MyMedR

Isolated unilateral hypoglossal nerve palsy from suppurative retropharyngeal lymphadenitis in an infant

Ng BW, Lee JS, Lau FS, Chieng CH

BMJ Case Rep, 2024 Jun 05;17(6).

PMID: 38839397 DOI: 10.1136/bcr-2024-260266

Retropharyngeal infections (RPIs) are uncommon in young infants and are difficult to diagnose due to their non-classical presentation. RPI can occasionally be complicated with multiple cranial nerve palsies but rarely in isolation. Isolated hypoglossal nerve palsy (HNP) due to RPI has been described in the literature but mostly in older children and adults. Assessment for hypoglossal nerve function is challenging in a young infant because the conventional signs of hypoglossal nerve dysfunction are difficult to elicit in this age group. Early recognition and treatment of RPI are associated with good HNP recovery. We present a case of a young infant with tongue deviation and difficulty with feeding attributed to an isolated HNP caused by suppurative retropharyngeal lymphadenitis. The infant underwent incision and drainage with complete recovery of the tongue function after 8 weeks.

Matched MeSH terms: Suppuration

Pyopneumothorax--a rare sequelae of retropharyngeal abscess

Lokman S, Sani A, Sidek DS

J Laryngol Otol, 1993 May;107(5):460-2.

PMID: 8326234

A case of massive pyopneumothorax as a rare sequelae of retropharyngeal abscess following fish bone ingestion is reported. An initial attempt at removal of the fish bone in the oesophagus using the fibroptic oesophagoscope was unsuccessful, causing failure of its removal and the development of this rare and potentially fatal complication. The intercommunication of the retropharyngeal space with other spaces of the neck and thorax that allow this and most other complications to occur is described. Rigid endoscopes are the instrument of choice in retrieving sharp foreign bodies in the oesophagus.

Matched MeSH terms: Suppuration/complications

Fulltext Roles and mechanisms of stem cell in wound healing

Ayavoo T, Murugesan K, Gnanasekaran A

Stem Cell Investig, 2021;8:4.

PMID: 33829056 DOI: 10.21037/sci-2020-027

Wound healing phases comprise of highly synchronized process that begins due to a damage and restores the integrity of the injured tissues. Wound healing reduces the damage in tissue and supply sufficient oxygen and tissue perfusion, provide proper nourishment and humid wound healing atmosphere to re-establish the essential status of exaggerated parts. The untreated wound becomes susceptible for pus development, bacterial infection and complications like sepsis. Traditional and modern approaches are in practice to treat acute, open and chronic injuries, however, present wound care management has met with challenges and minimal positive effects. Stem cells have possible wound healing capability to overwhelm restrictions of the current wound care practices as it produces faster tissue regeneration in wound repair. Stem cells are unspecialized cells derived from adult body tissues and embryos that differentiate into any cell of an organism and capable of self-regeneration. The understanding on molecular mechanisms of stem cells has become the central and promising field in scientific study. This review focuses on the pre-existing traditional and modern treatments for wound healing, and types and roles of stem cells in wound care management. This review also focuses on the fundamental molecular characterization and factors influencing the molecular mechanisms of stem cells in wound healing.

Matched MeSH terms: Suppuration

Liver abscess

Monro JK

Journal of the Malaya Branch of the British Medical Association, 1941;5:108-9.

Matched MeSH terms: Suppuration

Fulltext Mucopyocele in the oral region: an unusual case

Telang , Ajay, Lahari, T., Chacko , James P.

Archives of Orofacial Sciences, 2011;6(2):1-4.

MyJurnal

Mucopyoceles are rare lesions defined as infected mucoceles. They have been reported only in the paranasal sinuses and appendix. Our case is the first to be reported in the oral region. A 58- year-old male presented with complaint of a painless swelling of two years duration in the right buccal sulcus with associated pus discharge. Radiographic examination ruled out pulpal and periodontal foci of infection and histopathology confirmed an underlying mucopyocele in the right buccal mucosa.

Matched MeSH terms: Suppuration

Dengue Maculopathy Associated with Choroidopathy and Pseudohypopyon: A Case Series

Ng CWK, Tai PY, Oli Mohamed S

Ocul Immunol Inflamm, 2018;26(5):666-670.

PMID: 27929712 DOI: 10.1080/09273948.2016.1254804

Matched MeSH terms: Suppuration/etiology; Suppuration/pathology

Fulltext Bilateral subtentorial empyema complicated with nosocomial acinectobacter ventriculitis: a case report

Sim SK, Ch'ng CH, Tan YC, Kandasamy R, Abdullah JM

Med J Malaysia, 2014 Apr;69(2):86-8.

