Single Abscess Research Articles

PSV-28 Liver abscess microbiota of beef cattle administered in-feed tylosin differ according to abscess size and fraction

Abstract Liver abscesses (LA) pose a significant challenge to the Canadian beef industry as they are estimated to cost the industry ~ $61.2 million annually. This is likely an underestimate as it does not account for losses in animal productivity. Tylosin phosphate is widely used to reduce LA, but concerns over antimicrobial use selecting for antimicrobial resistance has created an urgency to explore alternative approaches. Understanding the impact of tylosin on the microbial ecology of LA is crucial to this. We hypothesized that altering the duration of in-feed administration of tylosin to feedlot cattle would alter the microbial community of LA. To investigate this, we collected abscessed livers from cattle fed a diet containing tylosin 1) throughout finishing, 2) during the first 78% of the feeding or 3) during the last 75% of the feeding period. We examined LA microbial ecology of purulent material, abscess capsule tissue, originating from abscesses of different sizes using a metataxonomic approach. Our findings revealed that shortening tylosin administration did not notably alter the alpha (P > 0.05) or beta-diversity (P > 0.05) of LA microbial communities. There was a significant difference in microbial richness associated with abscess capsule (P < 0.05) compared with bulk purulent material. Fusobacterium or Bacteroides ASVs dominated LA microbiomes, alongside probable opportunistic gut pathogens and other bacteria. Interestingly, classifying samples based on whether they originated from a liver with a single abscess, multiple abscesses or a very large abscess tended to differ in microbiome composition (P = 0.06). These insights contribute to our understanding of factors impacting liver abscess microbial ecology and will be valuable in identifying antibiotic alternatives. They underscore the importance of exploring varied approaches to address liver abscesses while reducing reliance on in-feed antibiotics.

Pyogenic liver abscess in pediatric populations in beijing (2008–2023)

BackgroundData on pyogenic liver abscess (PLA) of children in China have been limited. We aimed to summarize the clinical feather, microbiological characteristics, management, and outcome of PLA in children.MethodWe retrospectively reviewed PLA cases from January 2008 to June 2023 at Beijing Children’s Hospital. Clinical characteristics, pathogens and management were analyzed.ResultsWe diagnosed 57 PLA patients in our center. The median onset age was 4.5 years and the male-to-female ratio was 1.6:1. The median diagnostic time was nine days and the median length of stay was 22 days. Twenty-eight patients (49.1%) had predisposing factors, around 71.4% of the patients had malignant hematology and primary immunodeficiency disease. Patients with underlying factors were more likely to have extrahepatic organ involvement (p = 0.024), anemia (p < 0.001), single abscess (p = 0.042), unilateral involvement (p = 0.039), and small size of the abscess (p = 0.008). Twenty-four patients (42.1%) had extrahepatic organ involvement. Pathogens were identified in 17 patients (29.8%), the most common pathogens were Klebsiella pneumoniae and Staphylococcus aureus. The positive rate of metagenomic next-generation sequencing (mNGS) was 87.5% (7/8). On multivariable analysis, the extrahepatic organ involved (p = 0.029) and hepatomegaly (p = 0.025) were two independent factors associated with poor outcomes.ConclusionsPLA is usually seen in children with predisposing factors. Malignant hematology and primary immunodeficiency disease were the most common underlying diseases. Extrahepatic organ involvement and hepatomegaly are associated with poor prognosis. Increased use of mNGS could be beneficial for identifying pathogens.

Thyroid abscess presenting as a discharging sinus: a case report

BackgroundIt is unusual to get an isolated thyroid abscess. Thyroid abscess or acute suppurative thyroiditis accounts for 0.7–1% of all instances of thyroid diseases. The thyroid gland typically has a high level of iodine, a well-enveloped capsule, and resistance to infections. The diagnosis and treatment of this unusual entity are covered in this paper.Case presentation.An adult male patient presented with anterior neck swelling for 15 days and pus discharge for 2 days. The neck ultrasound revealed characteristics that could indicate a thyroid abscess. The thyroid function test and other laboratory data were within normal bounds. A neck contrast-enhanced computed tomography scan was performed, and it only revealed a single thyroid abscess and no other abnormalities. After starting the patient on intravenous antibiotics, the abscess was incised and drained. The patient’s symptoms got better.ConclusionIn the era of advanced antibiotics incidence of thyroid abscess is extremely rare. Early diagnosis and intervention may improve the outcome of this condition. Knowledge of disease and its potential complications can prevent morbidity.

