MyMedR

Fulltext Fever with intradialytic pelvic pain: a case of iliopsoas abscess complicated with Methicillin-sensitive Staphylococcus Aureus bacteraemia in an end stage renal failure patient

Alif Adlan MT, Wan Mohd Rasis WA, Mohd Ramadhan MD

Med J Malaysia, 2016 04;71(2):72-3.

PMID: 27326946 MyJurnal

Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen. At surgery, she was found to have abscess at the posterior psoas muscle where she underwent open surgery drainage and percutaneous drain was inserted. A high index of suspicion of iliopsoas abscess should be maintained among haemodialysis patients presenting with intradialytic pelvic and hip pain and treated with optimal antibiotics therapy with appropriate surgical intervention.

Matched MeSH terms: Psoas Abscess/diagnosis

Fulltext The management of psoas abscess

Bajaj HN, Choong LT

Med J Malaysia, 1998 Sep;53 Suppl A:95-8.

PMID: 10968189

The presentation and management of psoas abscess was studied prospectively in 5 patients and retrospectively in 4. 3 patients had bilateral abscesses. All patients had back pain and a mass in loin or iliac fossa. 7 patients had no hip findings. One patient had a perinephric abscess and another had radiological features of tuberculosis of the spine. In the other seven no cause for the abscess could be identified. Ultrasonography demonstrated the abscess in all patients; CT scanning done in 5 patients was confirmatory. Drainage was done by an extraperitoneal route. Biopsy of the abscess wall in 2 patients demonstrated tuberculosis. They, the patient with TB spine and 3 others put empirically on anti-tuberculosis chemotherapy responded well. The perinephric abscess grew Pseudomonas sensitive to gentamycin, but she and two other patients died due to multiorgan failure.

Matched MeSH terms: Psoas Abscess/diagnosis

Fulltext Parapharyngeal and retropharyngeal abscess: anatomical complexity and etiology

Brito-Mutunayagam S, Chew YK, Sivakumar K, Prepageran N

Med J Malaysia, 2007 Dec;62(5):413-5.

PMID: 18705479 MyJurnal

The differential diagnoses of an abscess deep in the neck are retropharyngeal abscess and parapharyngeal abscess. We report a case each of these deep neck space abscesses to highlight their difference with emphasis on its anatomy and possible etiologies.

Matched MeSH terms: Retropharyngeal Abscess/diagnosis*

Fulltext Diagnostic dilemma of sacral abscess presented with seizure and altered conscious level in a patient with spinal cord injury

Chek Siang KC, Ahmad Fauzi A, Hasnan N

J Spinal Cord Med, 2017 01;40(1):113-117.

PMID: 26871508 DOI: 10.1080/10790268.2015.1133016

CONTEXT: Infection and septicaemia may clinically presented with seizure and altered conscious level. In spinal cord injury (SCI) population, they are at risk of having pressure ulcer which can be complicated further with infection and septicaemia.

FINDINGS: A 40-year-old man with complete T4 SCI and multiple clean and non-healing pressure ulcers at sacral and bilateral ischial tuberosity regions was initially admitted for negative pressure wound therapy (NPWT) dressing. He had an episode of seizure and subsequently had fluctuating altered conscious level before the diagnosis of deep-seated sacral abscess was made and managed. Prior investigations to rule out common possible sources of infections and management did not resolve the fluctuating event of altered consciousness.

CLINICAL RELEVANCE: We presented an unusual case presentation of septicemia in a patient with SCI with underlying chronic non-healing pressure ulcer. He presented with seizure and fluctuating altered conscious level. Even though a chronic non-healing ulcer appeared clinically clean, a high index of suspicion for deep seated abscess is warranted as one of the possible sources of infection, especially when treatment for other common sources of infections fails to result in clinical improvement.

Matched MeSH terms: Abscess/diagnosis*

Complications of chronic suppurative otitis media: a left otogenic brain abscess and a right mastoid fistula

Chew YK, Cheong JP, Khir A, Brito-Mutunayagam S, Prepageran N

Ear Nose Throat J, 2012 Oct;91(10):428, 430.

