Portal vein thrombosis complicating neonatal hepatic abscess

Hepatic abscess in a neonate is a rare but serious disorder. Diagnosis of hepatic abscess requires a high index of suspicion in any septic neonate. CT scan and ultrasound of liver are the most sensitive diagnostic tests in detection of hepatic abscess. Portal vein thrombosis and portal cavernoma formation is hitherto unreported complication of neonatal hepatic abscess in English literature. Present case report highlights the difficulty in diagnosis of neonatal hepatic abscess and describes the development of portal vein thrombosis and cavernoma during its treatment.     

Epilepsy and brain abscess

Among 22 children who had recovered from brain abscess, 9 later developed epilepsy. Epilepsy developing as a consequence of brain abscess depends on the length of the catamnestic period and the localization of the abscess. The appearance of epilepsy is more frequent after frontal and temporal abscesses and in cases presenting symptoms in the acute phase of the abscess. Since epilepsy may develop years or even decades after recovery from the brain abscess, it is recommended to keep the patient under control for years.     

Klebsiella brain abscess in a neonate

Klebsiella pneumoniae is rarely associated with neonatal cerebral abscess. A case of Klebsiella brain abscess in a neonate is described. Diagnosis of abscess was confirmed by magnetic resonance imaging and ultrasound-guided aspiration.     

小儿阑尾周围脓肿61例临床分析

目的总结19年来北京大学第一医院对于小儿阑尾周围脓肿的治疗经验,探讨治疗策略的变化。方法回顾性分析自1993年至2011年间,作者收治的61例阑尾周围脓肿患儿临床资料。治疗方法包括静脉输入抗生素、理疗、B超引导下脓肿穿刺及手术治疗。结果保守治疗32例,1例于4周后发生肠梗阻,1例1年后再发脓肿;B超引导下行脓肿穿刺4例,无并发症;手术25例（10例行脓肿切开引流并切除阑尾,其余行脓肿切开引流）,出现并发症（切口感染、肠梗阻、残余脓肿）11例。4例于随访期间发作急性阑尾炎,予手术切除阑尾,其中3例存在阑尾粪石。结论对于阑尾周围脓肿,应首选以静脉输入抗生素为主的保守治疗方法;对于部分脓肿较大的患儿,可在B超引导下行穿刺引流。存在阑尾粪石的患儿,应行二期阑尾切除术。     

Percutaneous drainage for post-traumatic hepatic abscess in children under ultrasound imaging

Hepatic abscess is rare in children. A patient with a post-traumatic hepatic abscess was successfully treated by ultrasound-guided percutaneous drainage. Although he underwent a drainage operation for the perihepatic abscesses, high fever continued. It was then considered that the traumatic hematoma had been infected and had become an abscess. Sonographically-guided percutaneous aspiration is useful for the definite diagnosis of hepatic abscess. Subsequent percutaneous drainage under ultrasound imaging is a safe and useful therapeutic method even in a poor-risk patient.     

Renal abscess in infancy

Renal abscess is a rare occurrence in infancy. Its differentiation from an infected renal cyst may be difficult, especially if a perinephric abscess develops. This report illustrates a hitherto unrecorded unusual presentation of renal abscess as a tumour arising from the left lumbocostal region in an infant.     

应用神经内镜治疗儿童多房脑脓肿

目的：神经内镜技术在最近20年取得了重大进步并得到了广泛应用,而儿童多房脑脓肿目前仍是神经外科的急症之一,死亡率和致残率较高。该文通过总结应用神经内镜治疗儿童多房脑脓肿的临床经验,探讨神经内镜技术在手术治疗儿童多房脑脓肿中的作用。方法：2002年1月至2007年6月,该研究应用神经内镜治疗了16例多房脑脓肿的患儿。结果：该组16例患儿术后颅高压症状均缓解, 术后复查头颅CT/MRI示脓肿腔消失,仅存脓肿壁。随访到的14例患儿随访时间为6个月至5年,13例脓肿壁均消失,术后脓肿复发1例。结论：用神经内镜治疗儿童多房脑脓肿具有安全、高效、并发症少的优势。［中国当代儿科杂志,2009,11（1）：41-43］     

Cerebral abscess in the under 6 month age group.

