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Megumi Yazaki, Takehiko Oami, Kazuya Nakanishi, Ryota Hase, Hiroyuki Watanabe
Although vancomycin administration is recommended for the treatment of infective endocarditis (IE) caused by methicillin-resistant Staphylococcus aureus (MRSA), it is unclear whether an alternative agent, daptomycin, can be used to treat IE with pulmonary complications. A 26-year-old female who had undergone surgical repair of a ventricular septal defect as an early teenager presented with fever, headache, and vomiting. She was admitted to our hospital and diagnosed with right-sided IE with septic pulmonary embolism caused by MRSA...
March 10, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
Z Jia, C J Zhang, C G Xi, Y Q Gong, K W Yang, D Peng, L B Liu, J Li, X S Li, Z S He, L Q Zhou
Objective: To study the clinical characteristics, image findings, therapeutic method and prognosis of metanephric adenoma. Method: The clinical characteristic, image findings, operation methods and prognosis of 16 metanephric adenoma patients treated at Department of Urology, Peking University First Hospital from January 2004 to March 2016 were analyzed retrospectively. Results: There were 6 male and 10 female patients in the study. The mean age of patients was 33.7 years (ranging from 14 to 83 years). Two patients came to the hospital because of fever, while other 14 patients had no symptoms and found renal tumor by medical examination...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Orçun Çiftci, Kerem Can Yılmaz, Atilla Sezgin, Mehmet Bülent Özin, İbrahim Haldun Müderrisoğlu, Mehmet Haberal
OBJECTIVES: Cardiac implantable electrical devices are widely used for patients with advanced heart failure and are usually explanted during orthotopic heart transplant. However, lead fragments and the pulse generator are sometimes left after the procedure. Given the concerns of infectious and thromboembolic complications, their removal is recommended. Herein, we report our experience with cardiac implantable electrical device explantation after orthotopic heart transplant. MATERIALS AND METHODS: We included recipients of heart transplants performed at Başkent University Faculty of Medicine, Department of Cardiovascular Surgery, who underwent lead and pulse generator explantation by manual traction between January 2012 and June 2017...
March 2018: Experimental and Clinical Transplantation
Shraddha Siwakoti, Rinku Sah, Rupa Singh Rajbhandari, Basudha Khanal
Introduction: Pantoea agglomerans, primarily an environmental and agricultural organism has been reported as both commensal and pathogen of humans. We present two case reports of P. agglomerans infections in children that involved the meninges and bloodstream. Case Presentations: A 6-month-old female baby, diagnosed as congenital hydrocephalus secondary to aqueduct stenosis with ventriculoperitoneal shunt in situ, operated 14 days back was brought to the pediatric emergency with a two-day history of high fever associated with vomiting, irritability, excessive crying, and decreased feeding...
2018: Case Reports in Pediatrics
Laura Sonnylal, Joel R Peterson, Alexander P Decilveo, Ian T O'Connor, James C Wittig
We report a rare case of giant periosteal osteoblastoma in the femur of a 21-year-old male. The patient presented with a painful, firm, non-tender mass in his left thigh. The pain was worse at night and was temporarily relieved with NSAIDS. He had no fevers, night sweats, or weight loss. The patient underwent preoperative radiological studies including plain radiographs, MRI, bone scan, and CT scan. An open biopsy was subsequently performed that was consistent with an aggressive, epithelioid osteoblastoma. Pathology demonstrated a neoplasm characterized by cohesive sheets of epithelioid osteoblasts, mixed with areas of conventional osteoblastoma displaying prominent osteoblastic rimming of woven bone trabeculae in a fibrovascular stroma...
March 10, 2018: Skeletal Radiology
Gerald Paul Fitzgerald, John Joseph Coughlan, Zahir Satti, Samer Arnous
A 23-year-old Asian student presented to our service with a 1-month history of fever, weight loss of 10 kg, night sweats, fatigue and general malaise. He was previously well with no significant medical or family history. He had a low-grade pyrexia and cardiac auscultation revealed a diastolic murmur consistent with 'tumour plop'. He had no sequelae of endocarditis. He had low-grade pyrexia of 37.7°C, and ECG showed sinus tachycardia at 130 bpm. He had raised inflammatory markers and was started on broad spectrum antibiotics...
March 9, 2018: BMJ Case Reports
Berk Hazır, Hakan Bahadır Haberal, Devrim Akıncı, Bülent Akdoğan
INTRODUCTION: A pelvic lymphocele is a collection of lymphatic fluid that develops after extensive lymphadenectomies in surgeries such as urological malignancies or renal transplantation. Pelvic lymphoceles may cause complications such as fever, abdominal pain, leg swelling, genital swelling and flank pain. This report summarizes the management of a pelvic lymphocele after open radical retropubic prostatectomy with bilateral lymphadenectomy. PRESENTATION OF CASE: Herein, we present a case in which a pelvic lymphocele developed seven months post-radical open retropubic prostatectomy and through this patient we discussed the lymphocele following radical prostatectomy...