PMID: 23076851

Otogenic brain abscess and postauricular fistula are complications of chronic suppurative otitis media. We describe a rare case of bilateral chronic suppurative otitis media that caused a left temporal lobe abscess and a right mastoid fistula.

Matched MeSH terms: Brain Abscess/diagnosis

Fulltext Nasal septal abscess with uncontrolled diabetes mellitus: case reports

Dinesh R, Avatar S, Haron A, Suhana, Azwarizan

Med J Malaysia, 2011 Aug;66(3):253-4.

PMID: 22111451

Nasal septum abscesses caused by uncontrolled diabetes mellitus are rare. We report 3 cases. Very few cases have been published concerning non-traumatic nasal septum abscesses. The development of the condition, possible complications, and treatment are discussed.

Matched MeSH terms: Abscess/diagnosis

Melioidosis presenting as spinal epidural abscess

Ganesan D, Puthucheary SD, Waran V

Br J Neurosurg, 2003 Dec;17(6):568-71.

PMID: 14756491

Central nervous system melioidosis is an unusual infection in humans. This article reports a case of melioidosis presenting as an acute spinal epidural abscess. A discussion of this case and its management together with a brief review of melioidosis of the central nervous system is presented.

Matched MeSH terms: Epidural Abscess/diagnosis*

Fulltext Metastatic cervical carcinoma presenting as psoas abscess and osteoblastic and lytic bony metastases

George J, Lai FM

Singapore Med J, 1995 Apr;36(2):224-7.

PMID: 7676275

A 60-year-old Chinese lady presented with a left flank mass and weight loss. Plain films showed a sclerotic L1 vertebral body, osteopenic L2 and L3 vertebral bodies and loss of left psoas outline. However initially unrevealed history of previous carcinoma of the cervix caused confusion as to the aetiology of a sclerotic vertebral body associated with an left flank collection. Psoas abscess with adjacent bony osteomyelitis was initially suspected. The left flank mass turned out to be an infected necrotic large metastatic lymph node compressing the lower pole of the left kidney. The sclerotic and osteopenic vertebral bodies represented an unusual presentation of bony cervical carcinoma metastases.

Matched MeSH terms: Psoas Abscess/diagnosis*

Mother with post-partum group B Streptococcus meningitis and cerebellar abscess

Ghani NA, Jaafar R, Ishak S, Zainuddin AA, Mukari SA, Mahdy ZA

J Obstet Gynaecol Res, 2007 Apr;33(2):195-8.

PMID: 17441895

We report the case of a 25-year-old Malay woman, admitted for preterm delivery at 35 weeks' gestation. Vaginal swab did not isolate any organism. She delivered a baby girl who developed respiratory distress syndrome, requiring ventilation. Although chest radiograph showed hyaline membrane disease with pneumonia, septic workout was negative. The mother was discharged on the next day. Seven days postpartum, the mother presented with fever and fits and was diagnosed to have meningo-encephalitis. Lumbar puncture isolated group B Streptococcus (GBS) and MRI revealed a superior cerebellar abscess. She was treated and survived the episode. This case illustrates the uncommon situation where GBS infection was confirmed via maternal septic workout rather than neonatal, although both presented with severe disease.

Matched MeSH terms: Brain Abscess/diagnosis

Liver abscess in the tropics: experience in the University Hospital, Kuala Lumpur

Goh KL, Wong NW, Paramsothy M, Nojeg M, Somasundaram K

Postgrad Med J, 1987 Jul;63(741):551-4.

PMID: 3658864

We reviewed 204 cases of liver abscess seen between 1970 and 1985. Ninety were found to be amoebic, 24 pyogenic and one tuberculous. The cause of the abscesses in the remaining 89 patients was not established. The patients were predominantly male, Indians, and in the 30-60 age group. The majority of patients presented with fever and right hypochondrial pain. The most common laboratory findings were leucocytosis, hypoalbuminaemia and an elevated serum alkaline phosphatase. Amoebic abscesses were mainly solitary while pyogenic abscesses were mainly multiple. Complications were few in our patients and included rupture into the pleural and peritoneal cavities and septicaemic shock. An overall mortality of 2.9% was recorded. The difficulty in diagnosing the abscess type is highlighted. The single most important test in helping us diagnose amoebic abscess, presumably the most common type of abscess in the tropics, is the Entamoeba histolytica antibody assay. This test should be used more frequently in the tropics.

