scholarly journals Spontaneous Drainage of Large Parapharyngeal Abscess

2021 ◽  
Vol 3 (6) ◽  
pp. 01-03
Author(s):  
Camilla Berkembrock
Keyword(s):  
Antibiotic Therapy ◽  
Ct Scan ◽  
Female Patient ◽  
Early Treatment ◽  
Complete Resolution ◽  
Clinical Suspicion ◽  
Parapharyngeal Abscess

The case of a 68-year-old female patient, without comorbidities, with a diagnosis of a large parapharyngeal abscess on the left, was reported by a neck CT scan, which evolved with spontaneous drainage and complete resolution of the peritonsillar bulging, completing the therapeutic plan with antibiotic therapy, without abscess recurrence. Clinical suspicion, associated with neck CT, is an indispensable item in the design of early treatment, in order to avoid complications.

scholarly journals Acute Hemorrhagic Leukoencephalopathy

1983 ◽  
Vol 10 (1) ◽  
pp. 63-67 ◽  
Author(s):  
O. Suchowersky ◽  
V.P. Sweeney ◽  
K. Berry ◽  
P.J.A. Bratty
Keyword(s):  
White Matter ◽  
Ct Scan ◽  
Early Treatment ◽  
Complete Resolution ◽  
Ct Scanning ◽  
Steroid Treatment ◽  
Low Density ◽  
White Matter Changes

SUMMARY:Two patients with acute hemorrhagic leukoencephalopathy, one of which was pathologically proven, were serially studied with CT scanning. Both patients showed marked distinctive low density white matter changes throughout both hemispheres, which correlated with clinically involved areas. One patient recovered from the disease, perhaps due to steroid treatment, and showed slow but complete resolution of CT scan changes. We feel that CT scan findings significantly help in the diagnosis of this disease, which may be amenable to early treatment with steroids.

Procalcitonin Testingreduce Unnecessary Antibiotic Use in Bacterial Infection

2019 ◽  
Vol 2 (1) ◽  
pp. 1-3
Author(s):  
Attabak Toofani Milani ◽  
Mahshid Mohammadian ◽  
Sadegh Rostaminasab ◽  
Roghayeh Paribananaem ◽  
Zohre Ahmadi ◽  
...  
Keyword(s):  
Antibiotic Therapy ◽  
Bacterial Infection ◽  
Diagnostic Test ◽  
Bacterial Infections ◽  
Intervention Studies ◽  
Antibiotic Use ◽  
Clinical Suspicion ◽  
Diagnostic Biomarker ◽  
Clinical Routine ◽  
Initial Rise

Conventional diagnostic test have limitations to deferential diagnosis in clinical suspicion ofbacterial infection cases, that in some cases lead to inappropriate antibiotic therapy and increases antibiotic resistance. A new diagnostic insight is procalcitonin (PCT) test to improve diagnosis of bacterial infections and to guide antibiotic therapy. Serum PCT levels are of useful test as a biomarker in patients with bacterial infections for several reasons. Initial rise of PCT levels due to bacterial infection, subsequent sequential PCT levels can be used to assess the effectiveness and duration of antibiotic therapy. Based on clinical researches results, in bacterial infections, promising good results obtained when use of PCT used as differential diagnostic test. But further intervention studies are needed before use of PCT in clinical routine tests. The goal of this review is to study the PCT reliability as infections diagnostic biomarker.

scholarly journals A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis: APPAC III trial study protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e023623 ◽  
Author(s):  
Suvi Sippola ◽  
Juha Grönroos ◽  
Ville Sallinen ◽  
Tero Rautio ◽  
Pia Nordström ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Antibiotic Therapy ◽  
Ct Scan ◽  
Symptomatic Treatment ◽  
Spontaneous Resolution ◽  
University Hospital ◽  
Controlled Study ◽  
Double Blind ◽  
Uncomplicated Acute Appendicitis

IntroductionRecent studies show that antibiotic therapy is safe and feasible for CT-confirmed uncomplicated acute appendicitis. Spontaneous resolution of acute appendicitis has already been observed over a hundred years ago. In CT-confirmed uncomplicated acute diverticulitis (left-sided appendicitis), studies have shown no benefit from antibiotics compared with symptomatic treatment, but this shift from antibiotics to symptomatic treatment has not yet been widely implemented in clinical practice. Recently, symptomatic treatment of uncomplicated acute appendicitis has been demonstrated in a Korean open-label study. However, a double-blinded placebo-controlled study to illustrate the role of antibiotics and spontaneous resolution of uncomplicated acute appendicitis is still lacking.Methods and analysisThe APPAC III (APPendicitis ACuta III) trial is a multicentre, double-blind, placebo-controlled, superiority randomised study comparing antibiotic therapy with placebo in the treatment CT scan-confirmed uncomplicated acute appendicitis aiming to evaluate the role of antibiotics in the resolution of uncomplicated acute appendicitis. Adult patients (18–60 years) with CT scan-confirmed uncomplicated acute appendicitis (the absence of appendicolith, abscess, perforation and tumour) will be enrolled in five Finnish university hospitals.Primary endpoint is success of the randomised treatment, defined as resolution of acute appendicitis resulting in discharge from the hospital without surgical intervention within 10 days after initiating randomised treatment (treatment efficacy). Secondary endpoints include postintervention complications, recurrent symptoms after treatment up to 1 year, late recurrence of acute appendicitis after 1 year, duration of hospital stay, sick leave, treatment costs and quality of life. A decrease of 15 percentage points in success rate is considered clinically important difference. The superiority of antibiotic treatment compared with placebo will be analysed using Fisher’s one-sided test and CI will be calculated for proportion difference.Ethics and disseminationThis protocol has been approved by the Ethics Committee of Turku University Hospital and the Finnish Medicines Agency (FIMEA). The findings will be disseminated in peer-reviewed academic journals.Trial registration numberNCT03234296; Pre-results.

