Lung abscess caused by Actinomyces odontolyticus

A 64-year-old woman with periodontal disease was admitted because of fever, right chest pain, and bloody sputum. Her chest radiograph revealed a nodular shadow in the right middle lung fields. From the results of a needle aspiration biopsy, she was diagnosed with a lung abscess due to Actinomyces odontolyticus (A. odontolyticus) and Streptococcus spp. The patient improved quickly with antibiotics. To our knowledge, only nine cases of pulmonary infection due to A. odontolyticus have been reported, and we report the first case in Japan. Although respiratory disease caused by A. odontolyticus is rare, the association of this organism should be considered even in healthy individuals.     

Purulent meningitis caused by Actinomyces successfully treated with rifampicin: a case report

A 64-year-old woman presented with fever and headache. Lumbar puncture revealed cerebrospinal fluid (CSF) that contained 67,386 /mm(3) of WBC; CSF culture revealed Actinomyces species. She was diagnosed with purulent meningitis caused by actinomyces, and treated with intravenous ampicillin 12 g/day. The administration of ampicillin was effective, but not sufficient to control the inflammation in CSF. CSF inflammation persisted and a gradual increase in granulation tissue was found in the subdural space on lumbar MRI. After administration of rifampicin 450 mg/day, the CSF was normalized and the enhancement of granulation tissue decreased. The patient completely recovered 5 months after the therapy was initiated. We suggest that rifampicin may be an option for the treatment of meningitis caused by actinomyces.     

Liver abscess caused by Ascaris lumbricoides: case report.

A case is reported of a woman who lived in a rural area with a chronic illness that consisted of weight loss and abdominal pain in the epigastrium and upper right quadrant. The initial diagnosis was a mass in the liver, which was later, demonstrated, both by direct and histological examination, to be an abscess caused by Ascaris lumbricoides. Eggs of Ascaris lumbricoides and abundant Charcot-Leyden Crystals were found.     

Thigh abscess caused by Eikenella corrodens and Streptococcus intermedius: a case report

A 35-year-old Chinese female has a large thigh abscess without a clear source. No underlying diseases were revealed in the patient. The combination of clindamycin and cefazolin or vancomycin was administered but without a clinical response. Eikenella corrodens and Streptococcus intermedius were isolated from puncture drainage. Then, ceftriaxone was administered and a surgery of incision and further draining was carried. Eventually, the patient recovered. To our knowledge, this is the first case of thigh abscess in a previous healthy adult.     

肛周假上皮瘤样增生一例报道

肛周假上皮瘤样增生,又称假癌样增生,临床上较为少见,是以肛周鳞状上皮细胞良性过度增生继发罕见的肛周良性疾病.其发病原因及机制不详,治疗尚无统一指南.本文报道一例肛周假上皮瘤样增生,旨在为临床医师提高辨别肛周假上皮瘤样增生诊断及治疗水平,以免误诊甚至漏诊.     

缓症链球菌肝脓肿1例报告

化脓性肝脓肿(pyogenic liver abscess,PLA)以大肠埃希菌和肺炎克雷伯杆菌感染为主[1],缓症链球菌(Streptococcus mitis,S.mitis)属于条件致病菌,致病力较弱,国内尚无由其引起PLA的报道。本文报道解放军总医院第八医学中心近期收治的1例S.mitis感染导致肝脓肿的病例,以提高临床医师对该病的认识。     

A case report of lung abscess caused by Capnocytophaga gingivalis infection

A 48-year-old male was admitted to our hospital because of fever, cough and of loss appetite. Chest X-P revealed an abnormal shadow in the left upper lobe. Bronchoscopy was performed and Capnocytophaga gingivalis was cultured from the bronchial lavage and bronchial curreting fluid. Ceftizoxime sodium and Clindamycin phosphate was administered intravenously. He was discharged after 30 days. He did not have any immunosuppressive underlying disease including HIV infection and diabetes mellitus which cause these lesions.     

