Paediatric neck abscesses: microbiology and management

2007 ◽  
Vol 122 (5) ◽  
pp. 480-484 ◽  
Author(s):  
I K Rustom ◽  
J A T Sandoe ◽  
Z G G Makura
Keyword(s):  
Mycobacterial Infection ◽  
Neck Mass ◽  
Atypical Mycobacteria ◽  
Incision And Drainage ◽  
Presenting Symptoms ◽  
General Infirmary ◽  
Intravenous Antibiotics ◽  
Atypical Mycobacterial Infection ◽  
The Mean

AbstractIntroduction:Paediatric neck abscesses remain common problems which are sometimes difficult to manage.Methods and materials:We conducted a retrospective study of 64 children who underwent incision and drainage of neck abscesses at Leeds General Infirmary from 1 February 2002 to 31 July 2006. The aim of this study was to identify the presenting symptoms in children, the appropriateness of prescribed antibiotics and the role of atypical mycobacteria in neck infections. The outcome measure was clinical resolution of the abscess.Results:The mean presenting age was 44.2 months (3.68 years). The commonest sign and symptom was neck mass (96.9 per cent). The mean period of hospitalisation was 3.7 (± standard deviation of 1.9) days. Staphylococcus aureus (48.4 per cent) was the commonest organism cultured. Atypical mycobacteria were found in only 4.7 per cent of the specimens. Flucloxacillin was the most common antibiotic used (57.8 per cent), often in combination with other antimicrobials. The abscess recurrence rate was 4.7 per cent. No fatalities occurred in this series of patients.Conclusion:Appropriately prescribed intravenous antibiotics and surgical drainage remain the central core of treatment. Atypical mycobacterial infection is an important differential diagnosis of a painless, cervico-facial mass. An algorithm for the management of paediatric neck abscesses is proposed.

scholarly journals Atypical Mycobacterial Exit-Site Infection and Peritonitis in Peritoneal Dialysis Patients on Prophylactic Exit-Site Gentamicin Cream

2013 ◽  
Vol 33 (3) ◽  
pp. 267-272 ◽  
Author(s):  
Man-wai Lo ◽  
Siu-ka Mak ◽  
Yuk-yi Wong ◽  
Kwok-chi Lo ◽  
Shuk-fan Chan ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Selective Pressure ◽  
Mycobacterial Infection ◽  
Atypical Mycobacteria ◽  
Site Infection ◽  
Dialysis Patients ◽  
Exit Site ◽  
Exit Site Infection ◽  
Atypical Mycobacterial Infection ◽  
Micro Organisms

We report 9 cases of exit-site infection and continuous ambulatory peritoneal dialysis peritonitis associated with atypical mycobacteria. All patients had been using topical gentamicin cream as prophylaxis for exit-site infection before the onset of these infections. Gentamicin cream is postulated to be a potential risk factor for atypical mycobacterial infection because of selective pressure on other micro-organisms. The microbiology of atypical mycobacteria and the treatment for atypical mycobacterial infections are discussed.

Endoscopic electrocautery and fibrin obliteration of an acutely complicated pyriform fossa sinus tract in a septuagenarian

2017 ◽  
Vol 131 (10) ◽  
pp. 933-936
Author(s):  
R Heyes ◽  
A G Aulakh ◽  
R K Lingam ◽  
T Tatla
Keyword(s):  
Case Report ◽  
Fibrin Glue ◽  
Fluid Collection ◽  
Complete Recovery ◽  
Sinus Tract ◽  
Neck Mass ◽  
Suppurative Thyroiditis ◽  
Incision And Drainage ◽  
Pyriform Fossa ◽  
Intravenous Antibiotics

AbstractBackground:Pyriform fossa sinus tracts classically present with neck abscess, recurrent infections and suppurative thyroiditis in children; acute presentation in a geriatric patient is rare.Methods:Case report and Medline literature review.Case report:A 79-year-old female presented with a left-sided neck mass and severe odynophagia of 3 days’ duration. Magnetic resonance imaging revealed a large-volume, loculated fluid collection extending throughout the deep spaces of the neck on the left, within and around the thyroid gland capsule. There was radiological evidence of internal jugular vein thrombophlebitis. Abscess incision and drainage, and endoscopic evaluation, were performed. A deeply penetrating sinus was seen in the left pyriform apex, the entrance of which was circumferentially cauterised and the lumen obliterated with fibrin glue. Following post-operative intravenous antibiotics, the patient made a complete recovery.Conclusion:This paper describes the first use of fibrin glue to obliterate a pyriform fossa sinus tract in an adult.

Pilonidal Sinus: How to Choose Between Excision and Open Granulation Versus Excision and Primary Closure?