BET 2: CT versus MRI for occult hip fractures

2018 ◽  
Vol 35 (10) ◽  
pp. 645-647 ◽  
Author(s):  
Bernard A Foex ◽  
Anna Russell
Keyword(s):  
Hip Fracture ◽  
Ct Scan ◽  
Hip Fractures ◽  
Clinical Suspicion ◽  
First Line ◽  
Bottom Line ◽  
X Ray ◽  
Occult Hip Fracture ◽  
Study Type ◽  
Occult Hip Fractures

A short-cut review was carried out to establish whether CT or MRI is better at detecting an occult hip fracture. Six studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that CT is a valid first-line investigation for a suspected plain X-ray occult hip fracture. If clinical suspicion remains after a negative CT scan, then MRI should be used.

scholarly journals Hydroxychloroquine for Early Treatment of Adults With Mild Coronavirus Disease 2019: A Randomized, Controlled Trial

2020 ◽  
Author(s):  
Oriol Mitjà ◽  
Marc Corbacho-Monné ◽  
Maria Ubals ◽  
Cristian Tebé ◽  
Judith Peñafiel ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Viral Load ◽  
Adverse Events ◽  
Usual Care ◽  
Symptom Onset ◽  
Early Treatment ◽  
Complete Resolution ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
The Mean

Abstract Background No effective treatments for coronavirus disease 2019 (COVID-19) exist. We aimed to determine whether early treatment with hydroxychloroquine (HCQ) would be efficacious for outpatients with COVID-19. Methods Multicenter open-label, randomized, controlled trial conducted in Catalonia, Spain, between 17 March and 26 May 2020. Patients recently diagnosed with <5-day of symptom onset were assigned to receive HCQ (800 mg on day 1 followed by 400 mg once daily for 6 days) or usual care. Outcomes were reduction of viral load in nasopharyngeal swabs up to 7 days after treatment start, disease progression up to 28 days, and time to complete resolution of symptoms. Adverse events were assessed up to 28 days. Results A total of 293 patients were eligible for intention-to-treat analysis: 157 in the control arm and 136 in the intervention arm. The mean age was 41.6 years (SD, 12.6), mean viral load at baseline was 7.90 log10 copies/mL (SD, 1.82), and median time from symptom onset to randomization was 3 days. No differences were found in the mean reduction of viral load at day 3 (−1.41 vs −1.41 log10 copies/mL in the control and intervention arm, respectively) or at day 7 (−3.37 vs −3.44). Treatment did not reduce risk of hospitalization (7.1% control vs 5.9% intervention) nor shorten the time to complete resolution of symptoms (12 days, control vs 10 days, intervention). No relevant adverse events were reported. Conclusions In patients with mild COVID-19, no benefit was observed with HCQ beyond the usual care.

scholarly journals Infectious conjunctivitis caused by Pseudomonasaeruginosa in infected and extrused scleral buckles

2020 ◽  
Vol 13 (1) ◽  
pp. e232296
Author(s):  
Alessandro Meduri ◽  
Antonio De Maria ◽  
Alice Antonella Severo ◽  
Pasquale Aragona
Keyword(s):  
Female Patient ◽  
Systemic Therapy ◽  
Complete Resolution ◽  
Systemic Treatment ◽  
Purulent Discharge ◽  
Scleral Buckle ◽  
Ocular Pain ◽  
Intense Pain ◽  
Periorbital Oedema ◽  
Caucasian Female

Extrusion of the scleral buckle is one of the complications patients may encounter undergoing the surgical treatment for retinal detachment. We present two cases of persistent Pseudomonasaeruginosa-related conjunctivitis which infected the silicone explant after retinal surgery. One of them is a 73-year-old Caucasian female patient with hyperaemia, intense pain and mucopurulent discharge. After the conjunctival swabs detected a P. aeruginosa infection, she started both topical and systemic treatment without any results; for this reason we opted for the buckle removal always under systemic therapy. The second case is an 84-year-old Caucasian female patient with fever, periorbital oedema, chronic ocular pain, hyperaemia and purulent discharge. P. aeruginosa has also been detected in this case. No improvement with topical and systemic treatment, so this convinced us to remove patient's buckles and to continue systemic therapy. Both cases had the complete resolution after surgery. It is important to quickly recognise exposed scleral buckles because they can be a source of infections and a rare but threatening cause of endophthalmitis.

scholarly journals A Child with Raccoon Roundworm Meningoencephalitis: A Pathogen Emerging in your Own Backyard?

