Abscess formation

Entamoeba histolytica is an anaerobic rhizopod that occurs in tropical and subtropical areas. It can cause intestinal and extraintestinal manifestations. It is transmitted orally by ingestion of cysts that develop into trophozoites in the large intestine. Amebic trophozoites release several cytolytic factors, e.g. amoe-bapore, which enable the parasite to invade tissue. In intestinal amoebiasis, E. histolyticatrophozoites invade the intestinal mucosa, causing a form of ulcerative colitis with bloody and mucous diarrhoea. Extraintestinal manifestation of amebiasis results in abscess formation, usually in the liver but sometimes in the brain. 

If iron dextran is administered, the nurse informs die patient that soreness at the injection site may occur. Injection sites are checked daily for signs of inflammation, swelling, or abscess formation. 

Imaging studies may identify abscess formation, gas in the soft tissues, or osteomyelitis. 

Injection drug use also predisposes individuals to polymicrobial cellulitis. The antecubital region of the arm is usually the site of infection. S. aureus, the most common isolate, is frequently associated with abscess formation. Because some injection drug users lick their needles to clean them, antibiotics with anaerobic coverage should be used. Occasionally, Candida spp. are isolated, and the patient may require antifungal therapy.18... 

Extraluminal infection and/or abscess formation can occur at any site after any of the other syndromes or may be the primary presentation. Metastatic infections have been reported to involve bone, cysts, heart, kidney, liver, lungs, pericardium, spleen, and tumors. 

Extravasation Calcium chloride and gluconate can cause severe necrosis, sloughing, and abscess formation with IM or subcutaneous administration. 

IM administration-MWd local reactions may occur (calcium gluceptate). Local necrosis and abscess formation may occur with calcium gluconate. Severe necrosis and sloughing may occur with IM or subcutaneous administration of calcium chloride. 

Inflammation/abscess formation at the site of injection Pyrogenic effect (fever)... 

Prompt diagnosis of intra-abdominal infections or of abscess formation elsewhere in the body by liberal use of ultrasound and other imaging techniques should lead to subsequent surgical treatment without delay. Soft tissue infections (superficial and deep) can have a dramatic clinical course. Timely diagnostic imaging and surgical treatment will equally reduce morbidity and mortality. 

Treatments are broadly the same as for ulcerative colitis being based on appropriate supportive measures, and the use of corticosteroids, the cytokine infliximab or adalimumab for severe and complicated disease and immunosuppressants, typically azathio-prine, for reducing the chances of relapse. Full thickness disease leading to flstulation, free perforation, abscess formation and stricturing usually requires surgery. Aminosalicylates appear ineffective in reducing the chances of relapse. 

Abscess formation at injection site, blepharospasm, convulsions, thrombocytopenia, and transient neutropenia occur rarely. 

In severe infection, patients be hospitalized under the direct supervision of physician and treatment should be started immediately with intravenous broad- spectrum antibiotics and surgical drainage if abscess formation is detected. 

Brain abscess formation was studied experimentally in rats, and treatment with different combinations of hyaluronidase, dexamethasone, and antibiotic has been investigated [128]. Hie results showed (hat combined theraov with antibiotic and hyaluronidase. started the dav before inocula-... 

Parenteral self-administration of oral methadone can cause cellulitis, abscess formation, and necrosis of the skin and deeper tissues (10). 

Outcome Resolution, abscess formation, chronic inflammation Tissue destruction, fibrosis... 

Topical fluconazole may be safe and effective in managing Candida keratitis with abscess formation. 

An external hordeolum is an acute focal inflammation with abscess formation, most often caused by a S. aureus infection of the glands of Zeis and Moll. It may occasionally be associated with staphylococcus blepharitis and can be recurrent. 

Diverticular disease affects 5-10% of Western people over the age of 45 the incidence rises to 80% in those over 80. Colonic dysmotility with increased intracolonic pressure, and diets high in refined carbohydrate and low in fibre are important pathogenic factors. Some patients experience abdominal pain from dysmotility whilst others remain asymptomatic. Infection of diverticula occurs in a minority, giving potential for rupture or abscess formation. 

Perihepatitis acuta gonorrhoica Of special relevance is a fibrinous inflammation of the subphrenic space without abscess formation, occurring as a sequel of gonorrhoeal adnexitis in women. It is also called the Fitz-Hugh-Curtis syndrome (A.H. Curtis, 1932 T. Fitz-Hugh, 1934),... 

Yersinia enterocolitica Infection with Y. enterocolitica or Y pseudotuberculosis, together with haematogenous spread, may lead to a septic-typhoid course with hepatic and splenic abscess formation. Especially ulcerative colitis was frequently found to favour the formation of multiple liver abscesses. A genetic disposition is assumed in the presence of the HLA-B 27 gene. Patients with hepatic overload of iron are at special risk of Yersinia infection, since iron plays a major role in the metabolism of Yersinia. (18, 23, 28, 31, 32)... 

De Bade, T., Roche, A., Amenabar, J.M., Lagrange, C., Ducreux, M., Rougier, R, ISllias, D., Lasser, R, Patriarche, C. Liver abscess formation after local treatment of liver tumors. Hepatology 1996 23 1436-1440... 

Solinas, A., Erbella, G.S., Distrutti, E., Malaspina, C., Fiorucci, St., Clerici, C., Bassotti, G., Morelli, A. Abscess formation in hepatocellular carcinoma complications of percutaneous ultrasound-guided ethanol injection. J. Clin. Ultrasound 1993 21 531-533... 

Fig. 32.2 Ascending, suppurative, destructive, relapsing cholangitis with abscess formation the loose periportal fibre cuff (arrow) points to previous cholangitic episodes (HE)...

Osteopathy, which is expected in chronic cholestasis and often verifiable in PBC as well, is less frequently detected in PSC. (302,350) Xanthelasmas, which are prevalent in PBC, are likewise less common in PSC (19% vs. 3%). The frequency of cholangitic episodes, however, is about 7 times higher in PSC than in PBC there is a risk of liver abscess formation. In PSC, hyperpigmentation can be identified in only 25% of cases (compared to >50% in PBC). Cirrhosis-related complications are more frequent in PSC (13%) than in PBC (8%). 

Complications associated with i.m. administration include nerve injury, muscle contracture, and abscess formation. Less common problems include... 

Hanke CW, Higley HR, Jolivette DM, Swanson NA, Stegman SJ. Abscess formation and local necrosis after treatment with Zyderm or Zyplast collagen implant. J Am Acad Dermatol 1991 25(2 Pt l) 319-26. 

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