Fourth branchial cleft anomalies are rare head and neck congenital lesions seen in children. They present as a neck inflammatory mass and arise essentially on the left side of the neck. We report the case of a 7-month-old female with a mass of the neck associated with respiratory distress. The mass was diagnosed as an incomplete fourth branchial cleft fistula. Surgical revision of the neck abscess from an external approach and plasma coblation of the orifice in the pyriform fossa by an endoscopic approach were performed.
- MeSH
- absces chirurgie MeSH
- branchiální krajina * abnormality chirurgie MeSH
- kojenec MeSH
- kraniofaciální abnormality chirurgie MeSH
- krk abnormality chirurgie patologie MeSH
- lékařské ilustrace MeSH
- lidé MeSH
- nemoci faryngu MeSH
- píštěle chirurgie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- přehledy MeSH
BACKGROUND: There exist multiple extraintestinal manifestations of inflammatory bowel disease. The most common are arthritis, aphthous stomatitis, or uveitis. Aseptic abscess syndrome is not usually included among these extraintestinal manifestations. In our case report, we present a rare case of aseptic abscess syndrome as the first manifestation of inflammatory bowel disease. CASE PRESENTATION: We present the case of a 10-year-old girl whose only initial medical issue was recurrent submandibular lymphadenitis unresponsive to standard antibiotic therapy. A broad differential diagnosis was initiated to exclude an infectious etiology. Eventually, it was necessary to proceed with extirpation of the suspected lymph node. Histological examination showed suppurative granulomatous inflammation, so it was further examined for noninfectious cause. Blood tests revealed positivity of ASCA antibodies (Anti-Saccharomyces cerevisiae) in both IgA and IgG classes. Despite absence of typical gastrointestinal symptoms, bowel ultrasound was performed, followed by magnetic resonance enterography. Both showed inflammatory changes in the terminal ileum. Subsequent endoscopy of the gastrointestinal tract and histological examination of biopsy specimens confirmed a diagnosis of Crohn's disease with terminal ileum and rectum involvement. A standard treatment based on current guidelines led to remission without recurrence of lymphadenitis. CONCLUSIONS: In cases of lymphadenitis that does not respond to standard antibiotic treatment, diagnosis of aseptic abscess syndrome should be considered as a potential etiology and, subsequently, inflammatory bowel disease should be investigated, given that this syndrome is associated with inflammatory bowel disease in as many as 70% of cases. To our knowledge, this is the first published case report describing aseptic abscess syndrome affecting cervical lymph nodes as an extraintestinal manifestation of pediatric Crohn's disease.
- MeSH
- absces * etiologie diagnóza MeSH
- Crohnova nemoc * komplikace diagnóza MeSH
- diferenciální diagnóza MeSH
- dítě MeSH
- lidé MeSH
- lymfadenitida * etiologie diagnóza MeSH
- syndrom MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
The parasitic protozoan Entamoeba histolytica secretes extracellular vesicles (EVs), but so far little is known about their function in the interaction with the host immune system. Infection with E. histolytica trophozoites can lead to formation of amebic liver abscesses (ALAs), in which pro-inflammatory immune responses of Ly6Chi monocytes contribute to liver damage. Men exhibit a more severe pathology as the result of higher monocyte recruitment and a stronger immune response. To investigate the role of EVs and pathogenicity in the host immune response, we studied the effect of EVs secreted by low pathogenic EhA1 and highly pathogenic EhB2 amebae on monocytes. Size and quantity of isolated EVs from both clones were similar. However, they differed in their proteome and miRNA cargo, providing insight into factors potentially involved in amebic pathogenicity. In addition, EVs were enriched in proteins with signaling peptides compared with the total protein content of trophozoites. Exposure to EVs from both clones induced monocyte activation and a pro-inflammatory immune response as evidenced by increased surface presentation of the activation marker CD38 and upregulated gene expression of key signaling pathways (including NF-κB, IL-17 and TNF signaling). The release of pro-inflammatory cytokines was increased in EV-stimulated monocytes and more so in male- than in female-derived cells. While EhA1 EV stimulation caused elevated myeloperoxidase (MPO) release by both monocytes and neutrophils, EhB2 EV stimulation did not, indicating the protective role of MPO during amebiasis. Collectively, our results suggest that parasite-released EVs contribute to the male-biased immunopathology mediated by pro-inflammatory monocytes during ALA formation.
- MeSH
- amébový absces jater imunologie parazitologie MeSH
- cytokiny metabolismus MeSH
- entamébóza imunologie parazitologie MeSH
- Entamoeba histolytica * imunologie patogenita genetika MeSH
- extracelulární vezikuly * imunologie metabolismus MeSH
- lidé MeSH
- monocyty * imunologie parazitologie MeSH
- signální transdukce * MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Autori v článku prezentujú kazuistiku 6-ročného chlapca s nefrogénnym diabetes insipidus a retrofaryngovým abscesom. Perioperačné obdobie bolo komplikované neadekvátnym perorálnym príjmom a poruchou minerálovej a tekutinovej rovnováhy. Nephrogenic diabetes insipidus is a rare disorder characterized by impaired concentration ability of the kidneys. For these patients, not only the adequate fluid intake is crucial, but also their composition itself. The adequate hydration is especially important in situations with limited oral intake, such as in the case of an operation and preoperative period. In this article, the authors present a case report of a 6-year-old boy with nephrogenic diabetes insipidus and retropharyngeal abscess. The perioperative period was complicated by inadequate oral intake and a disorder of mineral and water balance.
