laboratory studies including leukocyte count and urinalysis. The result were as follows: 1) Over all of the diagnostic accuracy was found to be 75.8%.The negative appendectomy rate in female was 31% compared to 18% in male, and that was statistically significant. 2) Among negativeappendectomy cases, the number of female was always larger than male in all age groups and this observation was statistically significant in second to fourth decades. 3) Negative appendectomy rate of operated group after 72 hours from symptom developed was 49% compared to 32% of operated group within 72 hours from symptom developed, and that was statistically significant. 4) Statistical significant solitary affecting factor is leukocytosis, migration pain, rebound tenderness and that these parameters were potmtially good indicators of acute appendicitis, second to fourth decades female, the time frome symptom onset to operation over 72 hours, and that these parameter were potentially indicators of non-appendicitis.
Appendectomy ; Appendicitis ; Diagnosis ; Female ; Fibrinogen ; Humans ; Laparotomy* ; Leukocyte Count ; Leukocytosis ; Male ; Prospective Studies ; Urinalysis

The case of a 27-year-old woman with an ectopic pancreas in the stomach, presenting as a cystic abscess formation, is presented. Physical examination revealed severe epigastric pain with a high fever. Laboratory data showed leukocytosis. A computed tomographic (CT) scan demonstrated a cystic mass adjacent to the gastric antrum. Endoscopy disclosed a submucosal mass at the antrum. With the diagnosis of a cystic mass laying near the gastric antrum, a laparoscopic approach was taken initially. An inflammatory abscess containing a cystic mass was found at the gastric antrum, so a partial gastrectomy was performed. Histological examination revealed an ectopic pancreas with cystic abscess formation. A review of the literature published in English showed that this case was an example of a rarely reported complicated change of an ectopic pancreas in the stomach.
Abscess* ; Adult ; Diagnosis ; Endoscopy ; Female ; Fever ; Gastrectomy ; Humans ; Leukocytosis ; Pancreas* ; Physical Examination ; Pyloric Antrum ; Stomach*

Acute multifocal bacterial nephritis is a severe form of acute renal infection in which a heavy leukocytic infiltrate occurs throughout the kidney with intrarenal abscess formation. It is also early phase of renal corticomedullary abscess. It is imperative that a prompt acute diagnosis be made in most of these conditions, for these patients may be or may rapidly become septic and suddenly deteriorate if not treated appropriately and in a timely manner. Clinically, acute multifocal bacterial nephritis present as acute pyelonephritis and could be diagnosed by radiologic grounds including abdominal computerized tomography(CT) which demonstrates poorly defined wedge-shaped area of decreased contrast enhancement identical to those found in acute focal bacterial nephritis. This case was a women with high fever, pyuria and severe leukocytosis. It was diagnosed by abdominal computerized tomography which show multiple wedge-shaped area of decreased attenuation and by computerized tomography guide aspiration biopsy which demonstrates E. coli. We report one case of acute multifocal bacterial nephritis with the reviews of literatures which showed involvement of both kidneys
Abscess ; Biopsy, Needle ; Diagnosis ; Female ; Fever ; Humans ; Kidney ; Leukocytosis ; Nephritis* ; Pyelonephritis ; Pyuria