Mastoiditis and Citelli’s abscess: a case report

<p>Citelli’s abscess is a rare often undocumented complication of otitis media. This is a case of a 52-year-old lady with learning difficulties, who presented with right sided mastoid swelling. On initial consultation the patient denied any otological symptoms but after being discharged and returning with her mother it was revealed she suffered with otalgia the previous month. On her return, the mastoid swelling had increased in size and there was also a large swelling across the right side of the neck. CT scan showed mastoiditis with Citelli’s abscess. The patient underwent a cortical mastoidectomy and myringotomy as well as drainage of the neck abscess. The report emphasises the importance of a clear, concise history and urgent surgical intervention to prevent further spread of the infection and potential intracranial complications.</p>

A STUDY OF BACTERIOLOGICALASSOCIATION AND ANTIBIOTIC SENSITIVITY IN PATIENTS OF NECK ABSCESSES.

INTRODUCTION: Deep neck infections which play an important role among neck abscesses have been described rstly by Galen and currently their incidence rates have ranged between 9 to 12/1,00,000. Usually the results of cultures are polymicrobial but as a whole, Streptococcus are the organisms most commonly cultured from deep neck abscesses.The incidence of deep neck infections is decreasing with the use of antibiotics.In this study we have tried to nd out association of microorganisms in neck abscess patients and their antibiotic sensitivity. AIM AND OBJECTIVE: AIM OFTHE STUDY1.Find out association of various microorganisms with neck abscesses 2.To determine antibiotic sensitivity of various microorganisms associated with neck abscess formation. OBJECTIVE OFTHE STUDY- To nd out a proper knowledge regarding role of microorganisms in neck abscess patients so that denitive treatment lines can be established. METHODOLOGY: :Aprospective study was performed in 90 cases of neck abscesses in a tertiary care hospital for a period of 1.5years from February 2019 to July 2020 to nd out association between neck abscesses with bacteriological factors and antibiotic sensitivity of the microorganisms. RESULT: It was found that klebsiella pneumoniae was higher proportion in associated bacteria.The antibiotic sensitivity testings revealed proper medical treatment path by directing necessary antibiotics for specic microorganisms involved in cases of neck abscess. Thus a multidisciplinary treatment approach is always advisable.

Descending mediastinitis secondary to deep neck abscess in a healthy patient: Case report

Necrotizing descending mediastinitis is an emergency which can be fatal in most cases. 80% to 85% of patients who develop descending necrotizing mediastinitis are young, previously healthy persons. We present the case of a healthy patient who, after a neck abscess, developed descending necrotizing mediastinitis complicated by atypical interstitial pneumonia.

A case of neck abscess caused by rare hypervirulent Klebsiella pneumoniae, capsular type K20 and sequence type 420

Background This case report describes a neck abscess caused by a strain of Hypervirulent Klebsiella pneumoniae in a middle aged man with diabetes without a history of travel to East and South East Asia. This case report is of notable significance as Hypervirulent Klebsiella pneumoniae neck abscesses are rarely seen in the UK and are very infrequently documented in individuals who have not first travelled to the high prevalence areas of East and South East Asia. Case presentation This case report describes a 53 year old diabetic man who contracted a Hypervirulent Klebsiella pneumoniae neck abscess which led to the development of sepsis. Klebsiella pneumoniae was cultured from blood cultures and fluid aspirated from the abscess grew the pathogen with same antimicrobial susceptibility. Hypervirulence was demonstrated after the samples were analysed, at the Antimicrobial Resistance and Healthcare Associated Infections Reference Unit Public Health England Colindale, and found to contain the K20 (rmp)A and rmpA2 virulence genes. Discussion Hypervirulent Klebsiella pneumoniae is a Gram-negative, encapsulated, non-motile bacillus notable for its ability to metastatically spread and cause potentially life threatening infections in otherwise healthy adults, but especially in those with diabetes. Genes responsible for the production of hyperviscous mucoid polysaccharide capsules and siderophores, such as those isolated in this case, enable the bacteria to more efficiently evade the hosts immune system and disseminate and invade surrounding and distant tissues. Data from Public Health England shows Hypervirulent Klebsiella pneumoniae are rare in the UK. A review of current literature also showed Hypervirulent Klebsiella pneumoniae almost exclusively occur in those who have traveled to East and South East Asia. Conclusions This case reported a rare Hypervirulent Klebsiella pneumoniae neck abscess outside of, and without travel to, East and South East Asia. This raises concerns about future, potentially life threatening, Hypervirulent Klebsiella pneumoniae infections becoming more widespread without the need for endemic travel. This concern is further exacerbated by the growing global challenge of antimicrobial resistance.

Melioidosis – A Rare Cause of Neck Abscess in Immunocompromised

Introduction Melioidosis is an infectious disease caused by Burkholderia pseudomallei, a saprophytic bacterium found in soil and water. Though multiple abscesses are a common presentation of melioidosis, isolated neck abscess due to B. pseudomallei is extremely rare and it is more prevalent in immunocompromised people. Case Report A young woman with uncontrolled Type II diabetes presented with neck abscess. Abscess was drained and culture showed Burkholderia pseudomallei. Appropriate treatment was given, including 3 weeks of parenteral antibiotics and 3 months of oral prophylactic antibiotics to prevent relapses. Patient responded well to treatment. Discussion Increased awareness of opportunistic infections like melioidosis is essential in the present era as diabetes is emerging as a global pandemic. It clinically resembles tubercular neck abscess. Strong clinical suspicion, early intervention and long term antibiotics can cure the disease completely without relapse.