Neprohrogenic diabetes insipidus is a rate disorder characterized by impaired concentration ablility of the kidneys. For these patients, not only the adequate fluid intake is crucial, but also their composition itself. The adequate hydration is especially important in situations with limited oral intake, such as in the case of an operation and preoperative period. In this article, the authors present a case report of a 6-year-old boy with nephrogenic diabetes insipidus and retropharyngeal abscess. The perioperative period was complicated by inadequate oral intake and a disorder of mineral and water balance.
- MeSH
- dítě MeSH
- lidé MeSH
- nefrogenní diabetes insipidus * MeSH
- perioperační období MeSH
- retrofaryngeální absces chirurgie MeSH
- tekutinová terapie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- diferenciální diagnóza MeSH
- lidé MeSH
- plicní absces * diagnostické zobrazování klasifikace patologie terapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Parapharyngeal abscess in an infant is a very rare condition. We present the case of a 4-month-old girl with large masses on the neck's left side. Computed tomography showed an extensive parapharyngeal abscess. Left tonsillectomy was performed under general anesthesia from a transoral approach, followed by an incision and evacuation of the abscess from the parapharyngeal space. Microbiological analysis identified a massive occurrence of Streptococcus intermedius.
- MeSH
- absces * mikrobiologie chirurgie MeSH
- kojenec MeSH
- lidé MeSH
- nemoci faryngu mikrobiologie chirurgie MeSH
- počítačová rentgenová tomografie MeSH
- spatium parapharyngeum * chirurgie diagnostické zobrazování mikrobiologie MeSH
- Streptococcus intermedius izolace a purifikace MeSH
- streptokokové infekce * mikrobiologie chirurgie MeSH
- tonzilektomie MeSH
- Check Tag
- kojenec MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Klíčová slova
- parafaryngeální absces,
- MeSH
- absces diagnostické zobrazování diagnóza etiologie klasifikace MeSH
- dítě MeSH
- edém * diagnóza etiologie klasifikace MeSH
- faryngitida diagnóza etiologie klasifikace MeSH
- krk * diagnostické zobrazování patologie MeSH
- lidé MeSH
- retrofaryngeální absces diagnostické zobrazování diagnóza etiologie MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2) caused imminent acute infection of respiratory tract known as Coronavirus disease 2019 (COVID-19). Complications of hepatobiliary system especially liver often found in post-acute COVID-19 patients. However, there are only few studies specifically discussing about liver abscess in patients who had history of contracted COVID-19. We present a case of a 54-years-old gentleman with no previous medical illness and no history of vaccination, who was presented with ruptured liver abscess post COVID-19 infection Category 4 (symptomatic with lung infection and the need of oxygen supplementation). Percutaneous drainage was performed to drain the abscess and collections.
OBJECTIVES: This study of 331 primary brain abscess (PBA) patients aimed to understand infecting agents, predisposing factors, and outcomes, with a focus on factors affecting mortality. METHODS: Data were collected from 39 centers across 16 countries between January 2010 and December 2022, and clinical, radiological, and microbiological findings, along with their impact on mortality, were analyzed. RESULTS: The patients had a mean ± SD age of 46.8 ± 16.3 years, with a male predominance of 71.6%. Common symptoms included headache (77.9%), fever (54.4%), and focal neurological deficits (53.5%). Gram-positive cocci were the predominant pathogens, with Viridans group streptococci identified as the most frequently isolated organisms. All patients received antimicrobial therapy and 71.6% underwent interventional therapies. The 42-day and 180-day survival rates were 91.9% and 86.1%, respectively. Significant predictors of 42-day mortality included intravenous drug addiction (HR: 6.02, 95% CI: 1.38-26.26), malignancy (HR: 3.61, 95% CI: 1.23-10.58), confusion (HR: 2.65, 95% CI: 1.19-5.88), and unidentified bacteria (HR: 4.68, 95% CI: 1.76-12.43). Significant predictors of 180-day mortality included malignancy (HR: 2.70, 95% CI: 1.07-6.81), confusion (HR: 2.14, 95% CI: 1.11-4.15), temporal lobe involvement (HR: 2.10, 95% CI: 1.08-4.08), and unidentified bacteria (HR: 3.02, 95% CI: 1.49-6.15). CONCLUSION: The risk of death in PBA extends beyond the infection phase, with different factors influencing the 42-day and 180-day mortality rates. Intravenous drug addiction was associated with early mortality, while temporal lobe involvement was associated with late mortality.
- MeSH
- absces mozku * mikrobiologie mortalita MeSH
- antibakteriální látky terapeutické užití MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- retrospektivní studie MeSH
- rizikové faktory MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
