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

OBJECTIVETo discuss diagnosis and treatment of iatrogenic purulent lumbar spinal infection.

METHODSFrom December 2006 to January 2010, 4 patients with iatrogenic purulent lumbar spinal infection were treated with posterior debridement. There were 2 males and 2 females, ranging in age from 50 to 66 years (respectively in 52, 66, 58, 50 years); in course of disease from 2 weeks to 2.5 months (respectively in 21, 14, 60, 75 days ). All patients had fever, lumbago, local tenderness and limited lumbar activity before operation. White blood cell count (WBC), erythrocyte sedimentation rate (ESR) were abnormal. The clinical effects were evaluated by symptoms and laboratory examination.

RESULTSSymptoms of lumbago and fever vanished in 4 patients, of which wounds were primary healing without complications. The patients were followed up for 3 months, no infection (WBC, C-reactive protein and ESR were normal) and lumbar instability were found.

CONCLUSIONIatrogenic purulent lumbar spinal infection can be diagnosed according to course of disease, clinical symptoms and signs, imaging finding. In the items, magnetic resonance imaging finding have necessarily specificity, once finding abscess-formation, will promptly operate.

Aged ; Debridement ; methods ; Diagnosis, Differential ; Female ; Humans ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Spondylitis ; diagnosis ; surgery ; Suppuration

Maxillofacial infection often place the oral and maxillofacial surgeon in situations where timely decisions have to be made. These decisions can be lifesaving. Odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often repond to surgical and antimicrobial management. Otheriwise odontogenic infections have the potential to spread via the fasical spaces in the head and neck region. They can compromise vital structures in this region or involve distant structures. The classic signs of maxillofacial infections include pain, swelling, fever, dysphagia, and dehydration. The goals of management should be to correct these conditions. We have undertaken clinical studies on infections in the oral and maxillofacial regions (facial space) by analyzing hospitalized patients in the Dept. of Oral and Maxillofacial Surgery, Kyung Hee University Hospital past 5 years from 1991. To 1995. And bacterial cultures and antibiotics sensitivity test were performed and the comparative analysis of the antibiotics was done. The results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic 68% and in 23% patients with signs and symptom aggrevated after teeth extraction. 2. The most common fascial spaces involved was buccal space 36.1%, followed by submandibular space 12.3% and 3 cases were Ludwig's angina. 3. Antibiotics were administrated in all cases and surgical incision and drainage was performed in 88.6%. 4. The most causative organisms isolated from the pus cultures were streptococci group 51.1%.
Anti-Bacterial Agents ; Deglutition Disorders ; Dehydration ; Drainage ; Fever ; Head ; Humans ; Ludwig's Angina ; Neck ; Suppuration ; Surgery, Oral ; Tooth

This is a retrospective study on the Ludwig's angina patients treated in Dept of Oral and Maxillofacial Surgery of Pusan National University Hospital for the period of Jan. 1985 to March 1996. The used materials of this study were 30 in total, including 18 male patients, 12 female patients. The author analyzed the distribution and incidence of sex, age, etiologic factor, pus culture, involved systemic disease, treatment methods, mortality rate. The results were as follows; 1. The incidences was higher in sixth decades(26.7%) and prevalent in male. 2. The most cause was odontogenic(83.3%) and in 15 cases(50%), the symptom aggravated after dental treatment. 3. The causative organism isolated from pus culture were Streptococci (40.7%), Staphylococci(22.2%), Bacteroid(14.8%), Candida(11.1%), Pseudomonas(3.7%), Pneumococci(3.7%), Salmonella(3.7%). 4. The patients with systemic disease were 66.7%, involved disease were DM(25%), malnutrition(22.7%), rheumatoid arthritis(11.4%), pulmonary disease(11.4%), hypertension(11.4%). 5. In all patients, surgical I&D was done, and 5 cases(16.7%) required tracheostomy. 6. In all patients, we used combination antibiotics, and the most commonly used antibiotics in the treatment were combination of Penicillin, Cephalosporin and Aminiglycoside(46.7%), and combination of Cephalosporin, Aminiglycoside and Metronidazole(30%). 7. The mortality rate was 6.7%.
Anti-Bacterial Agents ; Busan ; Female ; Humans ; Incidence ; Ludwig's Angina* ; Male ; Mortality ; Penicillins ; Retrospective Studies ; Suppuration ; Surgery, Oral ; Tracheostomy

