Brain abscess caused by Salmonella typhi. Case report

The authors report a rare case of a brain abscess associated with osteomyelitis caused by Salmonella typhi that remained in contact with human tissues for 33 years without losing its virulence.     

Brain abscess

Possibilities of utilization of isozymes as markers of the activity of genes in ontogenesis are considered. There are cases of both the synchronous and asynchronous activation of paternal and maternal genes controlling the synthesis of appropriate isozymes. The asynchronous activation is peculiar, mainly, of interspecific hybrids. The organospecific pattern of isozymes in ontogenesis is determined not only by the activity of structural genes controlling their syntheses, but also by numerous genes-modificators active at the translation and posttranslation levels.     

Lung abscess caused by Legionella micdadei

We describe a case of lung abscess caused by sporadic infection with Legionella micdadei in a patient with AIDS. L micdadei infection can be very difficult to diagnose because the organism stains only weakly Gram negative, requires special culture media, and is not detectable with some direct fluorescent antibody tests that are directed only at Legionella pneumophila. Since it can stain acid fast, it may be confused with mycobacteria. The abscess was successfully treated using antibiotics and percutaneous catheter drainage.     

Lung abscess caused by Paecilomyces lilacinus

AIM: To present characteristics of heart and great vessel injuries in patients wounded during the 1992-1994 war in Bosnia and Herzegovina and their management in conditions of lack of complex diagnostic and therapeutic procedures. METHODS: Retrospective analysis was performed on the medical records of 31 patients treated for cardiac and great vessel injuries at the Department of Surgery, Tuzla University Hospital, between January 1992 and December 1994. RESULTS: The most frequent localization of the injuries was the right and left ventricles (each 10 cases), left atrium in 5, superior caval vein in 5, and inferior caval vein in 5 cases. Isolated pericardial injury was found in 5 cases. Immediately after injury, 22 injured suffered from shock, 7 from pericardial tamponade, and 2 were in a stable state. The mortality rate was 58%. Eight patients died during the operation as a consequence of bleeding. The highest mortality rate was recorded in the injuries of the left ventricle followed by the injuries of the in right ventricle and of superior caval vein. All 4 patients with multiple heart and great vessel injuries died. Mortality rate was significantly higher in patients who suffered from shock than in those who suffered from tamponade. CONCLUSIONS: Penetrating war injuries of heart and great vessels are among the most serious injuries in war. These injuries require prompt treatment to save life, but this is hardly manageable in hospitals without cardiopulmonary bypass facilities.     

Retropharyngeal abscess caused by atypical mycobacterium

Mycobacterial retropharyngeal abscesses are usually secondary to cervical tuberculous osteomyelitis. A case is presented of a retropharyngeal abscess that was caused by the atypical mycobacteria with no mucous membrane or cervical spine involvement. The operative and medical management is discussed.     

Prostatic abscess caused by anaerobic germs

The system SOSUI for the discrimination of membrane proteins and soluble ones together with the prediction of transmembrane helices was developed, in which the accuracy of the classification of proteins was 99% and the corresponding value for the transmembrane helix prediction was 97%. AVAILABILITY: The system SOSUI is available through internet access: http://www.tuat.ac.jp/mitaku/sosui/. CONTACT: sosui@biophys.bio.tuat. ac.jp.     

Liver abscess caused by Haemophilus paraphrophilus and Streptococcus anginosus

A downward facing tissue flap from the posterior wall of trachea and the anterior wall of esophagus was made after total laryngectomy, then inserted into the esophageal cavity to form a fistula. In order to cover the fistular opening and also to avoid food aspiration, 2-3 mm of the valvular tip must be kept. Of 11 cases undergoing this operation, 5 patients obtained a good vocalization, a comparative dysphonia occurred in 3 patients and another 3 patients got a esophageal voice due to shut of their fistulae. We consider this method a rather simple one, vocalization can recover easily without any special training, and also there were few complications will emerge.     

Brain abscess and congenital heart disease

The clinical features and management of 18 patients with congenital heart disease and a brain abscess are reviewed. Except for one patient all had cyanosis. All abscesses were large, containing at least 50-60 ml of pus, and mostly unilocular. Bilocular and multilocular abscesses were also encountered. The organisms cultured from the pus had little relation to the mortality. Tapping may be the final investigation, and is also the treatment of choice. The high mortality (50%) is attributed to the delay in referral of these patients to a neurosurgical unit.     

Brain abscess. A difficult diagnosis?

It is vital to diagnose brain abscess early, but this can be intricate. Four cases of brain abscess are described, illustrating the diagnostic difficulties. One of the patients had multiple brain abscesses. Important aspects of brain abscess are discussed. Brain abscess should be suspected in cases of increasing intracranial pressure combined with focal neurological signs or epileptic seizures, even with no apparent signs of infection. The characteristic contrast-enhancing ring lesion and surrounding oedema may be sufficient for diagnosis, but biopsy and bacteriological culture are often necessary. Epileptic seizures and various neurological sequelae are common, even if the abscess is treated immediately. Delay in diagnosis may lead to fatal outcome.     

Brain abscess: diagnostic and therapeutic problems

The uropygial gland of the white stork secrets mono- and diester waxes as well as triglycerides, all of which contain unbranched medium chain fatty acids. n-Decanol and n-dodecanol have been the only alcohols detected in both types of waxes. The diester waxes contain 2-hydroxy fatty acids.     

Psoas abscess caused by Salmonella enteritidis: presentation of a case

The psoas abscess is an entity of infrequent occurrence in daily clinical practice. Many pathogens have been related with the genesis of this focal infections, but it can be said nowadays that the Staphylococcus aureus is more often involved in them. We present the case of a male aged 26, with a culture of purulent drained material, where Salmonella enteritidis, a microorganism of exceptional presentation in this pathology, was isolde. Moreover, some hypothesis have been proposed about the possible physiopathology and the current state of the diagnostic and therapeutic techniques in these processes is revised.     

Supraclavicular abscess caused by Salmonella enteritidis in patient without gastrointestinal symptoms

Soft tissue infections are among the rare manifestations of extra intestinal salmonellosis and occur more frequently in immunocompromised patients. Herein we report a case of a 51-year-old white male with type II. diabetes mellitus, diagnosed with supraclavicular abscess caused by Salmonella enteritidis. The patient denied any gastrointestinal symptoms, and stool cultures were negative. After incision, drainage, and administration of intravenous ampicillin (4 x 1.5 g/day for two weeks) the patient recovered completely. To our knowledge, this is the first reported case of cervical soft tissue abscess caused by Salmonella enteritidis without preceding gastrointestinal symptoms. We feel that the presence of diabetes was a risk factor for developing the infection.     

Neonatal hand abscess, osteomyelitis and meningitis caused by Streptococcus pneumoniae

Pathologic splenic rupture is a rare and life-threatening complication of acute leukemia. It is even more uncommon as the initial manifestation, and only a few cases has been reported in the literature. Early recognition of this complication is vital because the prognosis is fatal without immediate treatment by splenectomy. We report the case of a spontaneous spleen rupture irreversibly complicating the onset of acute lymphoblastic leukemia in a 19-year-old man, in spite of splenectomy. In our case abdominal ultrasound was a good, non-invasive diagnostic test. Therefore, we believe that the course of the underlying disease and the physical condition of the patient dramatically influenced the disease evolution.