abscess

Hyperphosphatemic Familial Tumoral Calcinosis (HFTC) is a rare autosomal recessive metabolic disorder characterized by abnormal phosphate regulation and soft tissue calcifications. Early diagnosis is crucial for optimal management to prevent complications.

A one-year-old child presented with intermittent fevers and a gluteal mass. Ultrasound revealed a calcified abscess, and biopsy confirmed a pseudocyst. Further workup identified elevated blood calcium, phosphorus, and neutropenia. The patient was ultimately diagnosed with HFTC.

Early diagnosis of HFTC is challenging due to the rarity of the disease and the potential for non-specific initial symptoms. This case highlights the importance of considering HFTC in the differential diagnosis for a young child with unexplained soft tissue masses or skeletal abnormalities, even outside the usual age range.

This case report emphasizes the need for a high index of suspicion for HFTC in pediatric patients with suggestive clinical features, regardless of age. Early diagnosis and prompt intervention are essential to improve long-term outcomes and prevent complications.

To introduce minimally invasive methods for the successful treatment of tubo-ovarian abscesses (TOAs), an antibiotic regimen was considered the first line of treatment. However, in some cases, this approach fails, and another intervention (laparotomy or minimally guidance drainage) is required.

3 women with a history of long-time infertility, all of them were candidates for in vitro fertilization referred to the obstetrics and gynecology department with similar manifestations. For these 3 cases (30-40 yr) the first approach was a broad-spectrum antibiotic therapy. In 2 cases the last step in treatment was transvaginal ultrasound guidance drainage, and in one case laparotomy was done after antibiotic regimen failure; however, in all of 3 cases the best results were seen in transvaginal ultrasound guidance drainage.

Patients who have ovarian endometrioma and undergo an assisted reproductive technology cycle, as well as ovum pick up, increase the possibility of TOA occurrence in them. The use of transvaginal ultrasound guidance drainage approach for the treatment of TOA in selective cases, in addition to broad-spectrum antibiotics in patients might reduce their need for invasive treatment with laparotomy.

Oral infections have been seen in humans since ancient times. Excessive penetration of this infection can cause human death. Most of these infections are gum cysts and abscesses. The cyst creates large hard lumps in the gums, which is causes loose, and protruding teeth and abscesses, causing cavities in the jawbone and teeth. In this article, we have discussed for this infectious disease in 4000 – year - old ancient humans from Qazvin Province, Iran. The bone remains of our research are related to Sagezabad ancient cemetery in Qazvin plain.

We tried to use reliable international atlases to get detailed information about ancient oral infections. The bones were extracted from the 2019 excavation of the Ghara Tappe area of Sagezabad for the Iron Age 2nd and 3rd Qazvin plains of Iran. This cemetery belongs to the period of the Medes Kingdom (pre - Achaemenian kingdom) in Iran.

We have discussed one of the ancient cemeteries with a large number of ancient populations. In this cemetery, there are signs of war and infectious diseases on the bones, which can be clearly seen. We have specially mentioned the abscess as the cause of oral infection from Sagezabad cemetery.

Oral infection existed in Iran since 2000 BC. Of course, this infection was common in ancient times and even Paleolithic period, like Homo Heidelbergensis.

Extra-intestinal salmonellosis is associated with higher case fatality and is underestimated in the developing countries like India. Here we present a case series of bacteriologically proven extra-intestinal salmonellosis managed at our institute over the past two years.

Retrospective analysis of bacteriologically proven extra-intestinal salmonellosis over two years between January 2020 to December 2021 was carried out. Medical records were reviewed for site of infection, evidence of any underlying or predisposing illnesses and antimicrobial susceptibility report.

Eight patients were diagnosed with extra-intestinal salmonellosis. Male to female ratio was 3:1. Mean age was 44 years. Four were typhoidal and four were nontyphoidal Salmonellae. The extra-intestinal sites involved were purulent aspi- rates from scrotum, caecum, perianal region, intraperitoneal collection, synovium, and urine. Predisposing factors include chronic myeloid leukemia, HIV and gastric malignancy. All deep seated abscess required surgical intervention. All typhoidal Salmonella (n=4) were sensitive to cotrimoxazole, ampicillin, ceftriaxone. Among nontyphoidal Salmonella, one was resis- tant to cotrimoxazole; two were resistant to ampicillin, ceftriaxone and three resistant to ciprofloxacin.

