scholarly journals Neonatal brain abscess development following fetal scalp electrode placement: a rare complication

2021 ◽  
Author(s):  
T. Fick ◽  
P. A. Woerdeman
Keyword(s):  
Brain Abscess ◽  
Electrode Placement ◽  
Superficial Infection ◽  
Skin Site ◽  
Scalp Electrode ◽  
Large Brain ◽  
Fetal Scalp ◽  
Asymmetric Growth ◽  
Clinical Illness

AbstractA fetal scalp electrode (FSE) is a frequently used investigation during labor. However, it is an invasive procedure which can lead to complications. Our patient developed a very large brain abscess after initial superficial infection of the skin site due to an FSE. The patient was admitted to the hospital after an asymmetric growth of the skull was noticed with no further signs of clinical illness. MRI showed a very large brain abscess which was aspirated and treated with antibiotics for 10 weeks. A 2-year follow-up showed only a slight developmental delay in gross motor skills. Only once before a similar case has been described at which the patient developed a brain abscess after superficial infection of the scalp following an FSE. In both cases, the brain abscess was noticed due to an asymmetric growth of the skull without any further signs of clinical illness. A brain abscess has a high mortality and morbidity rate, and early diagnosis is vital for the optimal outcome. We therefore recommend to organize an out-patient clinical follow-up for every infant with a superficial infection of the skin site after placement of an FSE.

scholarly journals Brain Abscess Caused by Nocardia: Case Report and Literature Review

2020 ◽  
Author(s):  
Guilherme Finger ◽  
Maria Eduarda Conte Gripa ◽  
Tiago Paczko Bozko Cecchini ◽  
Tobias Ludwig do Nascimento
Keyword(s):  
Case Report ◽  
Antibiotic Therapy ◽  
Brain Abscess ◽  
Clinical Signs ◽  
Occipital Lobe ◽  
High Morbidity ◽  
Rare Clinical Entity ◽  
Brain Abscesses

AbstractNocardia brain abscess is a rare clinical entity, accounting for 2% of all brain abscesses, associated with high morbidity and a mortality rate 3 times higher than brain abscesses caused by other bacteria. Proper investigation and treatment, characterized by a long-term antibiotic therapy, play an important role on the outcome of the patient. The authors describe a case of a patient without neurological comorbidities who developed clinical signs of right occipital lobe impairment and seizures, whose investigation demonstrated brain abscess caused by Nocardia spp. The patient was treated surgically followed by antibiotic therapy with a great outcome after 1 year of follow-up.

scholarly journals Profile vs Tubular Plate in Unimalleolar or Bimalleolar Fractures: is There a Real Difference in Wound complications?

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0015
Author(s):  
Paolo Ceccarini ◽  
Rosario Petruccelli ◽  
Michele Bisaccia ◽  
Giuseppe Rinonapoli ◽  
Auro Caraffa
Keyword(s):  
Wound Dehiscence ◽  
Deep Infection ◽  
Ankle Fractures ◽  
Bone Union ◽  
Wound Complications ◽  
Fisher Exact Test ◽  
Superficial Infection ◽  
Operative Care ◽  
Group B

