2.Neonatal priapism associated with spontaneous bilateral pyocavernositis.
Rajeev SOOD ; Surender Nath WADHWA ; Vikas JAIN
Annals of the Academy of Medicine, Singapore 2006;35(6):425-427
INTRODUCTIONNeonatal priapism is known to be associated with a wide range of aetiologies, but an association with spontaneous purulent cavernositis has not been reported in the paediatric literature. We report the first of such case.
CLINICAL PICTUREA 24-day-old neonate was brought with the history of persistent erection of penis since day 4 of life and swollen penis of 4 days' duration, which revealed frank pus on cavernosal aspiration bilaterally.
TREATMENTThe child was treated with closed aspiration drainage; cross-irrigation with antibiotic solution under systemic antibiotic cover helped in achieving complete detumescence.
OUTCOMEOn follow-up, child demonstrated normal full bladder tumescence and colour doppler revealed bilateral normal corporo-cavernosal appearance and blood flow, indicating good functional and anatomical recovery.
CONCLUSIONThis case report describes the presentation, successful management and excellent functional and anatomical outcome, on follow-up, of this rare association of neonatal priapism with spontaneous bilateral pyocavernositis. An attempt has been made to describe the underlying pathophysiology.
Algorithms ; Humans ; Infant, Newborn ; Inflammation ; complications ; Male ; Penile Diseases ; complications ; Priapism ; complications ; therapy ; Suppuration
3.Acute pyogenic bone and joint infections.
Annals of the Academy of Medicine, Singapore 1987;16(2):252-255
Acute infections of bone and joints is a curable condition and the chance of cure is related to a number of factors like type and virulence of the organism, resistance of the host, choice of antibiotics, early drainage of the joint in septic arthritis and appropriate treatment after early diagnosis with adequate dosage and duration of antibiotic therapy. Late diagnosis and inadequate treatment can often lead to high mortality and morbidity and leave the patient with crippling sequelae like chronic osteomyelitis, joint destruction, pain, shortening, deformity and limp.
Acute Disease
;
Arthritis, Infectious
;
complications
;
diagnosis
;
therapy
;
Humans
;
Osteomyelitis
;
complications
;
diagnosis
;
therapy
;
Suppuration
4.Stenosis of Esophageal Reconstruction by Abscess.
Jong Phill SONG ; Kyoung Hoon KIM ; Sung Hyock CHUNG ; Kyoung Min KANG ; Sub LEE ; Kyoung Hoon KANG ; Byung Yul KIM ; Jung Ho LEE
The Korean Journal of Thoracic and Cardiovascular Surgery 1997;30(10):1048-1050
We experienced a case of unusual complication following esophageal reconstruction. In 1969, accidentally the patient swallowed lye and was developed benign esophageal stricture one year later. In 1972, esophageal reconstruction with right colon was done but pus was drained out of the abdominal wound. After then wound disruption and healing were repeated. In 1996, stenosis of colonic graft was found and resection of stenotic area and end to end anastomosis was done. We concluded that it was developed inflammatory change of graft by intraoperative infection.
Abscess*
;
Colon
;
Constriction, Pathologic*
;
Esophageal Stenosis
;
Humans
;
Lye
;
Postoperative Complications
;
Suppuration
;
Transplants
;
Wounds and Injuries
7.Pressure ulcers and acute risk factors in individuals with traumatic spinal fractures with or without spinal cord injuries: A prospective analysis of the National Spinal Column/Cord Injury Registry of Iran (NSCIR-IR) data.
Farzin FARAHBAKHSH ; Hossein REZAEI ALIABADI ; Vali BAIGI ; Zahra GHODSI ; Mohammad DASHTKOOHI ; Ahmad POUR-RASHIDI ; James S HARROP ; Vafa RAHIMI-MOVAGHAR
Chinese Journal of Traumatology 2023;26(4):193-198
PURPOSE:
To identify risk factors for developing pressure ulcers (PUs) in the acute care period of traumatic spinal fracture patients with or without spinal cord injuries (SCIs).
METHODS:
Data were collected prospectively in participating the National Spinal column/Cord Injury Registry of Iran (NSCIR-IR) from individuals with traumatic spinal fractures with or without SCIs, inclusive of the hospital stay from admission to discharge. Trained nursing staff examined the patients for the presence of PUs every 8 h during their hospital stay. The presence and grade of PUs were assessed according to the European Pressure Ulcer Advisory Panel classification. In addition to PU, following data were also extracted from the NSCIR-IR datasets during the period of 2015 - 2021: age, sex, Glasgow coma scale score at admission, having SCIs, marital status, surgery for a spinal fracture, American Spinal Injury Association impairment scale (AIS), urinary incontinence, level of education, admitted center, length of stay in the intensive care unit (ICU), hypertension, respiratory diseases, consumption of cigarettes, diabetes mellitus and length of stay in the hospital. Logistic regression models were used to estimate the unadjusted and adjusted odds ratio (OR) with 95% confidence intervals (CI).
RESULTS:
Altogether 2785 participants with traumatic spinal fractures were included. Among them, 87 (3.1%) developed PU during their hospital stay and 392 (14.1%) had SCIs. In the SCI population, 63 (16.1%) developed PU during hospital stay. Univariate logistic regression for the whole sample showed that marital status, having SCIs, urinary incontinence, level of education, treating center, number of days in the ICU, age, and Glasgow coma scale score were significant predictors for PUs. However, further analysis by multiple logistic regression only revealed the significant risk factors to be the treating center, marital status, having SCIs, and the number of days in the ICU. For the subgroup of individuals with SCIs, marital status, AIS, urinary incontinence, level of education, the treating center, the number of days in the ICU and the number of days in the hospital were significant predictors for PUs by univariate analysis. After adjustment in the multivariate model, the treating center, marital status (singles vs. marrieds, OR = 3.06, 95% CI: 1.55 - 6.03, p = 0.001), and number of days in the ICU (OR = 1.06, 95% CI: 1.04 - 1.09, p < 0.001) maintained significance.
