MMed (Otorhinolaryngology), Faculty of Health Sciences, University of the Witwatersrand / HIV/AIDS continues to be an important public health challenge in sub Saharan Africa. It is estimated that approximately 68% of people living with HIV in the world are from this region [1]. South Africa has the largest infected population in the world, the adult (15-49 years) HIV prevalence is estimated at 17.64% [2]. It has been estimated that 40 - 70% of such HIV positive individuals present with head and neck manifestations, which include infection, inflammation and tumours, and are often the only and initial presenting sign [3,4]. Peritonsillar abscess is the most common deep infection of the head and neck in young adults and can occur in all age groups, but the highest incidence is in adults 20 to 40 years of age [5]. The aim of this study was to assess the relationship between peritonsillar abscess and the HIV status of patients. Method: An analytical cross sectional study utilising retrospective clinical data from ward registers, patient records, treatment registers and National Health Laboratory System (NHLS) databases. This study was conducted in the adult ENT ward at the Chris Hani Baragwanath Hospital and sample consisted of patient records over a 4 year period from January 2005 to December 2008. All patients admitted to the ENT ward with the discharge diagnosis of peritonsillar abscess that have been tested for HIV were included in this study. In this study period 450 patient files were reviewed of which 291 fulfilled the inclusion criteria. The demographic details, clinical presentation which included head and neck manifestations of HIV, the HIV status, management and complications of peritonsillar abscess were recorded. This data was analysed using STATA-10 software. Results: The age ranged from 15 to 63 years with a mean (SD) 29.3 years (9.58). From the 291 patients, 86 (29.55%) were HIV positive. This is significantly higher than the adult (15-49years) HIV prevalence rate of 17.64% [6]. The male: female ratio of HIV positive patients 1:1.53. Forty-nine (16.84%) patients presented with cervical lymph nodes of which 65.31% were HIV positive (P< 0.001). From the 86 HIV positive patients oral candida was present in 15.12% (P<0.001), lymphoma in 6.98% (P<0.001), oral hairy leukoplakia in 2.33%, Kaposi’s sarcoma in 1.16% and complications (parapharyngeal abscess) 3.48%. There was no statistical significance in the management of HIV positive patients, however hospital stay was longer with a mean of 3.802 days (P<0.001). From this study sample the HIV prevalence of 29.55% suggests that peritonsillar abscess may be an early clinical marker of HIV infection. Due to the high incidence of head and neck manifestations in HIV positive patients identifying a clinical marker (quinsy) in the earlier stages of HIV infection would allow for better screening, earlier diagnosis and treatment of HIV infection.

Thesis (M.S.)--University of Wisconsin--Madison, 1967. / eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

The purpose of this study was to find out the causative organism of bovine hepatic abscess; the characteristics of this etiological agent, particularly its immunogenic capacity, and to determine the degree of immunity conferred by vaccination of laboratory animals. Sixty-seven liver abscesses were collected from cattle at slaughter, from 55 of which Sphaerophorus necrophorus was isolated in pure culture. In another 7, it was shown to be present in combination with other organisms. The morphological, cultural and biochemical characteristics of this organism have been studied. The abilities of various media to support growth, form filaments, reduce lag phase, and increase the stationary phase, have been studied. The effects upon growth of other contributory factors, such as dose of inoculum, age of the seed culture, pH of the medium, temperature of incubation have also been investigated. An attempt was made to immunize 13 rabbits and 7 guinea pigs by inoculating killed organisms. When challenged by the intravenous route with living culture, all the vaccinated animals resisted 7½ M.L.D., but succumbed to 15. In rabbits, intravenous inoculations of washed suspension of the organism produced a higher titre of agglutinins than the subcutaneous inoculations of heated whole culture. Rabbits with titres of 1:20,000 did not show any more immunity than those with 1:2500. The sera of cattle with hepatic abscess showed in general slightly higher agglutination titres than those free from abscess. However, this difference was on the whole slight. Hence, it is concluded that the agglutination test cannot be employed in the diagnosis of necrobacillosis. Judging by the cross-agglutinability, and despite some evidence of complex agglutinogenic structure, it was concluded that the various strains studied belong to one fairly homogeneous group. Two types of agglutinations, granular and floccular, were found to occur, depending on the average length and age of the organism used in the test. It was observed that the site of coherence which may correspond with the site of adsorption of the agglutinins is situated terminally or subterminally in both filaments and rods. / Science, Faculty of / Microbiology and Immunology, Department of / Graduate

Thesis (M.Sc.(O.T.), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Studies of patients presenting with brain abscess (BA) and Empyema are not routinely focused on occupational therapy (OT). There is a paucity of literature on deficits other than hemiplegia. Aims of this study were to determine the relationship between BA, Empyema, motor and other deficits and whether an OT intervention protocol is needed. Record review was used to establish clinical presentation trends. Hemiplegia was the most common motor deficit and the majority scored below the norm on the Beery- Buktenika Developmental Test of Visual Motor Integration (VMI). Patients with Brain Abscess generally had more significant deficits than those with Empyema for both motor and process deficits. Part B followed up a small sample (n=8) which indicated clinical improvement on the VMI test with the score on the supplemental test of motor coordination remaining a concern. Occupational Therapy is recommended to address these issues based on the Occupational Therapy Practice Framework-II.

