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; Psoas Abscess/microbiology*; Psoas Abscess/surgery

Fulltext Abdominal tuberculosis manifested as tuberculosis of the urachal sinus in an adolescent and the role of laparoscopy in the management: a rare case report

Siow SL, Sha HL, Wong CM

BMC Infect Dis, 2016 Feb 05;16:68.

PMID: 26850778 DOI: 10.1186/s12879-016-1405-6

BACKGROUND: Abdominal tuberculosis (TB) is an uncommon affliction in adolescence. It is usually associated with pulmonary tuberculosis. The disease is caused by lymphohaematogenous spread after primary infection in the lung or ingestion of infected sputum and has a typically protean and nonspecific presentation. The occurrence of TB in an urachal remnant is probably from the contiguous spread of an abdominal focus or mesenteric lymph node. Urachal TB is a rare entity, with only two reported cases in the literature. We report here a case of clinically silent pulmonary and abdominal TB that manifested in the infection of an urachal sinus and highlight the role of laparoscopy in its diagnosis and treatment.

CASE PRESENTATION: A 14-year-old boy presented to our institution with peri-umbilical swelling and purulent discharge from his umbilicus for 2 weeks duration. There were no radiological, microbiological or clinical evidences of TB in the initial presentation, though he had close social contact with someone who had TB. A computed tomography scan of the abdomen confirmed the diagnosis of an urachal abscess. An incision and drainage procedure was performed followed by a course of antibiotics. A scheduled laparoscopic approach later showed that the peritoneum and serosal surface of the small and large intestines were studded with nodules of variable sizes, in addition to the urachal sinus. The histology of the resected tissues (urachal sinus and nodules) was consistent of TB infection. He recovered fully after completing 6 months of anti-tuberculous therapy.

CONCLUSION: This report highlights a rare case of TB urachal abscess in an adolescent boy, the difficulties in the diagnosis of abdominal tuberculosis, the need to consider TB as a cause of urachal infection in endemic areas and the use of laparoscopy in both diagnosis and treatment.

Matched MeSH terms: Abdominal Abscess/microbiology; Abdominal Abscess/pathology; Abdominal Abscess/surgery

Fulltext Lower lip numbness due to peri-radicular dental infection

Ngeow WC

Med J Malaysia, 1998 Dec;53(4):446-8.

PMID: 10971994

Lower lip numbness has always been a sinister symptom. Much has been written about it being the sole symptom of pathological lesions and metastatic tumours in the mandible. It may also be a symptom of manifestations of certain systemic disorders. A case of lower lip numbness resulting from the compression of the mental nerve by a peri-radicular abscess is presented because of the unusual nature of this spread of infection.

Matched MeSH terms: Periapical Abscess/complications*; Periapical Abscess/radiography; Periapical Abscess/therapy

Melioidosis, the great mimicker: a report of 10 cases from Malaysia

Yee KC, Lee MK, Chua CT, Puthucheary SD

J Trop Med Hyg, 1988 Oct;91(5):249-54.

PMID: 3184245

Between 1981 and 1986, 10 consecutive cases of melioidosis were seen at the University Hospital, Kuala Lumpur, Malaysia. They illustrate the amazing guises of melioidosis presenting as: abscesses of the supraspinatus muscle, psoas muscle, brain and liver; three different pulmonary forms; an acute suppurative dermal lesion; an acute septicaemia; and chronic lymphadenitis. The majority had underlying diseases: diabetes mellitus, the commonest, was present in six, out of whom three had previous pulmonary tuberculosis; other predisposing conditions were renal failure, corticosteroid therapy and malnutrition. Three patients who died had pre-existing renal impairment and developed renal failure later, suggesting that the former is a bad prognostic sign. Clinical diagnosis was difficult: all cases were diagnosed bacteriologically. A high level of clinical awareness is necessary, especially when presentation simulates pulmonary or extrapulmonary tuberculosis in patients with diabetes or other compromised states.

Matched MeSH terms: Abscess*; Lung Abscess*

A Single Posterolateral Scapular Approach to Drain Post-Traumatic Intramuscular Scapular and Axillary Abscess in an Adolescent: A Case Report

Khaw YC, Faisham WI

Malays Orthop J, 2019 Jul;13(2):56-58.

