Thigh Abscess Research Articles

Isolation of Enterococcus mundtii from normally sterile body sites in two patients

Enterococcus mundtii, a recently described nonmotile, yellow-pigmented enterococcal species, was isolated from a chronic thigh abscess and from operatively obtained sinus mucosa. It is emphasized that this species may be encountered in clinical specimens and that the correct species identification may be missed when commercially available identification systems are relied on.

THREE CASES OF OBTURATOR HERNIA IN WHICH THE DIAGNOSIS AND TREATMENT WERE DIFFICULT

Relatively rare hernias include obturator hernia in aged patients. We experienced 3 cases of obturator hernia presenting with complicated manifestations. Case 1 presented with an intermuscular abscess in the left thigh. The abscess was drainaged, and the herniation was cured thereafter. Case 2 showed recurrent ipsilateral obturator hernia ten years after former herniation was cured operatively. Case 3 presented with panperitonitis due to perforation of iluem, and emergent operation saved the patient. All 3 cases had peculiar manifestations and we had difficulties in the preoperative diagnosis and treatment. The key points for diagnosing obturator hernia are: 1) to doubt of its existence; and 2) to relay on CT among imaging methods. While it is emphasized for treatment that the hilus should be reinforced by covering not only with peritoneum but also with ovary and its ligament. A review of more than 200 cases of obturator hernia reported in Japan since 1926 is also described.

A Case of Prostatic Cancer Associated with DIC

A case of prostatic cancer associated with DIC was reported. On admission, the patient was in hypercoagulable state. On 9th hospital day, he developed a decompensated DIC in association with a high fever. The origin of the fever was thought to be an abscess of the right thigh. After the treatment of the infection with antibiotics, the patient was cured of decompensated DIC without anticoagulant therapy.

Intra-abdominal sepsis following liver trauma.

Of 330 consecutive patients with liver trauma having a celiotomy over a 5-year period, 295 (89%) survived more than 72 hours. Of these 295, 35 (12%) developed sepsis, and 11 (31%) of these septic patients died. The sources of the sepsis in 30 of these patients included: abdominal abscesses--23, pneumonia or empyema--seven, acalculous cholecystitis--two, gangrene of right colon--two, and thigh abscess--one. In five other patients, the source of the sepsis was not found, even at autopsy. The mortality rate in the 30 patients with one or more identifiable foci of infection was 23%. In contrast, when the source of the sepsis could not be found, the mortality rate was 80% (4/5) (p less than 0.05). Factors associated with an increased incidence of abdominal abscess included: splenectomy, 75% (3/4); liver packs, 63% (5/8); 20+ units of blood, 57% (8/14); Class IV-V liver injury, 35% (8/23); 10-19 units of blood, 25% (7/28); colon injury, 19% (7/36); and open (Penrose) drainage of the abdomen, 11% (23/213). None of 82 patients without drains developed an intra-abdominal abscess. Thus early control of an identifiable source of infection provides the best results with sepsis following liver trauma. The most effective method for preventing intra-abdominal abscesses appears to be avoidance of drains in mild (Class I-II) liver injuries. The use of a closed system in the most severe injuries is still controversial and needs to be addressed in a prospective trial.

Sonography of Thigh Abscess: Detection, Diagnosis, and Drainage

Sonography of Thigh Abscess: Detection, Diagnosis, and Drainage

Sonography of thigh abscess: detection, diagnosis, and drainage

Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate.

Thigh abscess: An uncommon presentation of intraabdominal sepsis

Abscesses of the thigh are rare and, although easily diagnosed, their cause is often obscure. We present two cases of thigh abscesses which resulted from the extension of intraabdominal sepsis. A review of the literature reveals only 46 previously reported cases. The underlying pathologic abnormality is usually a retroperitoneal perforation of a colorectal neoplasm or diverticular disease, whereas origin from the small bowel or appendix is distinctly less common. Routes of extension of infection into the thigh can be either direct, through the subcutaneous tissues, or through naturally occurring defects in the abdominal wall. These include: (1) along the psoas muscle deep to the inguinal ligament; (2) through the femoral canal; (3) by way of the obturator foramen; and (4) through the sacrosciatic notch. The two cases presented are unusual in that they both followed radical cystectomy with lymph node dissection, which opens up these natural avenues to the spread of intraabdominal infection. The overall mortality in the literature is high (53 percent), but recognition of an abdominal source and appropriate treatment combined with local drainage of the thigh abscess appears to improve survival.