Swiss Surgery ◽  
2002 ◽  
Vol 8 (6) ◽  
pp. 255-258 ◽  
Author(s):  
Perruchoud ◽  
Vuilleumier ◽  
Givel
Keyword(s):  
Hospital Stay ◽  
Pilonidal Sinus ◽  
Primary Closure ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
Healing Time ◽  
Incision And Drainage ◽  
The Mean ◽  
Primary Healing

Aims: The purpose of this study was to evaluate excision and open granulation versus excision and primary closure as treatments for pilonidal sinus. Subjects and methods: We evaluated a group of 141 patients operated on for a pilonidal sinus between 1991 and 1995. Ninety patients were treated by excision and open granulation, 34 patients by excision and primary closure and 17 patients by incision and drainage, as a unique treatment of an infected pilonidal sinus. Results: The first group, receiving treatment of excision and open granulation, experienced the following outcomes: average length of hospital stay, four days; average healing time; 72 days; average number of post-operative ambulatory visits, 40; average off-work delay, 38 days; and average follow-up time, 43 months. There were five recurrences (6%) in this group during the follow-up period. For the second group treated by excision and primary closure, the corresponding outcome measurements were as follows: average length of hospital stay, four days; average healing time, 23 days; primary healing failure rate, 9%; average number of post-operative ambulatory visits, 6; average off-work delay, 21 days. The average follow-up time was 34 months, and two recurrences (6%) were observed during the follow-up period. In the third group, seventeen patients benefited from an incision and drainage as unique treatment. The mean follow-up was 37 months. Five recurrences (29%) were noticed, requiring a new operation in all the cases. Discussion and conclusion: This series of 141 patients is too limited to permit final conclusions to be drawn concerning significant advantages of one form of treatment compared to the other. Nevertheless, primary closure offers the advantages of quicker healing time, fewer post-operative visits and shorter time off work. When a primary closure can be carried out, it should be routinely considered for socio-economical and comfort reasons.

Long-term dynamics and destruction of marsh vegetation in the Kolokolkova Bay of the Barents Sea

2012 ◽  
pp. 66-77 ◽  
Author(s):  
I. A. Lavrinenko ◽  
O. V. Lavrinenko ◽  
D. V. Dobrynin
Keyword(s):  
Species Composition ◽  
Plant Communities ◽  
Barents Sea ◽  
Mean Value ◽  
Marsh Vegetation ◽  
Composition And Structure ◽  
The Mean ◽  
Species Composition And Structure

The satellite images show that the area of marshes in the Kolokolkova bay was notstable during the period from 1973 up to 2011. Until 2010 it varied from 357 to 636 ha. After a severe storm happened on July 24–25, 2010 the total area of marshes was reduced up to 43–50 ha. The mean value of NDVI for studied marshes, reflecting the green biomass, varied from 0.13 to 0.32 before the storm in 2010, after the storm the NDVI decreased to 0.10, in 2011 — 0.03. A comparative analysis of species composition and structure of plant communities described in 2002 and 2011, allowed to evaluate the vegetation changes of marshes of the different topographic levels. They are fol­lowing: a total destruction of plant communities of the ass. Puccinellietum phryganodis and ass. Caricetum subspathaceae on low and middle marches; increasing role of halophytic species in plant communities of the ass. Caricetum glareosae vic. Calamagrostis deschampsioides subass. typicum on middle marches; some changes in species composition and structure of plant communities of the ass. Caricetum glareosae vic. Calamagrostis deschampsioides subass. festucetosum rubrae on high marches and ass. Parnassio palustris–Salicetum reptantis in transition zone between marches and tundra without changes of their syntaxonomy; a death of moss cover in plant communities of the ass. Caricetum mackenziei var. Warnstorfia exannulata on brackish coastal bogs. The possible reasons of dramatic vegetation dynamics are discussed. The dating of the storm makes it possible to observe the directions and rates of the succession of marches vegetation.

Seasonal trends in the stable isotopic composition of snow and meltwater runoff in a subarctic catchment at Okstindan, Norway

2004 ◽  
Vol 35 (2) ◽  
pp. 119-137 ◽  
Author(s):  
S.D. Gurney ◽  
D.S.L. Lawrence
Keyword(s):  
Isotopic Composition ◽  
Mean Value ◽  
Mean Values ◽  
Stable Isotopic Composition ◽  
Meltwater Runoff ◽  
Stable Isotopic ◽  
The Mean ◽  
The Difference ◽  
Δ18o And Δd

Seasonal variations in the stable isotopic composition of snow and meltwater were investigated in a sub-arctic, mountainous, but non-glacial, catchment at Okstindan in northern Norway based on analyses of δ18O and δD. Samples were collected during four field periods (August 1998; April 1999; June 1999 and August 1999) at three sites lying on an altitudinal transect (740–970 m a.s.l.). Snowpack data display an increase in the mean values of δ18O (increasing from a mean value of −13.51 to −11.49‰ between April and August), as well as a decrease in variability through the melt period. Comparison with a regional meteoric water line indicates that the slope of the δ18O–δD line for the snowpacks decreases over the same period, dropping from 7.49 to approximately 6.2.This change points to the role of evaporation in snowpack ablation and is confirmed by the vertical profile of deuterium excess. Snowpack seepage data, although limited, also suggest reduced values of δD, as might be associated with local evaporation during meltwater generation. In general, meltwaters were depleted in δ18O relative to the source snowpack at the peak of the melt (June), but later in the year (August) the difference between the two was not statistically significant. The diurnal pattern of isotopic composition indicates that the most depleted meltwaters coincide with the peak in temperature and, hence, meltwater production.