PMID: 31467655 DOI: 10.5704/MOJ.1907.012

Scapular abscess is a rare clinical diagnosis. This is a report of an atypical case of extensive intramuscular scapular abscess involving the anterior and posterior aspects of the scapula with extension into the axillary region following minor trauma in a young healthy adolescent, describing a single posterolateral approach to the scapula to evacuate the abscess. Following surgical drainage and antibiotic treatment, patient recovered without any complication.

Matched MeSH terms: Abscess

Fulltext Submasseteric abscess: an unusual head and neck condition

Sayuti, R., Baharudin, A., Amran, M.

Archives of Orofacial Sciences, 2007;2(1):59-60.

MyJurnal

Submasseteric abscess is unusual in the head and neck region. Patients with this condition may be misdiagnosed as a parotid abscess due to the similarities in their presentation. Awareness and due recognition should be given to this unusual problem.

Matched MeSH terms: Abscess

Fulltext Non-Hodgkin's Lymphoma Masquerading as Psoas Abscess: A Case Report

Ng, W.M., Ong, T.C., Kwan, M.K., Cheok, C.Y.

Malays Orthop J, 2008;2(1):49-51.

MyJurnal

We report here a rare presentation of an extra-nodal non-Hodgkin's lymphoma. Both clinical presentation radiological findings were suggestive of psoas abscess. Surgical debridement was performed and histopathological examination of the tissue sample revealed the diagnosis of non-Hodgkin's lymphoma. It is therefore important to note that non-Hodgkin's lymphoma can mimic psoas abscess and that psoas lesion with vertebral involvement does not necessarily indicate infection. It is always advisable to obtain needle biopsy to establish diagnosis before embarking on surgical intervention. The practice to send any suspicious tissue obtained intra-operatively for histopathological examination is also warranted.

Matched MeSH terms: Psoas Abscess

Fulltext Uncommon presentation of a common aesthetic procedure: late infection of a ruptured silicone breast implant

Kosai, N.R., Aznan, M., Taher, M.M., Reynu, R.

Medicine & Health, 2014;9(1):85-88.

MyJurnal

Breast augmentation using silicone implant is a common and popular aesthetic procedure with a high safety profile. Infection of silicone breast implants is a rare clinical entity, with skin commensal organisms often implicated as causative pathogen. Surgical treatment often involves removal of the implant with salvage procedures limited to selected cases. This case highlights a delayed presentation of an infected silicone breast implant presenting as a chest wall abscess 15 years after initial surgery.

Matched MeSH terms: Abscess

Fulltext Liver abscess from retained cystic stones following laparoscopic cholecystectomy: A case report

Marjmin Osman, Razman, J., Shaharin, S.

International Medical Journal Malaysia, 2007;6(1):1-5.

MyJurnal

One of the causes of post cholecystectomy pain is due to stone in the cystic duct. This is a very rare occurrence although it can be debilitating to the patient. We report a case of a 64 year old man presented with retained cystic duct stone post cholecystectomy complicated by liver abscess and biloma. The management of this unusual presentation is discussed.

Matched MeSH terms: Liver Abscess

Fulltext Central Diabetes Insipidus in neonatal brain abscess

Asmaa, H.A., Rohani, A.J., Farah Inaz, S.A., Rosli, F.J.

Malaysian Journal of Paediatrics and Child Health, 2016;22(101):0-0.

MyJurnal

Neonatal Central Diabetes Insipidus (CDI) is extremely rare and its causes include infection, trauma, hemorrhage or tumor. A high index of suspicion is necessary as early treatment is required to prevent further complications. We report a case of Neonatal CDI as a complication of a Serratia brain abscess.(Copied from article)

Matched MeSH terms: Brain Abscess

Two extraordinary cases of liver abscess

Pasley CB

Lancet, 1915;185:1076-1077.

DOI: 10.1016/S0140-6736(01)65663-0

Matched MeSH terms: Liver Abscess

Fulltext Bezold's abscess: A rare complication of acute otitis media

Nasir F, Asha'ari ZA

Malays Fam Physician, 2017;12(2):26-28.

PMID: 29423127

Otitis media is a common disease encountered in the primary practice. Most cases are successfully treated with antibiotics without any sequelae. Because of these, potential serious complications of otitis media may be overlooked. We report a rare case of Bezold's abscess, as a complication of otitis media and discuss its pathophysiology and management.

Matched MeSH terms: Abscess

Fulltext Bezold’s abscess: A rare complication of acute otitis media

Nasir F., Zamzil Amin Asha’ari

Malays Fam Physician, 2017;12(2):26-28.