Analysis of risk factors leading to multiple breast abscesses during lactation.

We investigated 1805 cases of breast abscesses during lactation to estimate the risk factors for multiple breast abscesses during lactation. A total of 2000 cases of breast abscesses during lactation were investigated using an online questionnaire, and 1805 cases with complete data were analyzed. The survey response rate was 90%. According to the number of abscesses, the patients were divided into 2 groups: single breast abscess (number = 1298) and multiple breast abscess (number = 507). Pearson chi-square test was used to compare the 15 risk factors between the 2 groups. Risk factors with significant differences were substituted into a binary logistic regression model to analyze the independent risk factors associated with multiple breast abscesses during lactation. There were significant differences between the 2 groups in (1) weeks postpartum, (2) separated from the baby, (3) breastfeeding exclusivity, (4) nipple inversion, (5) fever, (6) breast redness/swelling, (7) nipple pain, (8) breast massage by nonmedical staff, with (1), (5), (6), and (8) being independent risk factors. Patients under 6 weeks postpartum, separated from the baby, not exclusively breastfeeding, having an inverted nipple on the affected side, fever, breast skin redness and swelling on the affected side, nipple pain, and having undergone a breast massage by nonmedical staff are more likely to develop multiple breast abscesses.

Isolated Tubercular Splenic Abscess: A Case Report

Tuberculosis is one of the deadliest infectious illnesses in the world. Splenic tuberculosis is typically a component of miliary TB, ranks third after lung and liver, and is more prevalent in people with weakened immune systems. An extremely uncommon variant of abdominal tuberculosis is splenic TB in immune-competent people with no extra splenic involvement. In individuals without pulmonary disease and without symptoms, splenic TB diagnosis is challenging. There are frequently no diagnostic standards for isolated TB. A definitive diagnosis is rarely reached by preoperative testing. When other potential causes of fever and splenomegaly have been ruled out in endemic areas, splenic TB should be suspected. The typical treatment for splenic TB without abscess is medical management (ATT). For splenectomy, a single TB splenic abscess in a healthy patient is recommended. Here we report the case of a 33-year-old patient, who complained of left-sided stomach pain that had been bothering him for four years but was unrelated to radiation or food consumption. It has been linked to several high-grade fever bouts and frequent hospitalizations for the same during the past three years. With standard preoperative pneumococcal immunization, the patient is scheduled for a routine open splenectomy.

Child Liver Abcess: Study of 12 Cases in the Pediatric Ward of the District Hospital of Bamako

Hepatic abscess is a suppurative collection developed in a neoformed hepatic cavity as a result of the invasion and multiplication of micro-organisms. The prognosis depends on early diagnosis and rapid treatment. The aim of the study was to determine the clinical, biological, ultrasound and therapeutic characteristics of liver abscesses in children aged between 1 month and 15 years hospitalised in the Paediatrics Ward of the District Hospital in Commune V, Bamako. This was a retrospective descriptive study which took place from January 2017 to December 2020, i.e. a period of 4 years, and a prospective study from January 2019 to December 2020, including all children aged between 1 and 15 years in whom the diagnosis of liver abscess had been confirmed by liver ultrasound. Out of 2756 children hospitalised during the study period from January 2017 to December 2020, i.e. a période of 4 years, 12 patients were diagnosed with liver abscess, i.e. a frequency of 0.43% or 4 cases/1000 admissions, with a female predominance of 58.3%, i.e. a sex ratio of 0.7. The mean age was 57 ± 34 months, with extremes of 16 and 120 months. The main reason for consultation was abdominal pain associated with fever, accounting for 75% of patients. Pus culture was positive for Staphylococcus Aureus in one patient (8%). Amebic serology was positive in 33% of patients. Ultrasound revealed a predominance of single abscesses located in the right lobe of the liver in 42% of patients. However, 92% of patients were cured, with an average hospital stay of 12 days, ranging from 2 to 19 days. Liver abscesses uncommon in our context, an early diagnosis and management can improve the prognosis.