The diagnosis of extra-intestinal salmonellosis requires a high degree of clinical suspicion and should be in- cluded in the differential diagnosis in patients with deep-seated abscesses.

Postoperative abscess after colpocleisis is rare. We reported a 67-year-old woman with an abscess after a month of Le Fort colpocleisis. Two abscesses of approximately 5 cm in size were drained. The injection of antibiotics continued up to 7 days after the surgery, and the drain was taken on the 4th day after the operation due to the improvement of the patient's general conditions and no discharge. It is recommended to consider pelvic abscess in patients suffering from fever, pain, pelvic pressure, and diarrhea after pelvic surgeries. Early diagnosis and treatment will reduce mortality and disability in patients.

The lingual abscess is rare due to several protective mechanisms against infection in this location. Concretely, the ab-scess in the base of the tongue (posterior lingual abscess) is even more exceptional. Its prompt detection is crucial toavoid potentially fatal airway complications. To familiarize physicians with this condition, we report 2 cases of posteriorlingual abscess. Both were referred to our emergency department due to minor oropharyngeal complaints. Finally, bothwere diagnosed and required surgical drainage. The clinical evolution was successful: both were discharged in less than72 hours and follow-up one week later confirmed clinical recovery.

Deep neck infection (DNI) is an infection that occurs in the deep neck fascia and spaces commonly found in diabetic patients. Impaired immune system due to hyperglycemic condition in diabetic patients leads to different clinical presentations, prognosis, and management and therapy in this group of patients.

We reported a case of deep neck infection and abscess in a diabetic patient that resulted in acute kidney injury and airway obstruction. We have done CT-scan imaging that supported the diagnosis of a submandibular abscess. Prompt and aggressive treatment of DNI with antibiotics, blood glucose control, and the surgical incision has exhibited a favourable outcome.

Diabetes mellitus is the most common comorbidity found among patients with DNI. Studies showed that hyperglycemia impaired bactericidal functions of neutrophils, cellular immunity, and complement activation. Aggressive treatment, including early incision and drainage of abscess, dental surgery to eradicate the source of infection, prompt, empirical antibiotic administration, and intensive blood glucose regulation, will result in favourable results without a prolonged hospital stay.

Nasal swab tests are widely used to screen for coronavirus disease 2019 (COVID-19). Pain, discomfort, and the urge to sneeze are the most common complications of this screening method. We report a case of a 55-year-old female patient with beta-thalassemia major suffering from a nasal septal abscess (NSA) as a complication of a COVID-19 nasal swab test. Following the test, the patient only had mild nasal congestion. However, three days later, her clinical condition deteriorated, and she developed fever, and her level of consciousness decreased to lethargy and drowsiness. Physical examinations revealed a bilateral nasal abscess. She underwent surgical intervention, and the abscess was removed. For the first time in Iran, a case of NSA after a COVID-19 nasal swab test is reported. It is strongly recommended to exercise caution while performing nasal swab tests, especially in the elderly and patients at risk of bleeding or hemoglobinopathy.

Anal abscess is considered as a relatively common compilation in type 2 diabetes mellitus (T2DM) patients. This study aimed to determine the risk factors of recurrent anal abscess in T2DM patients.

In this 4-year retrospective cross-sectional study, T2DM patients hospitalized due to anal abscess in Shahid Modar- res Hospital, Tehran, Iran from December 2016 to December 2020 were studied. The independent risk factors of disease recurrence were determined among demographic factors, underlying diseases, diabetes-related factors, clinical factors, laboratory parameters, abscess type, and culture using multivariate stepwise logistic regression analysis.