PMID: 25241818 MyJurnal

Subtentorial subdural empyema is a rare and life threatening intracranial suppuration. It is usually an intracranial complication of otogenic infections. Early diagnosis and surgical drainage are the most important factors determining prognosis. The high mortality reported in the literature reflects the severity of subtentorial subdural empyema if proper management is delayed. Intracranial infections usually require between 4 to 6 weeks of intravenous antibiotics therapy. However, the prolonged duration of hospitalization as well as requirement for neurosurgically inserted indwelling devices may predispose these patients to new nosocomial infections.

Matched MeSH terms: Suppuration

Fulltext An unusual case of chronic suppurative osteomyelitis of the mandible

Kamran Ali, Ashfaq Akram, Muhammad Usman Akhtar

Archives of Orofacial Sciences, 2012;7(1):1-5.

MyJurnal

Osteomyelitis of the mandible, a serious complication of untreated odontogenic infection has been reported. This case report describes an interesting presentation of chronic suppurative osteomyelitis (CSO) of the mandible in a 13 years old anaemic male patient. Investigations revealed inversion of his permanent teeth leading to trans-cutaneous extra-oral eruption along with marked destruction of mandible on the affected side. The treatment included a pre surgical course of antibiotics followed by the removal of the retained second premolar tooth, surgical debridement of the affected bone, and resection of the cutaneous sinus tract. The post-operative healing was uneventful. A combination of antibiotic therapy and surgical debridement were effective in the treatment of chronic suppurative osteomyelitis.

Matched MeSH terms: Suppuration

Prevalence and prediction of pressure ulcers in admitted stroke patients in a tertiary care hospital

Farid J, Amin R, Sheikh MA, Irfan M, AlRuwaili R, Alruwaili M, et al.

J Tissue Viability, 2022 Nov;31(4):768-775.

PMID: 35941057 DOI: 10.1016/j.jtv.2022.07.010

Pressure ulcer (PU) is a localized injury to the skin or underlying tissues usually over a bony prominence, which results due to pressure or pressure in combination with shear. It is an expensive health care problem that have deterring impact on the length of hospitalization and cause extra nursing care time. Moreover, PUs negatively impacts patients' health related quality of life. High PUs prevalence figures were found in specialized hospital units such as intensive care unit (ICU), orthopedics, surgery, and also in stroke patients in medical units. The major purpose of this study is to assess the frequency of pressure ulcers in stroke patients at Ayub teaching hospital. The methodology used for carrying out the research was cross-sectional study conducted during months of September, October, and November 2020. Questionnaire was used to collect the data and well-informed written consent was taken from the patients. A total of 120 stroke patients were initially included with the intention to study the frequency of PUs among them. Different age groups were taken but majority (48.3%) belonged to the age group 31-60 years. Maximum patients were hypertensive (65%), while few of them were diabetic (35%). From the results of proposed work, it is found that out of 120 stroke patients, 75.8% presented with ischemic stroke while 24.2% presented with hemorrhagic stroke. 8.3% that is 10 out of 120 stroke patients developed pressure ulcers of grade 1 (1.7%), grade 2 (1.7%), grade 3 (2.5%), and grade 4 (2.5%) mostly in the sacral region (6.7%) and also on ankle (0.8%), and shoulder (0.8%) respectively. Patients in the study group had unsatisfactory hygiene (6.7%) were malnourished (11.7%) and were not using preventive mattresses (79.2%). Those at the risk of developing pressure ulcers were not being repositioned (6.7%) and did not had awareness (10%). Prevention and treatment used in ward is 100%. Conclusively, the frequency of pressure ulcers in stroke patients was determined to be 8.3% and the most frequent localization was sacrum. The PU care in this hospital is appropriate but still could be improved further by improving risk assessment, prevention specially use of air mattress and patient education regarding PUs. The main objective of the study is to identify the frequency of PUs in stroke patients and to highlight various factors that would avoid PUs development.

Matched MeSH terms: Suppuration

A descriptive study on the knowledge and attitude of nurses toward the prevention of pressure ulcers in the intensive care unit

Bakar N, Abdullah SS, Sohor NA

Med J Malaysia, 2024 Mar;79(Suppl 1):29-33.

PMID: 38555882

INTRODUCTION: The study's objectives are to investigate the level of knowledge, attitude, and performance (KAP) of nurses on the prevention of pressure ulcers (PUs) prevention in the intensive care (ICU) and also to identify the relationship between nurses' KAP toward the implementation of preventive measures for PUs.

MATERIALS AND METHODS: This cross-sectional study was conducted among 60 registered nurses in the ICU at Taiping Hospital. to assess the nurses' knowledge and attitude level using the Knowledge and Attitude on prevention of PUs questionnaire. A descriptive analysis and Pearson Correlation were used to analyze the data.