Clinical Profile in Patients of Amoebic Liver Abscess with and without Hyperbilirubinemia: A Prospective Cohort Study

Introduction: In tropical countries like India, two-thirds of liver abscess cases are amoebic. Along with abdominal pain, fever, and other non-specific clinical features, jaundice is commonly observed in Amoebic Liver Abscess (ALA) cases. However, the understanding of jaundice in a patients with ALA is limited, and it is associated with a poor prognosis. Aim: To compare the morbidity and mortality of ALA patients with and without hyperbilirubinemia, as well as their clinical outcomes. Materials and Methods: The present prospective cohort study was conducted at a tertiary teaching institute in northern India. It included 150 patients aged between 20 and 60 years with a confirmed diagnosis of ALA. The patients were divided into two groups based on the presence or absence of hyperbilirubinemia. Those with jaundice resulting from other causes or a history of hepatitis were excluded. Variables examined in the study included age, sex, alcohol intake, basic laboratory parameters, ultrasound-assessed abscess size and number, and duration of hospital stay. Results: Among the 150 cases, 22 (14.6%) had elevated serum bilirubin levels (&gt;1 mg/dL). Additionally, 122 (81.33%) had a history of alcohol intake, and 117 (78%) had a single abscess cavity. In ALA patients with hyperbilirubinemia, 12 (54.55%) had abnormal creatinine values, and 6 (27.26%) experienced complications such as rupture and peritonitis. One mortality occurred in a patient with ALA and jaundice. Conclusion: ALA patients with jaundice exhibited larger abscess cavities, a higher complication rates, a longer hospital stays, and a poor prognoses.

The Pyogenic Hepatic Abscess: To Drain or not to Drain, that is the Question. Clinical Presentation and Outcome Evaluation after Conservative and Invasive Treatment

Background: Pyogenic hepatic abscess (PHA) is an uncommon infectious disease of the liver that should represents a life-threatening condition if not correctly diagnosed and managed. Nowadays there are not precise indications and clear evidences on the best therapeutic approach and on the superiority of a treatment. Methods: Patients with diagnosis of PHA admitted at the Policlinico “Paolo Giaccone” at Palermo University Hospital between January 2010 and December 2022 were identified in a prospective database. Among the demographic, epidemiological and clinical data collected we included the therapeutic choices – antibiotic treatment, image guided percutaneous drainage and surgical operation – and their effect in terms of healing time, treatment failure and time of hospitalization. Results: Patients with single abscesses treated with antibiotics have significant high healing time (p=0.0001) and in-hospital time (p=0.0001) and no differences in treatment failure than patients treated with invasive techniques. Patients that underwent surgical operation have significant higher healing time than percutaneous group (p=0.002) such as higher mean hospital stay (p=0.03 for abscesses &lt;5 cm and p=0.02 for abscesses larger than 5 cm). The last, the percutaneous approach shows a failure rate significantly higher than the surgical procedure (p=0.009 for abscesses &lt;5 cm and p=0.001 for abscesses larger than 5 cm). Conclusions: The study proposed showed the antibiotic therapy is the first line treatment and should first empirically and then directly modified on specimen culture results. Image guided percutaneous drainage should be considered when the antibiotic therapy alone is not sufficient or as bridge to surgery if surgical indications are proven.

Characteristics of Klebsiella pneumoniae pyogenic liver abscess from 2010–2021 in a tertiary teaching hospital of South China