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*

Intracranial abscess is a serious, life-threatening condition with a dire prognosis. Although the advent of the antibiotic era has drastically reduced the incidence of the disease, predisposing factors such as untreated ear infections, poor personal hygiene, significant trauma with violation of the sterile cranial environment as well as existing co-morbidities such as an immunocompromised state make intracranial abscess a horrifying reality. Ear infections, in particular, are notorious for being the origin of roughly 50% of cerebellar abscesses.1 Chronic suppurative otitis media (CSOM) is one of the leading causes of brain abscess. Shaw and Russell2 reviewed 47 cases of cerebellar abscess and showed that 93% were caused by CSOM; the most common mechanism of entry into the brain parenchyma being direct extension. Chronic infection in the middle ear space could erode through the tegmen tympani and into the temporal lobe or through the tegmen mastoidei into the cerebellum. Neurological symptoms may be delayed as the abscess ‘grows’ in areas around the cerebellum that are regarded as ‘silent’, until vital areas such as those responsible for coordination and balance are violated. We describe a case of cerebellar abscess secondary to CSOM and discuss the possibility of performing ear surgery with simultaneous drainage of a contiguous abscess through a transmastoid approach in cases of chronic suppurative otitis media with intracranial complications.
Human ; Male ; Young Adult ; EAR DISEASES ; OTITIS ; Otitis Media, Suppurative ; OTITIS MEDIA-COMPLICATIONS, suppuration, SURGERY ; CHRONIC EAR DISEASE ; pain ; Headache

The purpose of this study was to report and discuss the diagnosis and treatment of obstructive atelectasis secondary to pus obstruction in a patient who had developed a maxillofacial abscess, and to review the literature on similar cases. Persistently discharging pus within the oral cavity can act as an aspirate, and may lead to obstructive atelectasis. Additionally, maxillofacial surgery patients should be carefully assessed for the presence of risk factors of obstructive atelectasis, such as, epistaxis after nasotracheal intubation, oral bleeding, and mucus secretion. Furthermore, patients with these risk factors should be continuously followed up by monitoring SPO₂, breath sounds, and chest x-ray.
Abscess ; Anesthesia, General ; Diagnosis ; Epistaxis ; Hemorrhage ; Humans ; Intubation ; Mouth ; Mucus ; Pulmonary Atelectasis ; Risk Factors ; Suppuration ; Surgery, Oral ; Thorax

OBJECTIVE: To study the clinical efficacy of callotasis for pathological segmental defects in child femur. METHODS: Thirty-nine patients with segmental femoral defects suffered from suppurative osteomyelitis were treated with the bilateral, unilateral external fixation frame or intramedullary callotasis. The rolongational rate was from 2 to 2.5 cm per month after the operation. RESULTS: After a 13 to 57 month follow-up, all cases were healed according to clinical examination and radiological observation. The prolongational length ranged from 9 to 31 centimeters. Average ratio of prolongation reached 49%. The healing index was 30 d/cm, and the healing time of non-union was 134 days. No recurrent suppurative osteomyelitis or fracture was observed. CONCLUSION Callotasis is a reliable, simple and hyperadaptable method for femural segmental defects.
Adolescent ; Bone Lengthening ; methods ; Bony Callus ; surgery ; Child ; Child, Preschool ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Male ; Osteomyelitis ; surgery ; Suppuration