March 6, 2018: International Journal of Surgery Case Reports
Spyridon Miliaras, Ioannis A Ziogas, Konstantinos S Mylonas, Vasileios N Papadopoulos
Malignant gastrointestinal melanoma is usually a metastatic lesion. We report the case of a 67-year-old female patient who presented with intermittent abdominal pain, fever, rigor and diarrhoea. CT scan of the abdomen revealed a large mass at the right iliac fossa with features concerning for intra-abdominal abscess. Exploratory laparotomy confirmed the preoperative diagnosis of abscess, and a right hemicolectomy was performed. Histopathological examination of the surgical specimen was indicative of malignant melanoma, and immunohistochemical examination showed positivity to S100 protein, Melan-A, HMB-45 and vimentin...
March 9, 2018: BMJ Case Reports
Yue Wu, Haihui Zhang, Bingxi Zhou, Shuangyin Han, Yanrui Zhang
Objective: The objective of this study was to evaluate the clinical value of endoscopic submucosal dissection (ESD) in the treatment of early esophageal cancer and precancerous lesions. Materials and Methods: We retrospectively analyzed 58 patients who suffered from early esophageal and precancerous lesions and received ESD in the First Affiliated Hospital of Zhengzhou University from February 2012 to January 2016. The clinical efficacy and safety of ESD in treating the early esophageal cancer and precancerous lesions was evaluated by analyzing the operation successful rate, postoperative pathology, complications, and follow-up data of patients who received ESD...
January 2018: Journal of Cancer Research and Therapeutics
Donghai Li, Jinhai Zhao, Zhouyuan Yang, Pengde Kang, Bin Shen, Fuxing Pei
Low doses of corticosteroids have been proved to be effective in decreasing the inflammatory cytokines and relieving the pain. However, the optimal dosage of corticosteroids in total knee arthroplasty (TKA) is undetermined. A total of 103 patients were randomly divided into three groups. Group A containing 32 patients received normal saline. Group B including 36 patients used two doses of 100 mg hydrocortisone, given 2 hours before and 8 hours after surgery. Group C involving 35 patients received four doses of 100 mg hydrocortisone, 8 hours apart...
March 7, 2018: Journal of Knee Surgery
Zahira Zouizra, Soukaina Benbakh, Gaël Biaou, Drissi Boumzebra
Mycotic aortic aneurysms are exceedingly uncommon in infants and they have a high risk of rupture. Their surgical management is extremely challenging. We report a case of a 22-month-old girl who presented with abdominal pain and fever revealing a ruptured mycotic aneurysm of the infrarenal aorta. The surgical treatment consisted of a ligature of the proximal and distal ends of the aneurysm. Postoperative course was significant for hypertension. A year and a half follow-up showed no other complications. Limited data are available concerning our chosen technique, but the reported cases showed a good short-term outcome...
2018: SAGE Open Medical Case Reports
Fumiaki Kawano, Kousei Tashiro, Hironobu Nakao, Yoshirou Fujii, Takuto Ikeda, Shinsuke Takeno, Kunihide Nakamura, Atsushi Nanashima
INTRODUCTION: Jejunogastric intussusception is a rare complication after gastric operation. Intussusception after gastric operation occurs mostly at the gastrojejunal anastomosis site and Braun anastomosis site of Billroth II reconstruction, and at the Y anastomosis site of Roux-en-Y reconstruction. However, jejunogastric intussusception after distal gastrectomy with Roux-en-Y reconstruction is very rare. We report a surgical case of jejunogastric intussusception after distal gastrectomy for gastric cancer treatment...
January 31, 2018: International Journal of Surgery Case Reports
Alicja Baranowska, Paweł Baranowski, Tadeusz Płusa
Infection of the surgical operation site is found in approximately 3% of patients and 20% of patients undergoing urgent surgery. The occurrence of this type of complications is affected both by coexisting diseases and the presence of infection in the environment in which the patient is staying. It should also be taken into account that the bacteria found in the implanted material and surrounding tissues have the ability to adhere to the implant, creating a biofilm structure there. The presented patient is an illustration of such a problem, because after L5 laminectomy and extensive L2-L3 and L3-L4 one-sided fenestration and L2-L3-L4-L5 facetectomy, interbody bone arthrodesis and transpedicular stabilization, he reported for fever and pain in right lumbar area...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Janusz Ławiński, Zbigniew Jabłonowski
The improvement of surgical care requires transparent, consistent and accurate reports concerning surgical outcomes which are assessed and documented in a standardized manner. No consensus has yet been reached as to how to define and assess postoperative complications with regard to the specificity of urological procedures. Therefore, the comparison of data from different centres is difficult. The modified Clavien-Dindo classification allows for a more uniform analysis of surgical complications. This study analyses the occurrence of perioperative complications after percutaneous nephrolithotomy assessed on the basis of the aforementioned classification...