Pyogenic liver abscess (PLA) is a severe and potentially fatal infectious disease. Klebsiella pneumoniae (K. pneumoniae) is the predominant pathogen responsible for PLA. This study aims to investigate the clinical characteristics and prognostic factors of K. pneumoniae-induced pyogenic liver abscess (KP-PLA), particularly those caused by carbapenem-resistant K. pneumoniae (CRKP). Analyses were performed on PLA patients from January 2010 to December 2021, to investigate the differences of K. pneumoniae from other etiologically infected PLA patients. Univariate and multivariate logistic regression analyses were used to compare prognostic factors between patients with carbapenem-resistant K. pneumoniae PLA (CRKP-PLA) and patients with carbapenem-sensitive K. pneumoniae PLA. Univariate analysis demonstrated a significant association between KP-PLA and factors including diabetes mellitus (P < 0.001), cholecystitis and cholelithiasis (P = 0.032), single abscess (P = 0.016), and abscesses with a diameter over 50 mm (P = 0.004). The CRKP group exhibited a higher prevalence of therapeutic interventions before K. pneumoniae infection, including abdominal surgery, mechanical ventilation, sputum suction, tracheal cannula, routine drainage of the abdominal cavity, and peripherally inserted central venous catheters (P < 0.05). Multivariate logistic regression analysis revealed that admission to the intensive care unit was an independent risk factor associated with CRKP-PLA (odds ratio 36; 95% confidence interval 1.77-731.56; P = 0.020). The KP-PLA patients were significantly associated with diabetes and were more likely to have single abscesses larger than 50 mm. PLA patients with a history of admission to intensive care unit or invasive therapeutic procedures should be given special consideration if combined with CRKP infection.

CLINICAL AND LABORATORY CHARACTERISTICS OF LIVER ABSCESS PATIENTS AT NGUYEN TRI PHUONG HOSPITAL

Background: Liver abscess is a common disease in tropical countries, including Vietnam. Nguyen Tri Phuong Hospital has treated many cases of liver abscesses since 2010. However, there has not been a research report summarizing the clinical and subclinical characteristics of liver abscess cases here. Subjects and methods: Retrospective study of patients diagnosed with a liver abscess at Nguyen Tri Phuong Hospital from January 2017 to December 2022. Results: There were 61 patients diagnosed with a liver abscess at the General Surgery Department of Nguyen Tri Phuong Hospital from January 2017 to December 2022 with the following characteristics: male/female ratio of 1.65/ first; average 56.1 ± 12.3 years old, history of diabetes accounted for 32.8%; The prominent clinical symptoms are fever (88.5%), right upper quadrant pain (85.2%). The average volume of liver abscess on ultrasound was 377.2 ± 50.4 ml, the liver abscess located in the right liver accounted for 73.4%, most of which was a single abscess (78.7%). Klebsiella pneumonia was cultured with the highest rate of 42.6% (26/61) Conclusion: Liver abscess is more common in the elderly, more in men than in women with common symptoms including fever and right upper quadrant pain. Klebsiella pneumoniae became the most common cause of the liver abscess.

Incidence, clinical profile and short term outcome of cerebral abscess in cyanotic congenital heart diseases

BackgroundBrain abscess is a serious infection of brain parenchyma in patients with cyanotic congenital heart disease (CCHD) and around 25–46 % of unrepaired CCHD patients develop brain abscess. Aim of this study was to determine the incidence, clinical features, microbiology and factors associated with early and short term outcome of cerebral abscess in CCHD. Methodology: This is a retrospective study, conducted at Pediatric cardiology department, National Institute of Cardiovascular Diseases (NICVD) Karachi. The data was collected from January 2019 to December 2021. All CCHD patients between 1 and 25 years of age were included. Data of patients with cerebral abscess was reviewed. ResultsAmong the 544 pediatric patients hospitalized in the last two years, brain abscesses were identified in 51 (9.3 %). Polycythemia (31.4 %) was the most significant contributing factor, especially in patients aged above 10 years. The most frequently seen CCHD was tetralogy of fallot (TOF) 60.8 %. Majority of the patients (84.3 %) had a single abscess while 15.7 % had multiple abscesses. E coli (9.7 %) was the most common isolated pathogen. Immediate complication identified was cerebral edema in 22 (43.1 %). Four patients (7.8 %) died, 47 (92.2 %) patients completed treatment course. 45.1 % had complete recovery however, 17 (33.3 %) had neurological deficits, 8 (15.7 %) had seizures and 2 (3.9 %) patients had residual abscess. Prolonged hospitalization was observed in patients of age group <10 years. ConclusionIn patients with underlying CCHD,early referrals and intervention are key to mitigating the severe consequences of cerebral abscesses and can drastically improve patient outcomes.

Indwelling Needle Puncture and Irrigation in the Conservative Treatment of Breast Abscess During Non-Lactation Period.