RESULT: From a total of 60 nurses 36 (60%) of nurses demonstrated a moderate level of KAP, and 17 (28%) demonstrated a high level of knowledge. They also exhibited neutral attitudes towards PUs prevention 49 (82%). The findings revealed a positive relationship between nurses' KAP toward implementing preventive measures on PUs (p=0.04; r=0.3). The findings show that nurses regularly performed the assessment of the risk factors of PUs for all hospitalized patients when performing PUs care. However, the plan for preventive nursing care was not properly reviewed.

CONCLUSION: This study suggested that appropriate guidelines, education programs, and an environment that makes it possible to provide continuing education should be created for nurses to prevent PUs in the ICU.

Matched MeSH terms: Suppuration

Fulltext Isolation of salmonella from unusual sites in the body

Jegathesan M

Med J Malaysia, 1984 Dec;39(4):289-91.

PMID: 6544935

During the period 1971-1982, 57 salmonella strains other than S. typhi and S. paratyphi were isolated from sites other than stools and blood. Cerebrospinal fluid was the commonest specimen followed by urine and pus. The commonest serotypes of the 22 encountered were S. typhimurium and S. enteritidis. Twenty-four of the 57 patients were children under one year of age. These findings highlight the need to remember the unusual manifestation of salmonellosis in differential diagnoses.

Matched MeSH terms: Suppuration/microbiology*

Enterotoxin production by Staphylococcus aureus strains isolated from humans, foods and animals in Malaysia

Lim YS, Jegathesan M, Koay AS

Southeast Asian J Trop Med Public Health, 1982 Mar;13(1):133-7.

PMID: 7112212

Enterotoxin production by strains of Staphylococcus aureus isolated from human, food and animal sources was investigated. Of the 130 isolates studied, 27 (20.8%) were found to be enterotoxigenic. The most common enterotoxin detected from human sources was enterotoxin C whereas enterotoxin B occurred more frequently in staphylococcal strains of food origin. The 2 enterotoxigenic strains, from animals isolated from a dog and a goat, produced enterotoxins A and C, respectively. Enterotoxin E was not detected alone from any of the enterotoxigenic strains studied, but occurred together with other enterotoxins. The need to detect enterotoxin in staphylococcal strains and in suspected foods for the confirmation of staphylococcal food poisoning is discussed.

Matched MeSH terms: Suppuration/microbiology

Fulltext Gas-containing liver abscesses: assessment by ultrasound (US) and computed tomography (CT)

Samad SA, Zulfiqar MA, Maimunah A

Med J Malaysia, 1993 Mar;48(1):33-9.

PMID: 8341170

Single gas-containing pyogenic liver abscesses in 11 patients were studied by ultrasound and computed tomography (CT). On ultrasound, all abscesses were predominantly echogenic compared to the normal liver parenchyma. The gas collections appeared as hyperreflective areas arranged in clusters associated with acoustic shadowing and ring-down artifacts. Ten abscesses (90%) had ill-defined margins on ultrasound, causing underestimation of their sizes in these patients. All abscesses were shown to be multiloculated and had clearly defined borders on CT, not appreciated or mistaken for multiplicity of abscesses on ultrasound. Ultrasound may be inadequate in the evaluation of gas-containing liver abscesses, as they have complex echotexture in addition to ring-down artifacts, acoustic shadows and poorly-defined margins; leading to underestimation of abscess size, difficulty in identifying loculations and erroneous interpretation of multiplicity of abscess cavities.

Matched MeSH terms: Suppuration

Diagnosis and management of purulent pericarditis. Experience with pericardiectomy

Majid AA, Omar A

J. Thorac. Cardiovasc. Surg., 1991 Sep;102(3):413-7.

PMID: 1881180

Twelve cases of purulent pericarditis seen over 6 years are described. Staphylococcus aureus was the most common causative organism (six patients), and a respiratory infection was the most common preceding illness. The chest radiograph and echocardiogram were useful pointers to the diagnosis, but the electrocardiogram was not reliable. Antibiotics, surgical drainage, and pericardiectomy were used in all 12 cases. There was one death (8.3%), which occurred in a patient who was seen late. A review of the literature dealing with the diagnosis and management of this condition is presented. The importance of early diagnosis before a significant degree of cardiac tamponade occurs is noted. Although there is general agreement that surgical drainage is mandatory, the approach, methods of drainage, and extent of pericardial resection have been the subject of some discussion, and at least seven techniques are available. We conclude that pericardiectomy has a definite place in the management of purulent pericarditis.

Matched MeSH terms: Suppuration

Common proctological conditions

Monro JK

Journal of the Malaya Branch of the British Medical Association, 1940;3:396-9.