February 23, 2018: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Fang Tan, Xiaoliang Gan, Yingqing Deng, Xiaoyun Li, Na Guo, Ziqing Hei, Qianqian Zhu, Zhuang-Gui Chen, Shaoli Zhou
Purpose: Dexmedetomidine (DEX) has been reported to attenuate inflammation in rats. The present retrospective cohort study aimed to investigate whether intraoperative administration with DEX could reduce the incidence of postoperative systemic inflammatory response syndrome (SIRS) in patients following percutaneous nephrolithotomy (PCNL). Patients and methods: A total of 251 patients were included in the analysis. Among these patients, 175 received intravenous DEX infusion during the intraoperative period and 76 did not...
2018: Therapeutics and Clinical Risk Management
Bong Hee Park, Chang Hee Han, Jae Dong Chung, Hyun Hwan Sung, Byong Chang Jeong, Seong Soo Jeon, Deok Hyun Han
OBJECTIVES: To evaluate the outcomes of laparoendoscopic single-site nephrolithotomy(LESS-NL) for symptomatic calyceal diverticular calculi. MATERIALS AND METHODS: From November 2009 to March 2014, 11 cases of LESS-NL with a homemade single-port device for calyceal diverticular calculi were performed by a single experienced laparoscopic surgeon. All patients were assessed at postoperative 1 month, 1 year, and 3 years for symptom-free status and by computed tomography for stone-free and calyceal diverticular obliteration status...
March 1, 2018: Journal of Endourology
Makoto Iijima, Ryota Azuma, Tetsuya Hieda, Yutaka Makino
We describe the surgical management of a 58-year-old man with inflammatory abdominal aortic aneurysm (IAAA) following treatment with preoperative steroids. The patient was transferred to our institution for abdominal pain and fever. Contrast-enhanced computed tomography showed juxtarenal abdominal aortic aneurysm surrounded by dense perianeurysmal fibrous tissue. Under a diagnosis of IAAA, steroid therapy with prednisolone was initiated to control the perianeurysmal inflammation. It continued for 3 weeks with a decreasing dose schedule, with remarkable decrease in the soft tissue mass...
February 2018: Journal of Surgical Case Reports
Masahiro Hashimoto, Kohei Murata, Yoshinori Kagawa, Atsushi Naito, Kenji Kawai, Takuya Sakamoto, Kohei Murakami, Yoshiteru Katsura, Akihisa Omura, Toru Masuzawa, Atsushi Takeno, Michiko Yoshimura, Yutaka Takeda, Takeshi Kato, Shigeyuki Tamura
Appendiceal mucinous adenocarcinoma accompanied by cysts ruptures by surgical operation and leakage of mucus into the peritoneal cavity results in deterioration of prognosis.We report a case where the appendix mucinous adenocarcinoma was safely excised by laparoscopically preceding vascular treatment, lymph node dissection and intestinal dissection.The case was a woman in her forty-age suffering from the right lower quadrant and fever; no improvement was observed even when antibiotics were administered.A cystic lesion with a maximum diameter of 75mm was found on the right side of the pelvis with CT, and numerous lymph adenopathy was observed along the iliac artery...
February 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Sjaak Pouwels, Darryl M Coll, Alexander G J van Marle
A 70-year-old man was admitted to our hospital for a penile circumcision due to phimosis using continuous dose spinal anaesthesia. On postoperative day 10 he came to the emergency department with a superficial abscess localised at the injection site of the spinal catheter. He was treated with intravenous antibiotics for 10 days, and the superficial abscess was incised and drained. Ten days later, the patient was readmitted to the emergency department with complaints of back pain and fever. A repeat MRI scan of his lumbar sacral area was done and showed epidural abscesses without any compression of the medulla or the myelum...
February 23, 2018: BMJ Case Reports
B J A Smarius, C H A L Guillaume, G Jonker, A B Mink van der Molen, C C Breugem
OBJECTIVES: Throat packs are commonly used to prevent ingestion or aspiration of blood and other debris during cleft lip/palate surgery. However, dislodgement or (partial) retainment after extubation could have serious consequences. The aim of the present study was to investigate the effect of omitting pharyngeal packing during cleft lip/palate surgery on the incidence of early postoperative complications in children. MATERIALS AND METHODS: A retrospective study was performed on all children who underwent cleft lip/palate surgery at the Wilhelmina Children's Hospital...
February 22, 2018: Clinical Oral Investigations
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