MyJurnal

Otitis media is a common disease encountered in the primary practice. Most cases are successfully
treated with antibiotics without any sequelae. Because of these, potential serious complications of otitis
media may be overlooked.
We report a rare case of Bezold’s abscess, as a complication of otitis media and discuss its
pathophysiology and management.

Matched MeSH terms: Abscess

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: Abscess/complications; Psoas Abscess/complications; Psoas Abscess/diagnosis; Psoas Abscess/microbiology; Psoas Abscess/therapy*

Pediatric subperiosteal orbital abscess secondary to acute sinusitis: a 5-year review

Tan VES

Am J Otolaryngol, 2011 Jan-Feb;32(1):62-8.

PMID: 20031268 DOI: 10.1016/j.amjoto.2009.10.002

Objective: Subperiosteal orbital abscesses (SPOAs) secondary to acute sinusitis are rare occurrences in the pediatric age group, more so in the neonatal period. Here, a rare case of SPOA in a 38-day-old newborn later drained via endoscopic sinus surgery is included also. This review describes the demographic data, clinical history, treatment, microbiology results, complications, and outcome.
Methods: The admission records for all the patients who were admitted to the Pediatric Surgical Ward in Sarawak General Hospital, Kuching, Malaysia, between January 2004 and May 2009 were retrospectively reviewed. Records of patients who presented with preseptal cellulitis, orbital cellulitis, subperiosteal abscess (extraconal), orbital abscess (intraconal), and cavernous sinus thrombosis were closely studied. Ophthalmology consultations were obtained in all these cases. Ultimately, 3 patients having SPOA secondary to acute sinusitis were selected for this review.
Results: All patients were male with rapid onset of periorbital signs, absence of purulent rhinorrhea, and presence of significant thrombocytosis (exceeding 500 × 109/L). The 38-day-old newborn had mixed infection of methicillin-resistant coagulase-negative Staphylococcus bacteremia and local Acinetobacter eye infection with Staphylococcus aureus in the SPOA. All had medially located SPOA that was adequately drained via endoscopic sinus surgery, resulting in full recovery.
Conclusion: Newborns with preexisting risk factors and immature immunity are at risk of severe and rare infections. Contrast-enhanced paranasal sinus computed tomographic scan is mandatory and reliable to differentiate preseptal and postseptal orbital infection, as both conditions can present similarly and rapidly deteriorate. In the contrast-enhanced computed tomography–demonstrable SPOA, endoscopic sinus surgery drainage of the abscess proved to be safe and reliable as the main treatment modality. All patients recovered well without complications.

Matched MeSH terms: Abscess/diagnosis; Abscess/etiology*; Abscess/microbiology; Abscess/therapy

Eikenella corrodens from a brain abscess

Karunakaran R, Marret MJ, Hassan H, Puthucheary SD

Malays J Pathol, 2004 Jun;26(1):49-52.

PMID: 16190107

A 2-year-old boy with underlying congenital cyanotic heart disease presented with seizures and fever and was found to have bilateral parietal cerebral abscesses. Drainage of the pus from the abscesses was done in stages; on the day of admission, four days after admission and 3 weeks after admission. Although the pus from the first drainage did not grow any organisms, the pus from the second drainage on the fourth day of admission yielded a mixed growth of Eikenella corrodens and Streptococcus milleri. Following the second drainage of pus, the child was noted to have mild weakness (grade 3/5) and increased tone in the left upper limb. Three weeks after admission, due to recurring fever, further neurological signs and findings of an enlarging right cerebral abscess on a repeat CT scan, a third drainage was carried out. However no growth was obtained from this specimen. This patient was managed both surgically and with appropriate antibiotics. Over the next four months, serial CT scans revealed gradual resolution of the abscesses with disappearance of the surrounding oedema. The child showed gradual recovery of his left sided weakness with resolution of tone and reflexes to normal.

Matched MeSH terms: Brain Abscess/complications; Brain Abscess/drug therapy; Brain Abscess/microbiology*; Brain Abscess/surgery

Parallel ELISAs using crude soluble antigen and excretory-secretory antigen for improved serodiagnosis of amoebic liver abscess

Wong WK, Foo PC, Olivos-Garcia A, Noordin R, Mohamed Z, Othman N, et al.

