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

Endophthalmitis ; complications ; drug therapy ; microbiology ; Humans ; Infant, Newborn ; Meningoencephalitis ; complications ; drug therapy ; microbiology ; Suppuration ; complications

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

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

Anastomosis, Surgical/adverse effects* ; Cholangitis/surgery* ; Gastroenterostomy/adverse effects* ; Humans ; Pancreatitis/complications* ; Suppuration/surgery*

Anti-Bacterial Agents ; therapeutic use ; Endophthalmitis ; complications ; drug therapy ; Humans ; Infant, Newborn ; Meningoencephalitis ; complications ; drug therapy ; Suppuration

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*

PURPOSE: To report a case of bilateral congenital lacrimal fistula that presented with repeated infection and inflammation after complete fistulectomy, which required an incision and drainage of pus from the operation site. CASE SUMMARY: A 22-year-old male without any medical history presented with repeated erythematous swelling and inflammation, resulting in tenderness around the opening of congenital lacrimal fistula. The lacrimal fistula opening was located approximately 12 mm inferiorly apart from the medial canthus. The complete excision of lacrimal fistula was performed without any inter-operative events. However, 4 days postoperatively, the patient complained of discomfort and swelling, with purulent discharge from the bilateral operation site. There was no improvement although treatment with antibiotics, incision and drainage was performed. After 1 month, an additional incision and drainage was necessary due to inflammation in the left operation site. One month later, pus and purulent discharge were occurring from the right operation site, requiring an additional incision and drainage. At that time, Actinomyces israelli was identified on wound culture examination. One month later, an additional incision and drainage was performed due to repeated inflammation in the left operation site. In the present case, we hypothesized the opening site of congenital lacrimal fistula was relatively far apart from the medial canthus and played a role in atypical repeated inflammation and infection on the operation site. CONCLUSIONS: In surgical treatment of congenital lacrimal fistula, careful preoperative observation of the location of the lacrimal fistula's opening site would be helpful in prediction of postoperative complication, such as wound infection and inflammation, as well as in educating and informing the patient.
Actinomyces ; Anti-Bacterial Agents ; Drainage ; Fistula* ; History ; Humans ; Inflammation* ; Male ; Postoperative Complications ; Suppuration ; Wound Infection ; Wounds and Injuries ; Young Adult

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

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