2009 ◽  
Vol 20 (4) ◽  
pp. e177-e180 ◽  
Author(s):  
Jan Hajek ◽  
Yvonne Yau ◽  
Peter Kertes ◽  
Teesta Soman ◽  
Suzanne Laughlin ◽  
...  
Keyword(s):  
Early Treatment ◽  
Neurological Impairment ◽  
Clinical Suspicion ◽  
Ocular Disease ◽  
Significant Recovery ◽  
Documented Case ◽  
Baylisascaris Procyonis ◽  
Severe Neurological Impairment

Raccoon roundworm (Baylisascaris procyonis) is a cause of devastating neural and ocular disease. The first documented case of raccoon roundworm encephalitis in Canada, in a seven-year-old boy who presented with severe neurological impairment, is presented. His significant recovery illustrates the importance of clinical suspicion and the benefit of early treatment.

scholarly journals Staphylococcal scalded skin syndrome: A pediatric dermatology case report

2018 ◽  
Vol 6 ◽  
pp. 2050313X1775089 ◽  
Author(s):  
Girish Gulab Meshram ◽  
Neeraj Kaur ◽  
Kanwaljeet Singh Hura
Keyword(s):  
Complete Resolution ◽  
Skin Lesions ◽  
Clinical Suspicion ◽  
The Body ◽  
Intravenous Fluids ◽  
Effective Management ◽  
Pediatric Dermatology ◽  
Staphylococcal Scalded Skin Syndrome ◽  
High Clinical Suspicion ◽  
Hygiene Measures

Staphylococcal scalded skin syndrome is a condition which predominantly affects children and causes a spectrum of skin lesions. We present a case of a 2-month-old infant with complaints of fever and fragile blisters over the body. The mucosal areas were spared. The diagnosis of staphylococcal scalded skin syndrome was reached on clinical grounds and culture report. The patient responded well to the treatment, which included an antibiotic (cloxacillin), an analgesic (paracetamol), and hydration with intravenous fluids. He was discharged after 8 days, with almost complete resolution of his skin lesions. Having a high clinical suspicion for staphylococcal scalded skin syndrome, early diagnosis/treatment, and following robust hygiene measures are imperative for the effective management of staphylococcal scalded skin syndrome. More efforts are needed to develop novel therapies for staphylococcal scalded skin syndrome.

Diagnostic challenges in tuberculous otitis media

2010 ◽  
Vol 124 (8) ◽  
pp. 913-915 ◽  
Author(s):  
I P Tang ◽  
N Prepageran ◽  
C A Ong ◽  
P Puraviappan
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
Antibiotic Therapy ◽  
Otitis Media ◽  
Surgical Intervention ◽  
Clinical Suspicion ◽  
Middle Ear Infection ◽  
Clinical Presentations ◽  
Tuberculous Otitis Media ◽  
Systemic Antibiotics

AbstractObjectives:To demonstrate the different clinical presentations of tuberculous otitis media and the management of selected cases.Case report:We report four cases of tuberculous otitis media with different clinical presentations, encountered between 1998 and 2002. None of the cases showed improvement with local or systemic antibiotics. The diagnosis, complications and management of these cases are discussed.Conclusions:A high index of clinical suspicion of tuberculous otitis media is required in patients who do not respond to standard antibiotic therapy for (nontuberculous) chronic middle-ear infection. Early diagnosis and treatment of tuberculous otitis media is important to avoid irreversible complications, surgical intervention and propagation of the disease.

An Unusual Cause of Osteomyelitis of the Rib and the Scalp

2017 ◽  
Vol 13 (01) ◽  
pp. 078-080 ◽  
Author(s):  
Aparna Jayaraman ◽  
Prasantha Gurusaran ◽  
Shobhana Sivathanu ◽  
Angelina Raghavendran
Keyword(s):  
T Cell ◽  
Maintenance Therapy ◽  
Antibiotic Therapy ◽  
Hodgkin Lymphoma ◽  
Complete Resolution ◽  
Surgical Drainage ◽  
Non Hodgkin Lymphoma ◽  
Paratyphi B ◽  
Salmonella Osteomyelitis

Abstract Salmonella osteomyelitis is unusual in nonsicklers. We report the case of a child with T-cell non-Hodgkin lymphoma (NHL) on maintenance therapy who developed osteomyelitis of two different flat bones. The culture grew Salmonella paratyphi B. Surgical drainage and appropriate antibiotic therapy led to complete resolution of this unusual infection.

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