scholarly journals Forensic Investigation of Four Monitored Green Infrastructure Inlets

Water ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 1787
Author(s):  
Leena J. Shevade ◽  
Franco A. Montalto
Keyword(s):  
Measurement Uncertainty ◽  
Green Infrastructure ◽  
Stormwater Management ◽  
Catchment Area ◽  
Low Flow ◽  
Inflow Rate ◽  
Forensic Investigation ◽  
Flow Conditions ◽  
The Mean

Green infrastructure (GI) is viewed as a sustainable approach to stormwater management that is being rapidly implemented, outpacing the ability of researchers to compare the effectiveness of alternate design configurations. This paper investigated inflow data collected at four GI inlets. The performance of these four GI inlets, all of which were engineered with the same inlet lengths and shapes, was evaluated through field monitoring. A forensic interpretation of the observed inlet performance was conducted using conclusions regarding the role of inlet clogging and inflow rate as described in the previously published work. The mean inlet efficiency (meanPE), which represents the percentage of tributary area runoff that enters the inlet was 65% for the Nashville inlet, while at Happyland the NW inlet averaged 30%, the SW inlet 25%, and the SE inlet 10%, considering all recorded events during the monitoring periods. The analysis suggests that inlet clogging was the main reason for lower inlet efficiency at the SW and NW inlets, while for the SE inlet, performance was compromised by a reverse cross slope of the street. Spatial variability of rainfall, measurement uncertainty, uncertain tributary catchment area, and inlet depression characteristics are also correlated with inlet PE. The research suggests that placement of monitoring sensors should consider low flow conditions and a strategy to measure them. Additional research on the role of various maintenance protocols in inlet hydraulics is recommended.

scholarly journals High Ripple-Density Resolution for Discriminating Between Rippled and Nonrippled Signals: Effect of Temporal Processing or Combination Products?

2021 ◽  
Vol 25 ◽  
pp. 233121652110101
Author(s):  
Dmitry I. Nechaev ◽  
Olga N. Milekhina ◽  
Marina S. Tomozova ◽  
Alexander Y. Supin
Keyword(s):  
Low Frequency ◽  
Noise Signal ◽  
Density Variation ◽  
Choice Procedure ◽  
Masker Level ◽  
Reference Signals ◽  
Forced Choice Procedure ◽  
The Mean ◽  
Density Resolution

The goal of the study was to investigate the role of combination products in the higher ripple-density resolution estimates obtained by discrimination between a spectrally rippled and a nonrippled noise signal than that obtained by discrimination between two rippled signals. To attain this goal, a noise band was used to mask the frequency band of expected low-frequency combination products. A three-alternative forced-choice procedure with adaptive ripple-density variation was used. The mean background (unmasked) ripple-density resolution was 9.8 ripples/oct for rippled reference signals and 21.8 ripples/oct for nonrippled reference signals. Low-frequency maskers reduced the ripple-density resolution. For masker levels from −10 to 10 dB re. signal, the ripple-density resolution for nonrippled reference signals was approximately twice as high as that for rippled reference signals. At a masker level as high as 20 dB re. signal, the ripple-density resolution decreased in both discrimination tasks. This result leads to the conclusion that low-frequency combination products are not responsible for the task-dependent difference in ripple-density resolution estimates.

scholarly journals Trends and Clinico-Epidemiological Features of Human Rabies Cases in Bangladesh, 2006–2018

2020 ◽  
Vol 41 (S1) ◽  
pp. s416-s416
Author(s):  
Sumon Ghosh ◽  
Md. Sohel Rana ◽  
Sukanta Chowdhury
Keyword(s):  
Effective Means ◽  
Scale Up ◽  
Traditional Healers ◽  
Human Rabies ◽  
Epidemiological Analysis ◽  
Increasing Trend ◽  
The Mean ◽  
Death Cases ◽  
Death Data

Background: Vaccinating dogs against rabies is an effective means of reducing human rabies. Methods: We analyzed 1,327 clinically diagnosed human rabies deaths and mass dog vaccination (MDV) data during 2006–2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (n = 422) for clinico-epidemiological analysis. Results: We found a positive and increasing trend of dog population vaccination (P = .01 and τ = 0.71) and a negative and declining trend (P < .001 and τ = −0.88) of human rabies cases (correlation coefficient, −0.82). Among 422 human rabies death cases, most victims (78%) sought treatment from traditional healers, and 12% received postexposure prophylaxis (PEP). The mean incubation period of rabies cases with exposure sites on the head and neck (35 days) was shorter than the upper limb (mean, 64 days; P = .02) and lower limb (mean, 89 days; P < .01). MDV is effective for reducing human rabies cases in Bangladesh. Conclusions: Creating awareness among the animal bite victims to stop relying on traditional healers rather seeking PEP, addressing the role of traditional healers through an awareness education program in respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV can help prevent human rabies deaths.Funding: NoneDisclosures: None

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