The objective of this study is to observe the effect of indwelling needle puncture and irrigation in the conservative treatment of breast abscesses in the non-lactation period. Non-lactating breast abscess patients were treated at the Daping Medical Breast Surgery Clinic, Chongqing. In the Incisive drainage group, 21 patients were treated with conventional incision and drainage. In the Indwelling needle group, 20 patients were treated by puncture and irrigation with a 20 G indwelling needle. The pain VAS scores and wound satisfaction in the Indwelling needle group were significantly lower than those in the Incisive drainage group (P < 0.001), and the cure time and complications were also significantly lower in the Indwelling needle group (P < 0.05). The cure rates of the two groups were similar (P > 0.05). There was a difference in the duration of illness, location, and number of pus cavities between the treatment failure and the treatment recovery (P < 0.05). However, there was no difference in the size of the pus cavity and the maximum amount of pus aspiration (P > 0.05). The indwelling needle can be used as an effective tool for puncture and irrigation of single breast abscess in a non-lactation period, potentially for non-invasive treatment of breast abscesses.

Positional shunt assist for slit ventricle syndrome.

Hydrocephalus is one of the most common pathologies in pediatric neurosurgery. One of the causes of recurring events of headaches among shunted children is "slit ventricle syndrome" (SVS). Several potential treatments have been proposed, yet SVS often represents a treatment challenge. The goal of the current series is to present our experience with adding a positional shunt-assist (SA) (Miethke, Aesculap) for the treatment of SVS. Clinical data was retrospectively collected from all consecutive children with SVS that were treated with SA (Miethke, Aesculap) at our center. Surgical and clinical outcomes as expressed by hospital visits, or need for additional surgery, were evaluated. Nine cases were included. Hydrocephalus etiology included IVH (6), postinfectious (1), and congenital syndromes (2). Average age at first shunt was 4months. Primary shunt type was differential-pressure-valve in all. Average age at SVS onset was 4years. Average age at SA placement was 5.5years. There were no perioperative complications besides a single stich abscess. A 6-month follow-up period after SA was compared to a 6-month period prior to the SA: average hospital visits decreased from 2.4 to 0.6 per patient (p < 0.0002). 4/9 patients needed an LP or shunt revision before the SA surgery, while no procedure was indicated during the immediate 6-month follow-up. At the last follow-up, there was a significant reduction in the rate of ER visits compared to prior to surgery; however, the number of neurosurgical procedures did not significantly differ. Using a SA for SVS was associated with a short-term improvement of symptoms in the majority of cases, reduction in hospital visits, and reduced need for SVS-related procedures.

Хвороба Крона в дітей. Клінічний випадок

Crohn’s disease (CD) is a chronic relapsing disease characterized by transmural granulomatous-ulcerative inflammation affecting some or all parts of the gastrointestinal tract. Purpose - to acquaint practicing doctors with the features of the manifestations, differential diagnosis and course of CD in children. The features of the differential diagnosis and clinical course of CD are given. The basic diagnostic value of complaints, anamnesis, clinical picture, laboratory and instrumental methods of research, histological study of a biopsy of the cecum and appendix is highlighted. Microscopic examination of the cecum biopsy revealed the presence of a corrugated surface of the mucous membrane of the large intestine with focally slightly disturbed histoarchitectonics: crypts of various sizes and shapes, some with an unevenly expanded lumen. The cellular composition of the crypts is represented by colonocytes and goblet cells with reduced mucus formation, the presence of single crypt abscesses. Own plate with foci of fibrosis, unevenly infiltrated with lymphocytes, plasma cells, segmented nuclear neutrophils, eosinophils, basal plasmacytosis is noted. The muscle plate is slightly thickened, with uneven full blood vessels, infiltrated with lymphocytes, plasma cells, segmented neutrophils, with the presence of single lymphoid follicles (“incomplete granulomas”). The morphological picture may correspond to CD (taking into account endoscopic, clinical, anamnestic and other data). The research was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent of the child’s parents was obtained for the research. No conflict of interests was declared by the authors.

Single Cerebral Metastasis Mimicking Pyogenic Abscess in a Patient with Lung Adenocarcinoma.