203 patients were enrolled in the study. 58 (28.6%) patients had at least one re-occurrence of anal abscess during four years. The recurrent episodes had occurred more frequently in the first year after the initial treatment (55.2%). The prevalence of comorbidities such as metabolic syndrome, coronary artery dis- ease, chronic kidney disease, end stage renal disease, and peripheral vascular disease was significantly higher amongst patients with abscess recurrence. The patients with recurrent anal abscess had statically significant poor glycemic control (HbA1C > 7.5), decreased levels of Estimated Glomerular Filtration Rate (e-GFR), and higher C-reactive Protein (CRP) upon the first admission. Presence of metabolic syndrome, HbA1c > 7.5%, WBC > 11.0 ×109/L, and CRP > 5 mg/l were amongst the independent risk factors of recurrence. HbA1c > 7.5% was the greatest independent risk factor of anal abscess recurrence (OR=2.68, 95% CI: 1.37-5.25; p < 0.001). The area under the receiver operating characteristic (ROC) curve (AUC) of HbA1C, CRP, and WBC in predicting the risk of abscess recurrence was 0.81, 0.71, and 0.64, respectively.

Th recurrence rate of anal abscess in this series was 28.6 %. It seems that in T2DM patients with uncontrolled diabetes who have metabolic syndrome and increased CRP and WBC in their routine tests, the probability of anal abscess reoccurrence is high

Retroperitoneal Abscess (RA) is a rare and often insidious disease, i.e., difficult to diagnose. RA could originate from different retroperitoneal or intra-abdominal organs. The disease manifests various clinical symptoms and is usually treated with a combination of antibiotics and therapeutic interventions.

Data from a total of 25 patients who were admitted to Loghman Hospital in Tehran City, Iran with a diagnosis of RA from 2010 to 2020 were reviewed in this research. Clinical findings, diagnostic tools, treatment approaches, and microbiology data were considered and analyzed.

Out of the 25 patients, the most frequent sources of RA were primary infections (36%), followed by gastrointestinal origin (20%). Fifty-two percent of patients presented no underlying disease; however, diabetes mellitus was the most prevalent underlying disease in the remaining ones. Fever, chills, and back or flank pain (56%) were the most common symptoms in the studied patients. Besides, a high erythrocyte sedimentation rate (mean: 93.58%) was found in most of the researched patients. Computed Tomography (CT) scan and Magnetic Resonance Imaging (MRI) could reliably diagnose the disease with an accuracy of 100% and 92.3%, respectively. Seventy-two percent of the study patients eventually underwent surgery. By taking advantage of CT scan, 24% of abscesses were drained and only 4% required medications to achieve remission. Mycobacteria and Klebsiella pneumonia were the most prevalent pathogens among the explored patients. The total mortality rate was equal to 12%; it occurred in cases with RA of a gastrointestinal (8%) or genitourinary (4%) origin.

There exist 3 major choices for treating abscesses, including surgery, image-guided percutaneous drainage, and medical therapy. Image-Guided drainage is recommended in primary infections; however, extra-peritoneal surgery is useful to treat secondary infections, especially those of a gastrointestinal source.

Heterotopic mesenteric ossification is a rare bone-like lesion located inside the abdominal cavity. Its etiology is unclear but most of the patients had a history of abdominal trauma or surgical operation.In this study, we present the case of a 29-year old woman admitted with acute abdominal pain and fever that underwent emergency laparotomy. She had a history of recurrent pelvic inflammatory disease and surgical appendectomy. During a laparotomy, a massive left tubo-ovarian abscess was seen and drained out. There was also a hard mass-like lesion measuring 2×1cm attached to the mesentery that was excised and sent for pathologic evaluation. The patient was discharged in good general condition.Microscopic evaluation of the mass in hematoxylin and eosin stained section revealed a structure consisting of bony trabeculae and fibroblastic proliferation.This case represents a rare simultaneous occurrence of mesenteric ossification with a ruptured tubo-ovarian abscess that due to a history of recurrent inflammatory disease introduce inflammatory prosess as a possible cause of heterotopic mesenteric ossification.