Abscesses developing within the retroperitoneal spaces are complicated and serious infections. These abscesses present insidiously, leading to considerable mortality and morbidity. A high clinical suspicion can help diagnose and treat this potentially fatal illness. Computed axial tomography is the best diagnostic modality for retroperitoneal abscess. Computed tomographic scan is useful, not only for diagnosing the retroperitoneal abscess, but can be used for therapeutic drainage of abscesses in high-surgical-risk patients. We present an illustrative case of retroperitoneal abscess and discuss the pathogenesis of retroperitoneal abscess, diagnosis, and treatment.

No description available.

No description available.

Over a four month period from 1 st November 1998 to 28th February 1999 a randomised prospective study was undertaken in 75 patients with peritonsiller abscess (PTA) to determine the treatment modality that is most effective in alleviating the excruiating pain and discomfort associated with the condition. The patients were divided into three treatment groups. There were 25 patients in each group. Group A patients were treated with intravenous antibiotics and intra muscular opiates, Group B aspiration and oral antibiotics and Group C incision and drainage and oral antibiotics. Pain relief was objectively assessed with each treatment modality by measuring the upper to lower incisor distance, 15 mins, 24 hours and 48 hours and oral intake at 2 hours, 24 hours and 48 hours after the initial treatment. The improvement of the mean upper to lower incisor distance 15 minutes after the initial treatment was 5% in Group A, 38% in Group B and 100% in Group C. Twenty four hours later the improvement was 30% in Group A, 111 % in Group B and 125% in Group C. None of the patients in Group A were able to take fluid orally at 2 hours. Only 2 patients (8%) could in Group B and 23 patients (92%) in Group C. 24 hours later, 15 patients (60%) could take fluid orally in group A, 19 (76%) in group B and 25 (100%) in group C. Treatment failures were those patients in whom the trismus, odynophagia and pyrexia failed to subside after 48 hours. There were 8 patients (30 per cent) in group A, 6 (24%) in group B and none in Group C. The 14 failures were successfully treated with incision and drainage. The conclusion derived from this study is that incision and drainage is superior to intravenous antibiotic and aspiration in alleviating the pain and discomfort associated with peritonsillar abscess. / Thesis (M.Med.)-University of Natal, 1999.

Master of Science / Department of Animal Sciences and Industry / James S. Drouillard / Since the 1960’s liver abscess incidence and severity have been identified as a problem associated with feeding high concentrate finishing rations to feedlot cattle. Liver abscesses lead to decreased feedlot performance and decreased carcass value. Tylosin phosphate is a macrolide antibiotic commonly used by feedlots throughout the United States and has been shown to successfully control liver abscesses. In 2013, the FDA issued Guidance for Industry #213, which encourages reduced usage of medically important classes of antibiotics, such as macrolides, in animal feed. This will be achieved by implementing veterinary oversight of these drugs via Veterinary Feed Directives (VFD). Thus, it is of importance to find alternative strategies to reduce usage of tylosin in finishing rations to control liver abscesses. One strategy that has been suggested is increasing dietary roughage concentration. However, this isn’t a viable option as increasing dietary roughage concentration not only leads to a decline in feedlot performance, hot carcass weight, and dressing percentage, but also has an environmental impact. Available research has also indicated that increasing dietary roughage has no impact on liver abscess incidence or severity. Our research objective was therefore to identify alternative strategies to reduce liver abscess incidence. Our first trial evaluated the impact of antioxidants on liver abscess incidence and severity. Treatments consisted of a control treatment (basal diet containing 200 IU/d α-tocopherol acetate), and an antioxidant treatment (basal diet containing 2000 IU/d α-tocopherol acetate and 500 mg/d crystalline ascorbate). Treatments were randomly assigned to 390 crossbred heifers. No differences in feedlot performance were detected; however, there was a tendency for improved feed intake (P = 0.075) and feed efficiency (P = 0.066) for heifers that received the antioxidant treatment. An increased number of yield grade 3 carcasses (P = 0.03) and fewer yield grade 1 carcasses (P < 0.01) was observed in the antioxidant treatment group. No differences were detected between treatments for other carcass characteristics or liver abscess incidence and severity. Another trial evaluated intermittent tylosin feeding and its impact on liver abscess incidence and antimicrobial resistant Enterococcus spp. when compared to continuous tylosin feeding. One of 3 treatments were randomly assigned to 312 crossbred steers: negative control (no tylosin fed throughout the feeding period); positive control (tylosin fed throughout the feeding period); or intermittent treatment (tylosin fed intermittently throughout the feeding period: 1week on, 2 weeks off). Fecal samples were collected on day 0, 20, and 118 to characterize antimicrobial resistant Enterococcus spp. By design, the intermittent treatment consumed 60% less tylosin than the positive control group. No differences were detected between treatments for feedlot performance. Liver abscess incidence was greatest for the negative control, and least for the positive control and intermittent treatments, with no difference being detected between the latter two treatments (P = 0.716). Antimicrobial resistance was unaffected by treatment, but was affected by sampling time. We concluded that supplementing antioxidants is not a viable option to reduce liver abscess incidence and severity, and that tylosin usage can be decreased without adversely affecting performance or liver abscess incidence.

Objectives: Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent Streptococcus intermedius brain abscess. Case presentation: The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.3 × 1.0 × 1.2 cm right frontal parasagittal mass culture-positive for S. intermedius. Neurologic symptoms were unmasked once insulin treatment was initiated and ketosis improved, supporting the relationship between therapeutic ketosis and the management of medication-refractory epilepsy. Conclusions: This case both supports the relationship between therapeutic ketosis and the management of medication-refractory epilepsy and highlights the need to carefully consider comorbid conditions in patients with DKA and new onset neurological symptoms.