Matched MeSH terms: Suppuration

spa diversity of methicillin-resistant and -susceptible Staphylococcus aureus in clinical strains from Malaysia: a high prevalence of invasive European spa-type t032

Jones SU, Chua KH, Chew CH, Yeo CC, Abdullah FH, Othman N, et al.

PeerJ, 2021;9:e11195.

PMID: 33889447 DOI: 10.7717/peerj.11195

Background: Staphylococcus aureus is one of the important pathogens causing nosocomial infection. spa typing allows identification of S. aureus clones in hospital isolates and is useful for epidemiological studies and nosocomial infection control. This study aims to investigate the spa types in Malaysian S. aureus isolates obtained from various clinical specimens.

Method: A total of 89 methicillin-resistant S. aureus (MRSA) [pus (n = 55), blood (n = 27), respiratory (n = 5), eye (n = 2)] isolates and 109 methicillin-susceptible S. aureus (MSSA) [pus (n = 79), blood (n = 24), respiratory (n = 3), eye (n = 2) and urine (n = 1)] isolates were subjected to spa typing with sequences analysed using BioNumerics version 7.

Results: The spa sequence was successfully amplified from 77.8% of the strains (154/198) and 47 known spa types were detected. The distribution of known spa types in MRSA (36.2%, 17/47) was less diverse than in MSSA (70.2%, 33/47). The most predominant spa types were t032 (50%) in MRSA, and t127 (19%) and t091 (16.7%) in MSSA, respectively. spa type t091 in MSSA was significantly associated with skin and soft tissue infections (p = 0.0199).

Conclusion: The previously uncommon spa type t032 was detected in the Malaysian MRSA strains, which also corresponded to the most common spa type in Europe and Australia, and has replaced the dominant spa type t037 which was reported in Malaysia in 2010.

Matched MeSH terms: Suppuration

Antibiotic Irrigation: A Promising Unconventional Method for Facial Carbuncle

Ng JJ, Gendeh H, Ong HY, Gopalan S, Abdul Karaf JH

Cureus, 2021 Apr 27;13(4):e14710.

PMID: 34079672 DOI: 10.7759/cureus.14710

Carbuncle is conventionally treated with combinations of intravenous antibiotics and surgical intervention; be it saucerization or incision and drainage. Cosmesis outcome might be unfavorable following surgical intervention, especially when the facial region is involved. Skin grafting surgery may even be needed as a second-stage procedure for a larger wound. We reported a series of three facial carbuncles treated successfully with a new improvised method. Our method includes performing a stab incision prior to draining of pus, coupled with minimal wound debridement, followed by regular irrigation of the wound with antibiotics containing solution. Based on the three cases reported in this article, we conclude that this method is more superior as there is more skin preservation, better patient tolerance, shorter hospital stays, and favorable cosmesis outcome.

Matched MeSH terms: Suppuration

Fulltext A case report of pyomyoma: radiological diagnosis of a potentially fatal complication of uterine leiomyoma.

Mubarak, M.Y., Noordini, M.D.

International Medical Journal Malaysia, 2008;7(2):63-65.

MyJurnal

Pyomyoma (suppurative leiomyoma) is a rare complication of uterine leiomyoma. It results from infarction and infection of a leiomyoma. It may lead to diagnostic and therapeutic difficulties with potential complications such as bacteraemia, uterine rupture, compressive effect to adjacent structures and even death. We report a case of pyomyoma based on the Ultrasound (US) and Computed Tomography (CT) findings and literature review on the subject.

Matched MeSH terms: Suppuration

Fulltext Clinical Patterns Of Oro-facial Infections

Rahman, Z.A.A., Hamimah, H., Bunyarit, S.S.

Ann Dent, 2005;12(1):-.

MyJurnal

The aim of this retrospective study was to study the clinical patterns of oro-facial infections presented and their management (or trends of management) at the Department of Oral and Maxillofacial Surgery, Dental Faculty, University of Malaya. These included the predisposing factors, presentations and management. This study reviewed the oro-facial infection cases over 15 years. The data was obtained from case note reviews of patients using specially designed proforma. A total number of 409 samples were included in this study. Majority of the patients were generally healthy with about 6.6% having diabetes mellitus. The common presentations were pain (47.4%), pus discharges (16.9%) and limitation of mouth opening (12.5%). The major site was in the submandibular region (18.9%) followed by cheek (13.2%). Most of the infections were from odontogenic source (63.2%). Other sources includes cysts (15.4%) and tumours (6.7%). Incision and drainage were the treatment of choice performed on 57.55% of patients. Monoantimicrobial therapy was the treatment instituted in 20.8% of cases.

Matched MeSH terms: Suppuration

Broncho-pulmonary cryptococcosis

Dutt AK, Krishnan M, Lim EJ

Med J Malaya, 1969 Sep;24(1):74-8.

PMID: 4243848

Matched MeSH terms: Suppuration

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