Category: Ankle; Trauma Introduction/Purpose: The aim of our study is to compare two types of plates, one third tubular plate and LCP distal fibula plate, evaluating the clinical outcome and the skin complications associated with their use. Methods: We collected the data of 122 consecutive unimalleolar or bimalleolar fractures treated by internal fixation for a closed, displaced distal closed fibular fracture. Exclusion criteria were: 1) open ankle fractures,2) trimalleolar fractures, 3) previous ankle fractures 4) severe venous insufficiency, 5) ankleosteoarthritis previous to surgery, 6) associated ankle dislocation. After this selection, 93 patients were included in our study and assigned in two groups, based on using of different implant: in group A48 patients were treated with one-third tubular and in group B 45 patients were treated with LCP distalfibula plate. There were no significant differences in the baseline characteristics. Patients received the same surgical procedure and the same post-operative care, then they were radiologically evaluated at1-3-12 months and clinical examination was made at 24 (range 15-36) months using AOFAS clinical rating system. All data were evaluated using chi-square test. Results: At the final 24-month follow-up a comparison between the two groups showed no statistical significant differences in reduction accuracy and bone union ratio at radiological examination. The wound complications rate of the overall study group was 7.6%. There were no statistical differences in the rate of wound complications between the two groups. There were no differences between both group in percentage of hardware removal at follow-up (overall 5.4%). In the group A occurred 1 deep infection, 2 superficial infection, no wound dehiscence; in group B occured 1 deep infection, 1 superficial infection and 2 wound dehiscence. There were no statistical differences in the rate of wound complications between the two groups (p=0.70; Fisher exact test). Conclusion: Our study has shown no difference in radiographic bone union rate, no significant differences in terms of clinical outcomes, in time of bone reduction and wound complication rate between the LCP distalfibula plate and conventional one-third tubular plate. RCT or metanalasys are in this case useful to improve scientific evidence and give more information for the correct surgical treatment of ankle fractures.

Mixed brain abscess due to Streptococcus and Tuberculosis in a pregnant woman with favorable evolution. A case report

2020 ◽  
pp. 1-3
Keyword(s):  
Brain Abscess ◽  
Public Health Problem ◽  
Elective Cesarean Section ◽  
Histopathological Study ◽  
Global Public Health ◽  
Mother And Child ◽  
Elective Cesarean ◽  
Causes Of Mortality ◽  
Abscess Wall

Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child had a favorable evolution.

546 Management of Pediatric Pavement Burns

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S121-S122
Author(s):  
Syed F Saquib ◽  
Paul J Chestovich ◽  
Joseph T Carroll ◽  
Carmen E Flores
Keyword(s):  
Ambient Temperature ◽  
Average Length ◽  
Topical Therapy ◽  
Total Body Surface Area ◽  
High Ambient Temperature ◽  
Unknown Etiology ◽  
Oral Antibiotic ◽  
Superficial Infection ◽  
Plantar Aspect

Abstract Introduction Pavement burns are common in a dry high heat climate. This study reviews the etiology, management and outcome of pavement burns in children. Methods All patients age < 18 who suffered contact burns from hot pavement from Jan 1, 2014 to Dec 31, 2019 were reviewed. A total of 45 patient charts met inclusion criteria. High ambient temperature on each date, and zip code of each injury was extracted from Weather Underground (www.wunderground.com) Results In this study, 45 patients met criteria and were reviewed, of whom 27 patients (60%) were male. Average age was 3.29 years (SD 0.69), made up two discrete age groups: age under 3 (n= 40, 89%) and 14+ (n=5, 11%). 38 patients (84%) had no known medical history. All had 2nd degree burns and one patient (2%) had third degree burns. Mean total body surface area (TBSA) was 2.5% (SD 1.4%, range 0.75% to 5.5%). Burn etiology included 31 patients (69%) walking barefoot on pavement, 6 (13%) falling onto pavement, and other/unknown etiology for the remaining 8 patients (18%). 30 patients (67%) had injuries on the plantar aspect of bilateral feet, 2 (4%) to bilateral palms of hands, 4 (9%) to other parts of upper extremities and 10 (22%) to other parts of lower extremities. Thirty-four (34) patients (76%) were managed without any hospitalization. Those that were hospitalized had an average length of stay (LOS) of 2.72 days (range 1–9 days). All burns were managed non-operatively with topical therapy alone. 35 patients (78%) were managed initially with Silvadene, and 6 (13%) with bacitracin. Aquacel was utilized in 10 patients at a follow-up visit (22%). Three patients (6.7%) were treated with collagenase enzyme therapy. One patient developed a superficial infection requiring oral antibiotic therapy. There were no mortalities in this group. The high ambient temperature on date and location of each injury was 101 F (SD 1.10 F, range 73F-111F). Of the thirty that continued to follow up in clinic, the average time to the burn being 95% healed was 10.50 days (SD 8.97 days, range 2–40 days). Conclusions Pavement burns in children are partial thickness and are safely managed with topical therapy alone, with good outcomes. Patients age 3 and under are a vulnerable population and therefore at particular risk of injury.