Squamous Cell Carcinoma in Chronic Osteomyelitis

Malignant change at the site of a chronic osteomyelitis, a rare condition, is reported in a 45-year-old man, along with a review of the literature. This patient with a 30-year history of chronic osteomyelitis of the right femur and an intermittently discharging sinus had a large abscess in the lower thigh. The abscess was drained, and an ulcer developed at the mouth of the sinus tract. Soon afterward, he sustained a pathologic fracture through the lower femur. Biopsy specimens of the ulcer showed a well-differentiated squamous carcinoma. An amputation was performed at the level of the proximal 10 cm of the femur. The patient remains well 18 months later with no clinical or radiologic evidence of metastases. Changes in character of a previously innocuous osteomyelitis sinus tract should arouse suspicion of neoplastic transformation. Biopsy of various depths of the sinus tract, including the bone marrow, is essential. Early amputation for squamous cell carcinoma is indicated and offers a good prognosis.

Renal carcinoma with staghorn calculus, perinephric abscess, and xanthogranulomatous pyelonephritis in same kidney Subcutaneous abscess of thigh as initial presentation

A case is reported of the simultaneous occurrence of renal carcinoma with staghorn calculus, perinephrie abscess, and xanthogranulomatous pyelonephritis in the same kidney, with subcutaneous abscess of the thigh as the initial presentation. The coexistence of these diseases in the same kidney would seem to be important since they are frequently confused with each other.

William Cobbett, Benjamin Rush, and the Death of General Washington

GEORGE Washington's death on Dec 14, 1799, ended a tumultuous century in the history of the United States. With a finality that equaled the signing of the Declaration of Independence or Cornwallis' surrender at Yorktown, the church bells tolling Washington's death rang out the order of things as they had been for almost two centuries. <h3>Washington's Last Illness</h3> Although large and robust, Washington had numerous illnesses during his life, including bouts with smallpox and pneumonia, recurrent diarrhea, a large thigh abscess, and many dental problems.¹His final illness was mercifully short. After riding about his plantation in the freezing rain on Thursday, Dec 12, he contracted an upper respiratory tract infection with hoarseness developing on the following day. On Friday he went outdoors for a short time and in the evening read the newspapers aloud to his wife. Sometime between 2 and 3 AM on Saturday, the 14th, he awakened

A case report of the gravitation abscess due to the spontaneoous rupture of ureter

Gravitation abscess due to tuberuclosis of the spine, the pelvis, the hip joint and the greater trochanter is wellknown.In this paper, however, we report a case of the patient who was treated because of the gravitation abscess in the left thigh, resulting from the spontaneous rupture of ureter on the left side. Until the present time, as far as we know, it has not been reported in the world that the spontaneous rupture of ureter caused gravitation abscess.

Polyvinylpyrrolidone contrast enhancement: abscess imaging.

Rabbits with thigh abscesses received an intravenous solution of polyvinylpyrrolidone (PVP) and metallic salts, resulting in a dense ring of contrast enhancement as determined by computed tomography (CT). Enhancement increased during the first two weeks, stabilized, then decreased to control levels at eight weeks. After antibiotics the ring of enhancement appeared to mark the abscess perimeter as it regressed. Normal muscle density did not change. The magnitude and duration of enhancement would improve CT detection of small lesions and be useful in evaluating the efficacy of therapy.

