ABSTRACT
Bioprosthetic valves are implanted in elderly patients with good follow up results. The degeneration of these valves is slow and there are multiple aetiologies for that. It is unclear whether renal failure accelerates the degeneration of bioprosthetic valves in patients with normal calcium levels. We present a case with tissue valve degeneration 16 months postoperatively in a patient with renal failure.
Subject(s)
Aortic Valve Stenosis , Aortic Valve/pathology , Bioprosthesis/adverse effects , Calcinosis , Heart Defects, Congenital , Heart Valve Diseases , Heart Valve Prosthesis/adverse effects , Postoperative Complications/pathology , Aged , Aortic Valve/surgery , Aortic Valve Stenosis/etiology , Aortic Valve Stenosis/pathology , Bicuspid Aortic Valve Disease , Calcinosis/etiology , Calcinosis/pathology , Female , Heart Defects, Congenital/pathology , Heart Defects, Congenital/surgery , Heart Valve Diseases/pathology , Heart Valve Diseases/surgery , HumansABSTRACT
Descending necrotizing mediastinitis is a rare complication of upper respiratory infections. A quick diagnosis and prompt and complete surgical drainage is important for a successful outcome. A 74-year-old man with descending necrotizing mediastinitis needed a sternotomy, multiple washouts, and delayed sternal closure.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Mediastinitis/therapy , Peritonsillar Abscess/therapy , Retropharyngeal Abscess/therapy , Sternotomy , Taurine/analogs & derivatives , Thiadiazines/administration & dosage , Wound Closure Techniques , Aged , Combined Modality Therapy , Drainage , Empyema, Pleural/diagnosis , Empyema, Pleural/microbiology , Empyema, Pleural/therapy , Humans , Male , Mediastinitis/diagnosis , Mediastinitis/microbiology , Necrosis , Peritonsillar Abscess/diagnosis , Peritonsillar Abscess/microbiology , Retropharyngeal Abscess/diagnosis , Retropharyngeal Abscess/microbiology , Taurine/administration & dosage , Therapeutic Irrigation , Time Factors , Tomography, X-Ray Computed , Treatment Outcome , Wound HealingABSTRACT
BACKGROUND: Septic arthritis of the knee joint requires prompt diagnosis and treatment for optimal outcomes. Pyomyositis with abscess formation is uncommon but may present with similar symptoms in the vicinity of a joint. OBJECTIVE: This report describes two cases of medial thigh abscess initially diagnosed and treated as septic arthritis, and highlights the need to make an accurate diagnosis. CASE REPORT: Two patients presenting with knee pain secondary to pyomyositis and abscess formation in the medial thigh were investigated with aspiration and treated subsequently with knee surgery, resulting in contamination of the knee joint in one case and delayed diagnosis with significant morbidity in both. CONCLUSION: Failure to identify a soft tissue infection may lead to delayed diagnosis, misdirected treatment, and contamination of a normal joint. Diagnosis is best confirmed with thorough physical examination and specific imaging where available.