Matched MeSH terms: Liver Abscess/diagnosis*

Tuberculous liver abscess

Goh KL, Pathmanathan R, Chang KW, Wong NW

J Trop Med Hyg, 1987 Oct;90(5):255-7.

PMID: 3669128

Tuberculous liver abscess is uncommonly seen in our experience. We report a case of a 17-year-old boy who presented with typical clinical features of liver abscess, where a diagnosis of tuberculous liver abscess was made on laparotomy and biopsy of the abscess wall.

Matched MeSH terms: Liver Abscess/diagnosis*

Fulltext Subdural collections due to non-typhi Salmonella infections in two Malaysian children

Intan HI, Zubaidah CD, Norazah A, Norlijah O

Singapore Med J, 2008 Jul;49(7):e186-9.

PMID: 18695854

Subdural collections caused by Salmonella infection are rarely encountered in children. We present two cases caused by non-typhi Salmonella, one a four-and-a-half-month-old boy presenting with subdural effusion, and the other, a 16-month-old boy with empyema. The diagnosis was confirmed on blood and subdural pus cultures. One patient had status epilepticus following focal fit, and the other had prolonged fever without any localising signs of infection on admission. They responded well to prompt surgical drainage and prolonged systemic antibiotic therapy. Contrary to previous reports, both patients showed favourable outcome in terms of neurological sequelae.

Matched MeSH terms: Brain Abscess/diagnosis

Fulltext Right internal carotid pseudoaneurysm mimicking a retropharyngeal abscess in a child

Lee NNA, Long G, Ngai S, Sahrir S, Parker A, Lamont AC

Med J Malaysia, 2004 Dec;59(5):685-7.

PMID: 15889576

A 7-year-old girl with tonsillar infection with antibiotics. Two weeks later, there was a right sided neck lump. Computed tomography scans demonstrated a predominantly hypodense right retropharyngeal area with peripheral enhancement and mass effect. There was intense enhancement within the postero-superior aspect of the lesion which was continuous with the right internal carotid artery. Ultrasound demonstrated tapering of the right internal carotid artery. Magnetic resonance imaging and magnetic resonance arteriography showed a right internal carotid artery pseudoaneurysm. Surgical exploration confirmed the finding. This case highlights an unusual presentation of an internal carotid pseudoaneurysm and how imaging provided the diagnosis.

Matched MeSH terms: Retropharyngeal Abscess/diagnosis*

Fulltext Neonatal meningitis due to non-encapsulated Haemophilus influenzae in a set of twins--a case report

Lim CT, Parasakthi N, Puthucheary SD

Singapore Med J, 1994 Feb;35(1):104-5.

PMID: 8009266

A set of twins born to a 24-year-old primigravida had evidence of sepsis 24 to 60 hours after birth and were treated empirically with penicillin and gentamicin. A non-encapsulated H. influenzae biotype IV strain was isolated from the blood cultures of both and from the CSF of twin II. The isolates were beta-lactamase positive and hence showed resistance to ampicillin and therapy was changed to chloramphenicol only. Twin II recovered but Twin I developed a brain abscess in the left occipital region which resolved with extended antibiotic treatment. Although ampicillin-resistant H. influenzae have been reported in Malaysia, invasive disease by such strains are rare.

Matched MeSH terms: Brain Abscess/diagnosis

Fulltext Detection of spleen abscesses facilitates diagnosis of melioidosis in Malaysian children

Mohan A, Manan K, Tan LS, Tan YC, Chin ST, Ahmad R, et al.

Int J Infect Dis, 2020 Sep;98:59-66.