HomeRadiology: Imaging CancerVol. 5, No. 3 Images in CancerFree AccessSingle Cerebral Metastasis Mimicking Pyogenic Abscess in a Patient with Lung AdenocarcinomaVíctor Pérez-Riverola , Olalla Vázquez Muiños, Mario Prenafeta Moreno, Roser Monmany Badia, Khalid El-Hamshari Rebollo, Esther Granell MorenoVíctor Pérez-Riverola , Olalla Vázquez Muiños, Mario Prenafeta Moreno, Roser Monmany Badia, Khalid El-Hamshari Rebollo, Esther Granell MorenoAuthor AffiliationsFrom the Department of Neuroradiology, UDIAT-CD, Hospital Universitari Parc Taulí, Parc del Taulí 1, 08208 Sabadell, Spain.Address correspondence to V.P.R. (email: [email protected]).Víctor Pérez-Riverola Olalla Vázquez MuiñosMario Prenafeta MorenoRoser Monmany BadiaKhalid El-Hamshari RebolloEsther Granell MorenoPublished Online:Apr 7 2023https://doi.org/10.1148/rycan.230004MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In As clinical signs of infection are often absent in patients with pyogenic abscesses, differential diagnosis with cerebral metastases is based on MRI findings.However, both entities often manifest as ring-enhancing lesions. Pyogenic brain abscesses usually show restricted diffusion in the lesion core and the dual-rim sign at susceptibility-weighted imaging. The dual-rim sign consists of two concentric rims bordering the lesion: a complete, smooth outer hypointense rim representing the fibrocollagenous capsular wall and an inner hyperintense rim representing a zone of granulation tissue (1). At perfusion imaging, the capsule of a cerebral abscess has a lower relative cerebral blood volume than the necrotic or cystic peripheral wall of a tumor due to microvessel angiogenesis by the tumor (2).Some cerebral metastases also show restricted diffusion, which does not correlate with the histologic type of the primary cancer (3). Proposed mechanisms for restricted diffusion in metastases include intracellular edema in viable tumor cells during transition to complete liquefactive necrosis (4) and a highly viscous mucin concentration (5).Key findings that help distinguish these atypical metastases from pyogenic abscess include high peripheral wall relative cerebral blood volume and absence of the dual-rim sign (Figure).Brain MR images in a 37-year-old male patient, a heavy tobacco and cannabis smoker, after a first seizure. (A) Contrast-enhanced T1-weighted MR image shows a smooth, ring-enhancing nodular right frontal lobe lesion surrounded by abundant vasogenic edema. (B, C) On diffusion-weighted images, the central core shows restricted diffusion. (D) On susceptibility-weighted image, a hypointense smooth ring completely surrounds the lesion, simulating a capsule. (E) The relative cerebral blood volume of the lesion’s peripheral wall (arrows) is high (mean relative cerebral blood volume ratio: 7.61 ± 2.70 [SD]). Chest CT findings (not shown) detected a cavitary pulmonary mass. Tests for tuberculosis and bronchoalveolar lavage fluid analysis were negative. Chest CT findings were initially misinterpreted as an infectious process. Follow-up brain MRI 8 weeks after starting antibiotics showed enlargement of the frontal lobe lesion, new ring-enhancing cerebral and cerebellar lesions, and signs of leptomeningeal carcinomatosis in the posterior fossa. The patient was diagnosed with lung adenocarcinoma following lung lesion biopsy.Download as PowerPointOpen in Image Viewer Disclosures of conflicts of interest: V.P.R. No relevant relationships. O.V.M. No relevant relationships. M.P.M. No relevant relationships. R.M.B. No relevant relationships. K.E.H.R. No relevant relationships. E.G.M. No relevant relationships.Keywords: MRI, MR-Diffusion-weighted Imaging, MR-Perfusion, Metastasis, Neuro-oncology, Lung Adenocarcinoma, Pyogenic AbscessAuthors declared no funding for this work.