Acta Trop, 2017 Aug;172:208-212.

PMID: 28506795 DOI: 10.1016/j.actatropica.2017.05.017

Crude soluble antigen (CSA) produced from Entamoeba histolytica trophozoite is conventionally used for serodiagnosis of invasive amoebiasis. However, high background seropositivities by CSA-assay in endemic areas complicate the interpretation of positive result in clinical settings. Instead, incorporating a second assay which indicates active or recent infection into the routine amoebic serology could possibly complement the limitations of CSA-assay. Hence, the present study aimed to evaluate the diagnostic efficacies of indirect ELISAs using CSA and excretory-secretory antigen (ESA) for serodiagnosis of amoebic liver abscess (ALA). Reference standard for diagnosis of ALA at Hospital Universiti Sains Malaysia is based on clinical presentation, radiological imaging and positive indirect haemagglutination assay (titer ≥256). Five groups of human serum samples collected from the hospital included Group I - ALA diagnosed by the reference standard and pus aspirate analysis using real-time PCR (n=10), Group II - ALA diagnosed by the reference standard only (n=41), Group III - healthy control (n=45), Group IV - other diseases control (n=51) and Group V - other infectious diseases control (n=31). For serodiagnosis of ALA serum samples (Group I and II), CSA-ELISA showed sensitivities of 100% for both groups, while ESA-ELISA showed sensitivities of 100% and 88%, respectively. For serodiagnosis of non-ALA serum samples (Group III, IV and V), CSA-ELISA showed specificities of 91%, 75% and 100%, respectively; while ESA-ELISA showed specificities of 96%, 98% and 100%, respectively. Indirect ELISAs using CSA and ESA have shown distinct strength for serodiagnosis of ALA, in terms of sensitivity and specificity, respectively. In conclusion, parallel analysis by both assays improved the overall efficacies of amoebic serology as compared to either single assay.

Matched MeSH terms: Liver Abscess, Amebic/blood; Liver Abscess, Amebic/diagnosis*; Liver Abscess, Amebic/epidemiology; Liver Abscess, Amebic/parasitology

Fulltext Salmonella tuboovarian abscess

Thaneemalai J, Asma H, Savithri DP

Med J Malaysia, 2007 Dec;62(5):422-3.

PMID: 18705483 MyJurnal

A 38 year old lady with a previous history of an ovarian cyst, presented with a one week history of fever, diarrhoea and intense localized pain in the left iliac fossa. Laparotomy revealed a left tuboovarian abscess with adherent bowels. Pus from the ruptured cyst grew Salmonella enteritidis. Histologically the cyst wall showed haemorrhagic and degenerate endometriotic features. Recovery was uneventful with cefotaxime and metronidazole.

Matched MeSH terms: Abscess/diagnosis*

Fulltext Spontaneous splenic rupture secondary to phaeyohyphomycosis and splenic abscesses

Sithasanan N, Chong LA, Ariffin H

Med J Malaysia, 2007 Aug;62(3):247-8.

PMID: 18246918 MyJurnal

Phaeohyphomycosis consists of a group of mycotic infections characterized by the presence of dematiaceous (dark walled) septate hyphae. Splenic abscess and spontaneous rupture is an infrequent complication in children with haematological malignancies and can be life threatening. To the best of our knowledge this is the first report of a case of splenic rupture following the development of multiple abscesses secondary to infestation by this rare fungal species.

Matched MeSH terms: Abscess/pathology*

Fulltext Posterior mediastinal abscess secondary to esophageal perforation following fish bone ingestion

Ahmad R, Ishlah W, Shaharudin MH, Sathananthar KS, Norie A

Med J Malaysia, 2008 Jun;63(2):162-3.

PMID: 18942310 MyJurnal

Accidental swallowing of fish bone, which arrested in esophagus, is fairly common. However the incidence of esophageal perforation due to fish bone swallowing is low. Delayed posterior mediastinal abscess as a result of the esophageal perforation is a rare manifestation and may lead to fatal outcome. Two cases of delayed formation of posterior mediastinal abscess following esophageal perforation due to accidental fish bone ingestion are described here. In these cases patients presented with interscapular back pain. In one of the cases the patient died because of the presentation was misdiagnosed hence leading to delay in the intervention. Radiological findings and surgical management namely esophagoscopy and neck exploration are briefly described.

Matched MeSH terms: Abscess/etiology*

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