Infections of the oral and maxillofacial region are one of the most common conditions for which a patient presents to a maxillofacial surgeons. Although these infections can arise from a variety of source, dental disease is the most common etiology. So, odontogenic infection are frequently encountered in the practice of oral and maxillofacial surgery. These infections often respond to antimicrobial chemotherapy or surgical intervention, such as extraction of teeth, incision and drainage through clinical features. But, odontogenic infections have the potential to spread via the fascial spaces in the head and neck region, and, they spread to cavernous sinus, deep musculofascial space and other vital structure. We have undertaken clinical studies on infections in the oral and maxillofacial regions by analyzing retrospectively hospitalized patients in the Department of Oral and Maxillofacial Surgery, Chonbuk National University Hospital past 5 years from 2000 to 2004. And, the patients'age, sex, medical history, causes of the infection, surgical intervention, and other clinical parameters were reviewed. The obtained results were as follows: 1. The most frequent cause of oral and maxillofacial infection was odontogenic. And in the odontogenic cause, dental caries was the most common cause (47.2%). 2. The most common fascial space involved was the submandibular space (15.7%), followed by the buccal space (14.8%). 3. 60.4% of all patients required surgical drainage of the abscess, endodontic treatment or tooth extraction or periodontal treatment with drainage. 4. The most causative organism isolated from the pus culture were streptococcus viridans (53.9%). 5. Underlying medical problems were found in 136 patients (41.9%), the most common being hypertension (27.9%) and diabetes (14.7%).
Abscess ; Cavernous Sinus ; Dental Caries ; Drainage ; Drug Therapy ; Head ; Humans ; Hypertension ; Jeollabuk-do ; Neck ; Retrospective Studies ; Stomatognathic Diseases ; Suppuration ; Surgery, Oral ; Tooth ; Tooth Extraction ; Viridans Streptococci

surgery, Kyung-Pook University Hospital between 1962 and 1996. Following results were obtained. 1. The histologic diagnosis of oral cancer was mostly squamous cell carcinoma(78.1%) followed by adenoid cystic carcinoma(5.9%), malignant melanoma(3.5%), mucoepidermoid carcinoma(3.1%), osteosarcoma(2.7%), metastatic carcinoma(2.3%). 2. The primary sites were the lower alveolus and gingiva(21.8%), upper alveolus and gingiva(19.5%), mouth floor(17.6%), tongue(1.5%), palate(9.8%), maxillary sinus(7.4%), retromolar trigone(6.6%), buccal mucosa(3.9%), major salivary gland(2.0%), upper lip(0.45) and lower lip(0.45). 3. Males were involved more than females by oral cancer in the ratio of 2.5:1, especially squamous cell carcinoma in the ratio of 3.3:1. 4. Most of the case occurred in the 6th and 7th decades(58.%), and average age was 58. 5. The common symptoms were pain followed by swelling, ulcer, bleeding, pus discharge, trismus, paresthesia, pigmentation, paralysis. 6. Time lapse from the recognition of initial symptoms to the first visit was mostly less than 3 months. 7. According to TNM system in squamous cell carcinoma, stage IV(61.3%) was most frequent, followed by stage II(14.1%), stage I(12.7%), stage III(12.0%). 8. The degree of histopathological differentiation of oral squamous cell carcinoma was in the order of well, moderate, poor differentiated type. 9. In the treatment of squamous cell carcinoma, surgery was done in the 75 cases, and neck dissection in 58 cases. 10. 5-year survival rate of the patient treatment between 1982 and 1990, was 31.6%, 5-year survival rate of the patients treated between 1991 and 1996, was 54%.]]>
Adenoids ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Hemorrhage ; Humans ; Male ; Mouth ; Mouth Neoplasms ; Neck Dissection ; Paralysis ; Paresthesia ; Pigmentation ; Suppuration ; Surgery, Oral ; Survival Rate ; Trismus ; Ulcer