Cerebral abscess is rare in children under 6 months of age but is associated with high mortality and morbidity. We report the 12 cases admitted to this hospital in the past 20 years and review the published reports on cerebral abscess in infancy and childhood. Although mortality associated with cerebral abscess in infancy has improved, morbidity is still high. We recommend that all infants aged under 6 months presenting with bacterial meningitis have a computed tomogram or ultrasound examination to exclude cerebral abscess and hydrocephalus.     

Adrenobronchial fistula complicating a neonatal adrenal abscess: treatment by percutaneous aspiration and antibiotics

A case of retroperitoneal pulmonary fistula caused by a neonatal adrenal abscess is reported. The adrenal abscess was diagnosed by means of needle aspiration which guided the choice of antibiotic therapy. The fistula was demonstrated by direct injection of contrast medium into the adrenal abscess. Treatment by needle aspiration of the adrenal abscess and intravenous antibiotics was successful. Received: 26 February 1996 Accepted: 29 April 1996     

Recovery of anaerobic bacteria from a glossal abscess in an adolescent

Glossal abscess is infrequent in children. Anaerobic bacteria are rarely recovered from this infection and never have been reported in children or adolescents. A 15-year-old patient presented with a tongue abscess following trauma. Aspirate of the abscess yielded polymicrobial anaerobic flora: Prevotella melaninogenica, Fusobacterium nucleatum, and Peptostreptococcus micros. The patient recovered following incision and drainage and 14 days of antimicrobial therapy with clindamycin. This report illustrates the recovery of anaerobic bacteria from glossal abscess in an adolescent.     

The value of a CT-guided fine needle aspirate in infants with lung abscess

OBJECTIVE: To describe the range of pathogens isolated from a lung abscess in infants less than one year of age. To assess the role of direct culture from the abscess. METHODS: The two index cases were managed in 2002. An institution-based review was conducted of all infants up to one year of age diagnosed with a lung abscess between 1989 and 2002. Data sources were hospital's disease index and Neonatal Intensive Care Unit Audit database using ICD9 and ICD10 diagnostic codes for 'lung abscess'. RESULTS: Five infants, under the age of one year, were treated for a lung abscess. In the one case where the abscess was left-sided it was associated with a congenital cystic adenomatoid malformation of the lung. Pathogens were isolated following direct culture of the abscess in four cases. In three cases a single pathogen was isolated: pseudomonas aeruginosa, staphylococcus aureus and haemophilus influenzae. In one case a mixture of escherichia coli, streptococcus milleri and an anaerobe, propionibacteria, were cultured. Antibiotic therapy was directed at the identified pathogen(s) in all four cases. There was no mortality or recurrence. CONCLUSION: Predisposing factors for a lung abscess in infancy include prematurity, assisted ventilation, congenital lung anomaly and aspiration. Given the range of potential pathogens, direct culture by CT-guided fine needle aspiration is recommended to direct appropriate intravenous medical therapy provided the abscess is located peripherally.     

幼儿先天性皮毛窦并脊髓内多发脓肿1例

目的通过对幼儿先天性皮毛窦并脊髓内多发脓肿的病例报告,加深对脊髓内脓肿的认识,减少先天性皮毛窦并脊髓内脓肿的发生。方法对1例先天性皮毛窦并脊髓内多发脓肿患儿的临床表现、实验室资料、影像学结果进行分析。结果本例患儿由于没有肃清感染灶,未手术治疗,没有定期进行详细的体格检查,导致发病时感染扩散,发生脊髓内多发性脓肿。结论脊髓内脓肿是一种罕见的疾病,会导致神经功能异常,如不积极治疗,预后差,MRI可确诊。先天性皮毛窦可并感染,感染扩散后可发生脊髓内脓肿,导致神经系统后遗症。对先天性皮毛窦患儿应及时手术治疗,避免感染的并发症。     

Hepatic abscess: a rare manifestation of brucellosis in children

Hepatic abscess caused by brucellosis is extremely rare in children. We report the case of a 5-year-old girl in whom an abscess of the liver developed during an episode of acute brucellosis. To our knowledge, this is the second reported case of hepatic abscess caused by brucellosis in a child.     