CONCLUSIONS
These data confirm that individuals with traumatic spinal fractures and SCIs, especially single young patients who suffer from urinary incontinence, grades A-D by AIS, prolonged ICU stay, and more extended hospitalization are at increased risk for PUs; as a result strategies to minimize PU development need further refinement.
Humans
;
Spinal Fractures/etiology*
;
Pressure Ulcer/complications*
;
Iran/epidemiology*
;
Spinal Cord Injuries/epidemiology*
;
Risk Factors
;
Spine
;
Registries
;
Urinary Incontinence/complications*
;
Suppuration/complications*
8.Clinical analysis of purulent meningitis in 317 children.
Chinese Journal of Contemporary Pediatrics 2015;17(7):710-714
OBJECTIVETo study the clinical features, treatment, and prognosis of purulent meningitis (PM) in children.
METHODSA retrospective analysis was performed on the clinical data of 317 children with PM aged from 1 month to 15 years.
RESULTSPM was commonly seen in infants (198 cases, 62.6%). Most children with PM had preceding respiratory infection (171 cases, 53.9%). The major clinical manifestations of PM were fever, convulsions, and intracranial hypertension, and convulsions were more commonly seen in infants (152 cases, 93.6%). The major complication was subdural effusion (95 cases, 29.9%). Of the 95 cases of subdural effusion, 22 cases were diagnosed by subdural puncture; 68 cases underwent subdural puncture and 62 cases restored to normal temperature 3-5 days after puncture. Risk factors associated with complications and sequelae were young age and protein≥1 g/L in cerebrospinal fluid (CSF) (OR=0.518, 1.524 respectively; P<0.05). The third-generation cephalosporins were the first choice for PM, and vancomycin or carbapenems were replacement therapy. Thirteen (14.4%) out of 90 children had delayed cerebral vasculitis during a follow-up visit within 3 months after discharge.
CONCLUSIONSPM is more commonly seen in infants, and the infants have a high incidence of convulsions. Young age and protein≥1 g/L in CSF may increase the risk of complications and sequelae. Subdural puncture is not only a diagnostic method but also a therapy for subdural effusion. Some children have delayed cerebral vasculitis during a follow-up visit within 3 months after discharge, so follow-up visits should be performed within 3 months after discharge.
Adolescent ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Meningitis, Bacterial ; complications ; drug therapy ; microbiology ; Suppuration ; microbiology
9.Diagnostic Value of Computed Tomography for Intracranial Suppuration.
Woo Hong CHU ; Young Woo BYUN ; Man Bin YIM ; In Hong KIM
Journal of Korean Neurosurgical Society 1982;11(2):173-181
The authors report their experience with 22 cases of intracranial suppuration : 18 with brain abscess and four with subdural empyema. A small series of nine consecutive cases of intracranial suppuraion with one death is presented since Computed Tomographic brain scanning become a routine diagnostic procedure. These patient have been compared to 13 consecutive cases treated without benefit of CT analysis in order to determine the factors responsible for the recently improved prognosis. The mortality rate was 30.8% for al operated patients treated before availability of CT and 22.7% for the patient since advent of CT scan. Among the factors that may have contributed to the improved results for patients diagnosed with CT are : fewer patients with poor preperative clinical status, and a great incidence of total abscess removal. In addition, CT scanning provided more accurate diagnosis and localization of abscess and aided in the rapid detection of postoperative complication.
Abscess
;
Brain
;
Brain Abscess
;
Diagnosis
;
Empyema, Subdural
;
Humans
;
Incidence
;
Mortality
;
Postoperative Complications
;
Prognosis
;
Suppuration*
;
Tomography, X-Ray Computed
10.Infection with Scopulariopsis brevicaulis after Cosmetic Surgery of the Face.
Bong Joon OH ; Myong Jong CHAE ; Duck CHO ; Seung Jung KEE ; Myung Geun SHIN ; Jong Hee SHIN ; Soon Pal SUH ; Dong Wook RYANG
The Korean Journal of Laboratory Medicine 2006;26(1):32-35
Scopulariopsis brevicaulis is a ubiquitous soil saprophyte that commonly causes onychomycosis, accounting for 1-10% of such infections. Rarely, it may be responsible for cutaneous lesions or more severe infections, especially after traumatic or surgical injuries. We report of a 54-year-old female patient who developed facial cellulitis caused by S. brevicaulis, which occurred one year after the patient underwent cosmetic surgery of the face. The patient suffered from febrile sense, pain and a growing mass lesion on her left cheek, which were diagnosed as facial cellulitis associated with foreign material that had been implanted at the time of cosmetic surgery. Three pus cultures from the mass lesion which performed at a week interval yielded the same S. brevicaulis. Surgical removal and drainage by using liposuction procedure resulted in a favorable outcome. To our knowledge this is the first report of S. brevicaulis infection associated with cosmetic surgery in Korea.
Cellulitis
;
Cheek
;
Drainage
;
Female
;
Humans
;
Intraoperative Complications
;
Korea
;
Lipectomy
;
Middle Aged
;
Onychomycosis
;
Scopulariopsis*
;
Soil
;
Suppuration
;
Surgery, Plastic*