Tuberculous pericardial abscess: a case report

We present the case of a 71-year-old diabetic man who came to us complaining of dyspnea for 1 month. Chest X-ray showed cardiomegaly and bilateral pleural effusion. Echocardiography showed a pericardial cystic mass with external compression of the right ventricle. Because of clinically impending cardiac tamponade, we performed urgent sternotomy and removed the pericardial mass without event. Pathologic examination of the excised pericardial specimen showed caseous necrosis compatible with tuberculosis infection. The patient was put on a 1-year treatment regimen of anti-tuberculosis medication. This case is an important reminder that tuberculosis can occur as a pericardial abscess.     

酒精戒断致低钠血症1例

一、病例资料 患者男性,65岁.无明显诱因出现渐进性乏力、腹胀、上腹不适,伴呃逆、食欲下降,偶有恶心,无呕吐,胸闷气短,夜间难以入睡1月余,于2009年2月10日入住沈阳市某医院,行胃镜检查,发现浅表性胃炎,结肠镜检查未见异常.血钾(K+)4.7 mmol/L,血钠(Na+)120 mmol/L,血氯(Cl-)89.5 mmol/L.肝、肾功能等生物化学检查均正常.给予高张盐水(3%氯化钠)、营养支持等对症治疗后好转,于3月8日出院.出院后1周,上述症状再次出现并逐渐加重,于4月3日收入本院.     

Nephropathia caused by hantavirus puumala: a case report

We present a patient from Germany with Hantavirus infection, admitted in the Emergency room of our hospital, with fever, thrombocytopenia, acute renal failure, oliguria, mild proteinuria and hematuria. Percutaneous renal biopsy revealed an acute interstitial nephritis without medulla haemorrhages. The virus infection confirmation was made by detection of IgM against Hantavirus Puumala. This infection should be considered in patients with thrombocytopenia, fever and acute renal failure, over all if they are from North and Central Europe.     

Myocarditis caused by Trichinella spiralis: a case report

Trichinellosis is a cosmopolitan nematodosis which is rare in the developed countries. Myocarditis represents the most frequent form of cardiac complications, sometimes lethal. The authors report the observation of a 36-years-old patient admitted for trichinellosis, who presented asymptomatic electrocardiographic modifications and a rise in the troponine I. The magnetic resonance imaging (MRI) after gadolinium injection, highlighted an underepicardic late raising rendering the diagnosis of myocarditis highly probable. The paraclinic anomalies were corrected gradually under antiparasitarian treatment. Besides the EKG, the MRI is a non-invasive and repetitive method allowing as well the positive diagnosis as the follow-up of those patients.     

Retropharyngeal abscess revealing diabetes: a case report

Retropharyngeal abscess, a rare event in adults, is usually observed in immunodeficient persons or subsequent to foreign bodies. We report a case of retropharyngeal abscess which revealed diabetes mellitus. A 47-year-old woman with an uneventful history complained of fever, dysphagia and trismus. Clinical findings were swelling of the pharyngeal posterior wall. The CT scan showed an abscess in the retropharyngeal space. Puncture revealed the purulent nature of the collection. The bacteriological study identified a Gram-negative aerobic germ (Citrobacter freundii). Laboratory tests disclosed diabetes mellitus with ketosis. The treatment consisted in surgical drainage and lavage of the retropharyngeal space using a saline solution with gentamycin associated with infusion of appropriate antibiotics. Abscess formation in the retropharyngeal space is a rare event in adults. The immunological status of the patient should be carefully explored. Management requires drainage of the collection and infusion of active antibiotics.     

Epidural abscess and vertebral osteomyelitis caused by Listeria monocytogenes: case report and literature review.

A 69-y-old male with an epidural abscess and concomitant vertebral osteomyelitis caused by Listeria monocytogenes is presented, together with a brief review of the literature. To our knowledge, no cases of epidural abscess and only 3 cases of osteomyelitis have previously been reported in association with this organism.     

Psoas muscle abscess caused by Mycobacterium tuberculosis and Staphylococcus aureus: case report and review.

Tuberculosis psoas muscle abscess is currently an uncommon clinical entity in industrialized countries. It was considered the predominant cause of these abscesses in the early part of the 20th century as a result of complicated Potts disease. We describe the case of a psoas abscess caused by the combination of Mycobacterium tuberculosis and Staphylococcus aureus. In this patient, the abscess was not associated with Potts disease but with osteomyelitis of the iliac crest, in which the evaluation with magnetic resonance imaging was very specific in determining the extent and regional spread.