Perianal abscess and fistula‐in‐ano in children: Aetiology,management and outcome

Aim: We aimed to assess our experience in treatment and outcome of perianal abscess and/or fistula‐in‐ano in children. Method: The patients who were treated for perianal abscess and/or fistula‐in‐ano from January 2000 to December 2005 were included. Age, sex, duration of symptoms, number and site of the perianal abscess and/or fistula‐in‐ano, treatment modality and recurrences were recorded. Results: The study consisted of 39 patients (36 boys) with a mean age of 29 ± 49.1 months. At first examination the diagnosis was perianal abscess in 20 patients, perianal abscess with fistula in five patients and fistula‐in‐ano in 14 patients. No patients had an underlying illness. The primary local treatment of perianal abscess with or without fistula was incision and drainage (with or without antibiotic therapy) in 21 patients, and local care with antibiotic therapy was given to four patients. Of 20 patients with perianal abscess, 17 developed fistula‐in‐ano and three healed. One patient in the perianal abscess group who developed fistula‐in‐ano and two patients in the fistula group were lost to follow‐up. Thirty‐three patients with fistula‐in‐ano underwent surgical treatment either through a fistulotomy or through a fistulectomy. Five (15.1%) patients who experienced recurrent fistula‐in‐ano underwent fistulotomy were completely cured after the second operation. Conclusion: Treatment of a perianal abscess either through incision and drainage with antibiotics or through antibiotics alone resulted in a high rate (85%) of fistula formation. Fistula‐in‐ano can be treated either by fistulotomy or by fistulectomy, both of which are associated with a reasonable chance of recurrence of fistula‐in‐ano formation. We obtained good results in our patients through surgical approach (fistulotomy or fistulectomy), for fistula‐in‐ano formed following treatment of perianal abscess.     

Solitary liver abscess in a healthy child presenting with fever of unknown origin.

Pyogenic liver abscess is rarely encountered in normal children. We report a case of solitary pyogenic liver abscess in a healthy child aged 8 months. He presented with fever of unknown origin and mild hepatomegaly. Full recovery was achieved by surgical intervention and prolonged antibiotic treatment. Management and recommended treatment in children with liver abscess are presented.     

Tuberculous gluteal abscess in infancy

Primary tuberculous gluteal abscess without bone involvement has not been reported in infancy. We report 3 infants with isolated tuberculous gluteal abscess who presented with gluteal swelling of 2 weeks, 1 month and 6 months duration, respectively. Tuberculin test was positive in all cases. Pus cultures from the gluteal abscess grew Mycobacterium tuberculosis in all 3 infants.     

Amebic cerebral abscess mimicking bacterial meningitis

We report a case of an amebic brain abscess in a 2-year-old girl, with symptoms mimicking bacterial meningitis with no evidence of disease elsewhere. Histological evaluation of the abscess revealed the organisms, and the abscess regressed in response to specific medical treatment. This article reviews the rarity of these abscesses and difficulty in the diagnosis.     

Minimally invasive surgery of sinugenic orbital complications in childhood]

Orbital complications of acute sinusitis are classified into inflammatory edema, orbital cellulitis, subperiostal abscess and orbital abscess. The diagnosis is based on endoscopy of the nose, computed tomography of sinuses and orbit and an ophthalmological examination. Endonasal sinus surgery improves drainage and ventilation of sinuses and is free of long-term complications as observed with previous surgical techniques. Thus, the early surgical treatment of orbital complications is indicated even in children. Inflammatory edema and orbital cellulitis will still be treated conservatively. Subperiostal abscess and orbital abscess are treated surgically.