This study reports a 43 years-old man diagnosed with piriformis pyomyositis. A literature review was conducted by searching MEDLINE via Pubmed for English language case reports, published from 8th December 2019 to 20th January 2020. Patients' symptoms, laboratory tests, imaging, treatment, and other comorbidities were evaluated. Thirty-two cases diagnosed with piriformis pyomyositis, of which 21 patients developed piriformis abscess (including one new patient added by us) of which 52.4% were female, and the mean age was 26.98 ± 17.5. The most common manifestations were fever, lower back pain, and limited ambulation with increased ESR, CRP, or leukocytosis. Staphylococcus aureus was the most prevalent (57.14%) pathogen isolated. The authors suggested gynecologic manipulations, muscle overuse, and other co-infections as probable risk factors. However, we fail to find any association between these factors and abscess formation (p>0.05). Piriformis abscess should be regarded as a probable diagnosis in patients with gluteal pain, fever, and limited ambulation that have raised inflammatory markers or leukocytosis. MRI and CT scans are beneficial in diagnosing pyomyositis in early-stage. Full recovery is expected with timely antibiotic and surgical treatments.

Skin conditions are among the most common health problems worldwide and are associated with immense psychological, social, and financial burdens. Atopic dermatitis, alopecia, eczema, diabetic ulcers, and abscesses are common acute or chronic conditions, which are increasing dramatically in prevalence due to industrialization and unhealthy lifestyle habits. The use of complementary and alternative medicine to treat skin diseases has been increasing in recent years.

This review focuses on proposed skin conditions for leech therapy as mentioned by Avicenna, a great Iranian philosopher and physician (980-1037 AD)in the Canon of Medicine. Electronic databases including PubMed, Scopus, and Google Scholar were searched for clinical studies on treatment protocols in this book to compare them with recent clinical trials involving leech therapy.

Investigation of traditional Iranian medicine literature can lead to the identification of natural medicines for the management of skin problems. Leech saliva contains anti-coagulative, antiaggregative, and vasodilatory components.

In addition to the annelid’s mechanical ability to extract blood, leeches can contribute to patients’ health while posing minimal risks.

Urinary tract infection (UTI) is common in children and has many complications, but simultaneous occurrence of renal abscess and splenic abscess is rare.

In this case report, a 10-year-old boy with right flank, abdominal pain and high-grade fever was referred to Pediatric Nephrology Ward at Amirkola Childrenchr('39')s Hospital, northern Iran. In this patient abdominal ultrasonography revealed renal and splenic abscesses simultaneously. The patient was treated with kidney abscess drainage with the insertion of double-J (DJ) stent plus antibiotic therapy for about 4 weeks. An abdominal CT scan revealed complete cure and he was discharged with good condition.

Simultaneous occurrence of renal and splenic abscess should be considered in any patient accompanied with underline urinary tract obstruction.

Peritonsillar infection may emerge in two forms of abscess and cellulitis. Several factors could cause the disease, and effective treatments are required following the diagnosis. However, recurrence is likely after the treatment, threatening the health of the patients. Given the importance of this issue, the present study aimed to evaluate the cases of peritonsillar infection and some of the influential factors in 5th Azar Hospital of Gorgan, Iran during 2010-2017.

This cross-sectional, descriptive-analytical study was conducted by assessing the medical files of the patients with peritonsillar infection. The incomplete files were completed via phone call with the patients. Data analysis was performed in SPSS version 16.

In total, 93 patients were evaluated with the mean age of 32.31±14.59 years, and the majority of the patients were aged 20-30 years (33.31%). In terms of gender, 58.1% of the subjects were male, and the others (41.9%) were female. Peritonsillar abscess and peritonsillar cellulitis were detected in 76 (81.7%) and 17 cases (18.3%), respectively. In addition, significant correlations were observed between opium use, smoking habits, and abscess formation (P=0.014).

Considering the prevalence of peritonsillar infection and the possibility of recurrence after tonsillectomy, it is recommended that the necessary training be provided to the patients regarding the possibility of recurrence and surgery, especially upon discharge.