Factors Deciding Conservative or Intervention Treatment for Prostate Abscess: A Retrospective Case-Control Study

Prostate abscess (PA) can lead to severe urosepsis and septic shock if not treated promptly. However, early diagnosis can be hindered by the declining incidence of PA, especially in developing countries and high-risk patients. Despite the prevalence of PA, there is currently a lack of well-established contemporary guidelines or treatment algorithms. This study aimed to review the etiology, pathophysiology, diagnosis, and treatment options for PA, as well as analyze the characteristics, background profiles of patients, and clinical course. Ultimately, the goal was to develop a personalized treatment strategy for patients with PA. This retrospective study examined 44 patients diagnosed with PA at a tertiary medical center between 2010 and 2020. The patients were divided into two groups based on their treatment: conservative treatment or intervention (transurethral resection of the prostate [TURP] or transurethral prostate drainage [TPD]). The study evaluated various factors, including patients' background profiles, comorbidities, laboratory data, and PA size and volume. Complications of the interventions were also analyzed. No significant differences were found in basic data between the conservative treatment group (19 patients) and intervention group (25 patients; 20 for TURP, 5 for TPD). However, it was observed that single abscesses, size <2.2 cm, and prostate volume <48 cm3, may be suitable for conservative treatment. Patients with diabetes mellitus and human immunodeficiency virus should be monitored for thrombotic events. In addition, there was a significant difference in white blood count between the two groups (12.1 ± 7.0 vs. 17.6 ± 9.7 × 109/L, p < 0.05). A subgroup analysis of the intervention group showed no significant difference in the risk of complications between TPD and TURP. Patients with poorly controlled diabetes mellitus and immunodeficiency are at a high risk of PA but are not indicated for surgical treatment. The PA profile, including number, size, volume, and percentage to prostate volume, should be considered when deciding on surgical intervention for patients with PA. Patients with higher leukocytosis may require surgical treatment. Overall, these findings can help guide the development of a personalized treatment strategy for patients with PA.

A retrospective study of endogenous endophthalmitis-related pyogenic liver abscess: An increasing complication in North Vietnam.

Endogenous endophthalmitis-related Klebsiella pyogenic liver abscess is a rare complication of metastatic infection. In most cases, visual acuity results are often impaired, even blind, and even with aggressive treatment with topical antibiotics, the final results are unsatisfactory. The objective of this study is to retrospectively based on medical records to describe clinical features, risk factors, and visual outcomes of patients with endogenous endophthalmitis-related pyogenic liver abscesses. We reported a case series of 12 endogenous endophthalmitis-related pyogenic liver abscess patients from March 2021 to 2023. All cases of endogenous endophthalmitis were diagnosed at admission or during the hospital stay. From the medical records of 588 pyogenic liver abscess patients, we found 12 cases of endogenous endophthalmitis with 2.0%. The result showed a mean age of 61.5 ± 12.0 (41-78), diabetes mellitus (7 of 12), right lobe (7 of 12), single abscess (9 of 12), and the mean largest abscess diameter of 5.8 ± 1.7 cm (3.3-9). All patients had ocular symptoms such as eye pain (9 of 12), pus discharge (3 of 12), hypopyon (1 of 12), swollen eyelids (2 of 12), and corneal edema (2 of 12), pyogenic liver abscess before endogenous endophthalmitis (10 of 12), the median interval between endogenous endophthalmitis and pyogenic liver abscess 6.1 ± 1.9 days, ocular symptoms before diagnosis endogenous endophthalmitis 4.4 ± 2.3 days. All affected eyes were injected intravitreously with ceftazidime, amikacin, and vancomycin. Two patients underwent evisceration. Endogenous endophthalmitis has permanent morbidity, reducing visual acuity, poor quality of life, and lacks the warning signs, so it is essential for early detection of symptoms and referral to ophthalmologists.

Clinical and radiographic assessment of periodontal status among patients with post-COVID mucormycosis: A cross-sectional study.

An escalation in cases of rhinomaxillary mucormycosis among post-COVID patients is being reported. However, there is limited information about periodontal features in mucormycosis cases. This study explored the periodontal signs and symptoms among post-COVID mucormycosis individuals. This cross-sectional study was carried out with a total of 25 post-COVID mucormycosis patients attending tertiary care public teaching hospital. Clinical and radiographic assessments were done. An elevation in mean probing pocket depth (PPD) up to 6.21 ± 2.7 mm was noted. Nearly 16%-40% of patients had Miller's Grade III mobility in the affected site. Forty-four per cent had localized single or multiple abscess, 40% had palatal swelling, 32% had necrosis of soft tissue and bone exposure, and 52% had maxillary dentoalveolar segmental mobility in the affected site. Radiographic examination revealed varying stages of interdental bone loss. The present study observed an increase in mobility and mean PPD which did not commiserate with interdental bone loss in the affected maxillary region.