Linear Limb Sinus Tract in a Child

CHRONIC draining sinus tracts and recurrent abscesses are usually associated with chronic inflammatory disorders (tuberculosis, fungal disorders), neoplasms, inflammatory bowel disease, and the presence of a foreign body. This report describes the case of a child who had recurrent gluteal and thigh abscess, with persistent draining sinus tracts that, in the final analysis, represented a subdermal linear limb sinus tract covering the entire length of the lower extremity. We believe this lesion is of congenital origin; review of the English literature did not reveal a similar case. Report of a Case A 5-year-old girl was admitted to the James Whitcomb Riley Hospital for Children on the Indiana University Medical Center campus on April 11, 1972, with the chief complaint of persistent purulent drainage from the right gluteal fold. The draining area had been present for two years and was initially thought to be related to an insect bite. A single

A case of myelocytic leukemia simulating the mouse model diseases.

AbstractA case of myeloid leukemia is reported that occurred in a woman whose previous experiences are known to increase the incidence of myeloid leukemia in the mouse. Ovariectomy and sterile turpentine abscess formation increase the incidence of myeloid leukemia in mice exposed to ionizing radiation. In addition, antigenic similarities exist between certain variants of murine leukemia virus and mammary tumor virus. This patient experienced ovariectomy, thigh abscess formation, and partial body irradiation for carcinoma of the breast a few years before she developed leukemia. An association between human breast cancer and myelocytic leukemia has been described. While this case certainly does not prove that similar pathogenetic mechanisms of myeloid leukemia occur in mice and man, the events preceding the development of leukemia in this patient certainly mimicked the mouse models well.

Abdominal sepsis presenting as abscess of right thigh.

Abdominal sepsis presenting as abscess of right thigh.

Tuberculosis of pubis presenting as a cold abscess of the thigh.

Tuberculosis of pubis presenting as a cold abscess of the thigh.

The Identity of Fusiform Bacilli and Spirilla

It has been observed for several years that fusiform bacilli, usually associated with long spirilla,f are present in many pathological conditions. They were first demonstrated in cases of ulceromembranous angina (Vincent's or Plaut-Vincent's) and later in cases of ulceromembranous stomatitis, hospital gangrene, noma, pyorrhea alveolaris, appendicitis, subpectoral, brain, and thigh abscesses, and some other morbid processes. Both organisms have been observed in the healthy mouth and genitalia. In the majority of cases the bacilli and spirilla have been recognized in smear preparations, made from the seat of the disease, or in stained sections of tissues. Both organisms have been grown in mixed cultures. Fusiform bacilli have been isolated in pure culture by Veillon and Zuber, Ellermann and Weaver. The fusiform bacilli isolated by Dr. Weaver, and described in an article by Dr. Weaver and myself,1 appeared to be the same as those described by Ellermann, and compared quite closely with those found in smear preparations made from the seat of the disease. Although spirilla resembling those from the tissues have been grown in mixed cultures with fusiform bacilli and other organisms, all efforts to obtain them in pure culture have up to this time been unsuccessful. Most authors have believed that the fusiform bacilli and spirilla are entirely distinct organisms and that they act in symbiosis, the spirilla serving to increase the virulence of the bacillus. Some observers have maintained that they are different forms of one organism (Seiffert, Perthes, Sobel, and Herrman). As until recently no pure cultures of the bacilli and none of the spirilla have been obtained, it has been impossible to prove whether they were distinct organisms or not.

Letter from India.

Bombay, India, Jan. 15, 1902. <h3>To the Editor:</h3> —England has sent many of her best medical men to India for service in both army and civil hospitals. Bombay, the chief city of the Empire, is well supplied. The Grant Medical College is equipped for good work and the great hospital adjacent always teems with patients. At a surgical clinic recently held there eight capital operations were performed for various phases of tubercular infection; hip disease, amputation of forearm, peri-rectal abscess, deep cervical abscess, peritonitis, axillary glands, ankle joint and tendovaginitis of thigh. Many of the hot-climate ills are mere preparatory steps to general tuberculosis, whose ravages are fearful in the native population of the cities. <h3>INCREASE OF PLAGUE.</h3> Just now plague is again attracting attention. It is increasing rapidly in other parts of India and is spreading. The Plague Commission has made its reports. Nothing but the continued persistence of