Clinical analysis in diagnosis and treatment of serious pyogenic infection in deep neck / 上海第二医科大学学报

Objective To explore the clinical features,diagnosis and treatment of serious pyogenic infection in deep neck. MethodsFrom January 2002 to April 2005,the clinical data of 22 patients hospitalized with serious pyogenic infection in deep neck were collected and retrospectively analysed. Results All the patients suffered unilaterally.Besides the symptoms of infection,dyspnea,pain in swallowing,limitation of mouth opening and progressive limitation of cervical activity were presented.Bacterial cultivation were performed in 14 patients and positive results were detected in six.Fourteen of all the 22 patients were cured with antibiotics,and abscess incision drainage was carried out in the other eight.Preoperative cervical PA-LAT X-ray photography and contrast-enhanced CT scanning were performed on one and seven patients,respectively,all of which indicated the formation of abscess.All the patients were cured except one who died of cerebral infarction and multiorgan dysfunction. Conclusion Imaging evaluation plays a significant role in the preoperative diagnosis and systemic treatment of serious pyogenic infection in deep neck.Bacterial cultivation provides reliable evidence for the etiopathogenisis and helps to make the effective treatment.

MRI Diagnosis of the Pyogenic Infection in Gluteus Muscles / 实用放射学杂志

Objective To explore the applied value of MRI in diagnosing pyogenic of infection of gluteus muscles.Methods MRI data in 9 cases with pyogenic infection of gluteus muscles proved by operation or biopsy were retrospectively analysed by comparison with the pathological diagnosis.Results The pyogenic infections localized at unilateral gluteus muscles involving single,two or three gluteus muscles in all cases.On MRI,the infective gluteus muscles were swelling diffusely and the infections developed along the long axis of the muscles and most or all gluteus muscles were involved.4 cases appeared as suppurative myositis and 5 cases developed typical abscess.4 cases were accompanied with subcutaneous edema and the abscess broken into skin in one case.Conclusion The pathological characteristics of the stage and extent of the pyogenic infection in gluteus muscles can be displayed by MR imaging.

Pyogenic Sacroiliac Joint Infection / 대한정형외과학회잡지

Sacroiliac joint infection is relatively rare and difficult in differential diagnosis with other spinal disorders. Delay in diagnosis is frequent which causes an increased morbidity. The authors reviewed clinical courses of the patients who were treated for pyogenic sacroiliac joint infection from January 1985 to April 1997. Investigation included physical examination, bone scan, biopsy, ESR, plain radiography, CT scan, and MRI. The diagnosis was made on clinical findings and a positive results of the above investigation. There were 17 pyogenic arthritis. Six patients had all symptoms of triad(fever, unilateral buttock pain, limping gait) and fifteen patients had typical buttock pain. Increased ESR(>20mm/hr) was noticed in fourteen patients. In all seventeen cases, skeletal scintigraphy and Gaenslen test were positive. Also CT scan and MRI study were helpful in diagnosis of the sacroiliac joint infection. Pus culture could be done in twelve cases and staphylococcus aureus was found in seven cases. Conservative treatment was performed in eleven cases, and operation in six cases. Fifteen cases were recovered and two cases relieved.

Primary Infections Disorders of the Spine:Report of 40 Cases

Although the prevalence of infectious disorders has been decreased, tuberculous infections are still common in this country. Therefore epidemiological data for the correct diagnosis of some spinal infections and proper selection of susceptible antibiotics are necessary. We presented a series of 40 patients with primary spinal infection dated from January 1990 to December 1994. Tuberculosis was the most common infection constituting 85% of this series, while pyogenic infection constituted only 10%, and primary discitis shared 5%. In a half of the tuberculous spondylitis, there were histories of previous tuberculosis except the vertebrae. We could identify the pathogenic organisms in only 47.5% o the cases(in 4 of 6 pyogenic infection and 15 of 34 tuberculous infection). Since it is difficult to differentiate the pyogenic and tuberculous infections by clinical or radiological features alone, some pyogenic infections might have been regarded as tuberculous, although the pyogenic spinal infections are rare. Nevertheless the tuberculous spinal infection outnumbered pyogenic ones in this country, which is similar to the patterns of other third-world countries. Therefore, correct identification of the microbial agent is important not only for the proper treatment but also to evaluate the patients of primary spinal infections in this country.