1035. The Microbiological Pattern and Outcome of Community Acquired Brain Abscess: A Single Centre Study from Pakistan

Abstract Background Brain abscess is a potentially life-threatening infection. Streptococci and bacteroides are considered the predominant causative organisms in community acquired brain abscesses. Recommended empirical therapy is therefore ceftriaxone and metronidazole. Our objective was to assess the microbiological pattern and outcome in patients admitted with brain abscess in the neurosurgery unit of a tertiary care hospital in Karachi, Pakistan. Methods A retrospective study was conducted on all patients admitted with community acquired brain abscess at the Neurosurgery Department of Shaheed Mohtarma Benazir Bhutto Institute of Trauma from Jun 2018- Nov 2019. Demographic, microbiological, management and outcome data was gathered from medical records. Results Twenty-three patients were identified of which 13 were males (56.5%). Mean age was 18 (2-65) years. Predisposing factor was an otogenic focus in 17 (73.9%), and head trauma in 3 (13%). Of 23 patients, site of abscess was frontal in 7 (30.4%), occipital in 8 (34.7%), parietal in 4 (17.3%), and temporal in 3 (13%). Single brain abscess was seen in 18 (78.2%). Abscess was drained in all 23 patients (100%) patients and pus culture positive in 16, of which 8 (50%) were poly-microbial. Isolates were 6 (%) Bacteroides, 6 Streptococci, 5 Enterobacteriace, 3 Staphylococcus aureus, 3 Enterococci, 1 Hemophilus, 1 Acinetobacter and 1 Brevibacterium. Of 6 bacteroides isolates, 2 were resistant to metronidazole while only 3 of 10 aerobes isolated were susceptible to ceftriaxone. All patients did well with resolution of abscess/es after an average of 41.2 days of therapy. Conclusion The microbiological spectrum and antimicrobial susceptibility pattern of community acquired brain abscess is changing. Ceftriaxone and metronidazole may no longer be appropriate empirical therapy in these patients. Disclosures All Authors: No reported disclosures.

Clinical and ultrasonographic findings in rams with scrotal enlargement

The present study aimed to investigate the clinical, ultrasonographic, and serological findings of scrotal enlargement in Iraqi Awassi rams in Nineveh governorate, Iraq. A total of 172 rams were brought to the Veterinary Teaching Hospital, College of Veterinary Medicine, and a private clinic by the owners from different areas of Nineveh governorate between 1/4/2021 to 1/7/2021. All animals underwent ultrasonographic and serological examinations. The animals were 18 months - 6 years of age, with body condition scores ranging between 3-4 (on a scale from 1-5). The animal case history detailed was recorded, and clinical, with the ultrasonographic investigation, was done; a blood sample was taken to the lab and checked for Brucella spp by the Rose Bengal test. results revealed a total of 172 rams studied cases were 57 events of scrotal enlargement in study 57/172 (33.13%). Scrotal enlargement was associated with orchitis 29/57 (50.87%), peri-orchitis 12/57 (20.05%), and epididymitis 11/57 (19.29%). The other assorted finding was scrotal hernia 2/57 (3.50%), scrotal hematoma 1/57 (1.75%), hydrocele 1/57 (1.75%), and unilateral cryptorchidism 1/57 (1.75%). Orchitis 29 cases were associated with no abscess formation on 9/29 (31.03%), single abscess formation on 8/29 (27.58%), and multiple abscesses formations on 12/29 (41.37%). Serological tests of males with scrotal enlargement for Brucella spp were in frequency with other unknown cases which positive to Brucella were 37/57 (64.91%) cases and 22/57 (38.59%) negative cases, respectively. In conclusion, orchitis, peri-orchitis, epididymitis, and other male scrotal enlargement need more investigation and studies due to their effect on male fertility. Brucella spp was the main cause of male reproductive system infection, and ultrasonography was very effective for diagnosing infection when connected with lab data results.