Parenchymal abscess

Life-threatening infections - The IV route may be preferable for patients with bacterial septicemia, localized parenchymal abscesses (such as intra-abdominal abscess), peritonitis or other severe or life-threatening infections. 

IV route IV route is recommended for patients requiring single doses greater than 1 g or those with bacterial septicemia, localized parenchymal abscess (eg, intra-abdominal abscess), peritonitis, or other severe systemic or life-threatening infections. For infections due to P. aeruginosa, a dosage of 2 g every 6 or 8 hours is recommended, at least upon initiation of therapy. 

Cerebritis is focal inflammation of brain parenchyma myelitis in the spinal cord). Cerebritis precedes abscess formation but requires an early biopsy to be seen (see Tables 20.2 and 20.10). The inflammatory infiltrate is composed of neutrophils, macrophages, lymphocytes, and plasma cells, with or without parenchymal necrosis. Septic cerebritis is usually caused by bacterial agents, most often streptococci or staphylococci, and less commonly by gram-negative organisms, such as Escherichia coli. Pseudomonas, and Haemophilus influenzae. Cerebritis also occurs around neoplasms, ruptured vascular malformations, infarcts, and traumatic lesions. 

CT has a superior contrast resolution compared with that achieved on conventional radiographs. Optimal bowel filling and distension of the lumen with water or contrast media is essential to evaluate bowel loops and its surroundings. We must keep in mind that CT implies an increased radiation exposure. The information gained must justify the increased radiation burden. Indications for CT use include trauma, intestinal wall and liver/spleen parenchymal evaluation, abscesses and tumor staging (Devos and Meradji 2003 Nicolaou et al. 2005 Boudiaf et al. 2001). 

Bile leak with resultant biloma and intra-abdominal infection with abscess formation can occur following reduced-sized, split and living related liver transplantation due to leak from the parenchymal cut-surface or inadvertent bile duct injury. Biliary reconstruction is by Roux-en-Y hepaticojejunostomy, and may involve two anastomoses at implantation of the left lateral segment at split or living related liver transplantation if segment II and III ducts are sepa-... 

The differential diagnosis for focal liver lesions includes benign and malignant lesions (metastatic, recurrent or primary) and the parenchymal manifestations of arterial abnormalities, infarcts, and abscesses. Infarcts usually appear as round or geographic solid lesions, with central hypoechoic necrotic areas. Abscesses have thick walls and central hypoechoic areas. Infarcts and abscesses may contain intraparenchymal gas (Fig. 4.2.16). 

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