Spinal Cord Stimulation Electrode Design: A Prospective, Randomized, Controlled Trial Comparing Percutaneous with Laminectomy Electrodes: Part II–Clinical Outcomes

Neurosurgery ◽  
2005 ◽  
Vol 57 (5) ◽  
pp. 990-996 ◽  
Author(s):  
Richard B. North ◽  
David H. Kidd ◽  
Loredana Petrucci ◽  
Michael J. Dorsi
Keyword(s):  
Spinal Cord ◽  
Controlled Trial ◽  
Clinical Results ◽  
Failed Back Surgery Syndrome ◽  
Electrode Placement ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Failed Back Surgery ◽  
Back Surgery

Abstract OBJECTIVE: Spinal cord stimulation, in use for more than 30 years, has evolved into an easily implemented technique involving percutaneous or laminectomy electrode placement. In a randomized comparison of four-contact percutaneous and four-contact insulated laminectomy electrodes placed at the same level in the dorsal, epidural midline, quantitative measures of stimulator performance revealed significant technical advantages for the laminectomy electrodes. Our prospective, randomized, controlled trial compares clinical results in these same patients. METHODS: Impartial third parties followed our series of 24 patients with failed back surgery syndrome to gather clinical outcome data. We defined “success” as at least 50% sustained relief of pain and patient satisfaction with the result of treatment. RESULTS: At a mean follow-up of 1.9 years, 10 of 12 patients receiving the laminectomy electrode and 5 of 12 patients receiving the percutaneous electrode reported a successful outcome (P < 0.05). Follow-up at a mean of 2.9 years showed that this result was maintained in 5 of 12 patients with the laminectomy electrode and 3 of 12 with the percutaneous electrode (not statistically significant). Many patients reported improvements in most activities of daily living, and loss of function was rare. In addition, 9 patients with laminectomy electrodes and 4 with percutaneous electrodes reducted or eliminated analgesic intake (P < 0.05), and 2 returned to work. No electrode migration was observed. CONCLUSION: Laminectomy electrode placement, although more invasive than percutaneous placement, yields significantly better clinical results in patients with failed back surgery syndrome at mean 1.9 years follow-up. In our small sample, however, the statistical significance of this advantage disappeared at mean 2.9 years follow-up.

WHICH FETAL SCALP ELECTRODE?

The Lancet ◽  
1980 ◽  
Vol 315 (8164) ◽  
pp. 371 ◽  
Author(s):  
JohnP. Calvert ◽  
RobertG. Newcombe
Keyword(s):  
Scalp Electrode ◽  
Fetal Scalp

Fetal scalp damage and neonatal jaundice: a risk of routine fetal scalp electrode monitoring

1982 ◽  
Vol 2 (3) ◽  
pp. 161-164 ◽  
Author(s):  
S. W. D'souza ◽  
Patricia Black ◽  
T. Macfarlane ◽  
B. Richards
Keyword(s):  
Neonatal Jaundice ◽  
Scalp Electrode ◽  
Fetal Scalp

Hepatitis B infection following deployment to Angola

2008 ◽  
Vol 94 (3) ◽  
pp. 108-111
Author(s):  
A M Croft ◽  
J E Ollerton ◽  
N T Fear
Keyword(s):  
Hepatitis B ◽  
Military Personnel ◽  
Hepatitis B Infection ◽  
Viral Illness ◽  
Clinical Illness ◽  
The Tropics

AbstractWe describe the clinical illness and longterm follow up of two British personnel who acquired hepatitis B infection during a 3-month UN mission to Angola. Medical officers need to be familiar with this viral illness, which may present in military personnel after any exercise in or deployment to the tropics or subtropics.

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