PMID: 32535300 DOI: 10.1016/j.ijid.2020.06.025

OBJECTIVES: Melioidosis is associated with extremely high case fatality ratios. The aim of this study was to determine whether detection of abdominal visceral abscesses can facilitate diagnosis of melioidosis in children.

METHODS: We conducted a retrospective analysis of all children who had liver and/or spleen abscesses on abdominal ultrasonography admitted to Bintulu Hospital in Sarawak, Malaysia, from January 2014 until December 2018.

RESULTS: Fifty-three children had liver and/or spleen abscesses. Spleen abscesses were present in 48 (91%) cases; liver abscesses in 15 (28%). Melioidosis was confirmed by culture in 9 (17%) children; small occult splenic abscesses were present in all cases. In 78% of these cases, the lesions were detected before any positive culture (or serology) results were available. Four (8%) children had bacteriologically-confirmed tuberculosis. Two (4%) had Staphylococcus aureus infection. Of the remaining 38 (72%) culture-negative cases, 36 (95%) had clinical and imaging characteristics similar to that of children with culture-confirmed melioidosis and improved with empirical melioidosis antibiotic therapy.

CONCLUSIONS: A large number of children in Bintulu Hospital in Sarawak, Malaysia, were found to have spleen abscesses. Melioidosis was the most common etiology identified in these children. Abdominal ultrasonography is extremely useful in facilitating the diagnosis of pediatric melioidosis.

Matched MeSH terms: Liver Abscess/diagnosis

Fulltext Melioidotic prostatic abscess in Pahang

Ng TH, How SH, Amran AR, Razali MR, Kuan YC

Singapore Med J, 2009 Apr;50(4):385-9.

PMID: 19421682

Melioidosis is caused by Burkholderia pseudomallei, a Gram-negative bacillus. Melioidosis can affect many organs, including the prostate. However, prostatic abscess due to melioidosis is uncommon. We describe five cases of melioidosis with prostatic abscess. Four of five patients had diabetes mellitus and had more than one organ involvement. The diagnosis of prostatic abscess in our patients was only made with computed tomography of the abdomen and pelvis. None of our patients underwent surgical drainage and all remained well after treatment with antibiotics, except for one mortality secondary to severe septicaemia.

Matched MeSH terms: Abscess/diagnosis*

Fulltext Epitrochlear lymphadenitis mimicking subcutaneous abscess

Ong SCL, Tang PP

BMJ Case Rep, 2018 Feb 14;2018.

PMID: 29444798 DOI: 10.1136/bcr-2017-223669

Matched MeSH terms: Abscess/diagnosis*

Fulltext Infected intraparenchymal bronchogenic cyst mimicking recurrent lung abscess in a young adult

Ramzisham AR, Johann KF, Talal AR, Joanna OS, Zamrin DM

Med J Malaysia, 2007 Dec;62(5):416-7.

PMID: 18705480 MyJurnal

A 23 year old female with a past history of a lung abscess diagnosed at the age of 13 years presented with recurrent episodes of productive cough. Chest radiograph and a high resolution CT scan of the thorax led to the diagnosis of a left lower lobe lung abscess. She underwent a successful thoracotomy and a left lower lobe lobectomy. Histopathological examination revealed the diagnosis of an infected congenital bronchogenic cyst. The recent literature on this is reviewed.

Matched MeSH terms: Lung Abscess/diagnosis*

Fulltext Ultrasonographic findings of liver abscess

Sakijan AS

Med J Malaysia, 1988 Dec;43(4):332-7.

PMID: 3071729

Matched MeSH terms: Liver Abscess/diagnosis*

Fulltext Primary psoas abscess: case report and review of the literature

Sathyamoorthy P

Singapore Med J, 1992 Apr;33(2):201-3.

PMID: 1621132

A case of primary non-tuberculous psoas abscess is reported and the literature reviewed. The aetiology of psoas abscess is varied and there is a worldwide variation in the aetiology. Primary psoas abscess is due to Staphylococcal infection. The pathophysiology, clinical features, diagnosis and treatment are discussed with emphasis on the changing pattern in the aetiology and diagnosis.

Matched MeSH terms: Psoas Abscess/diagnosis*

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