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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The use of radiolabelled antibiotics is fast emerging as a promising diagnostic test for the detection of infective lesions, because of their specific binding to the bacterial component. Ciprofloxacin is a broad-spectrum antibiotic that has been used as a radiolabelled antibiotic in both the diagnosis of infections in rabbits and in clinical trials on humans. The diagnosis of skeletal microbial infections remains a challenge, especially in orthopaedic patients with implants. We present a case report of a patient with undiagnosed and unrelenting pain in the lower third of the left leg, which had persisted for 6 months. A novel scintigraphy, which was developed in-house using a 99mTC ciprofloxacin single vial kit, was used for diagnosing the active bacterial infection. A 99mTC methylene diphosphonate bone scan was also performed to locate precisely the site of the lesion. Gradually increasing concentrations of both the radiotracers confirmed the presence of active bacterial infection in the distal third of the left tibia. Follow-up scanning after antibiotic therapy showed the disappearance of the pooling of 99mTC ciprofloxacin, indicating a good response. Therefore, 99mTC ciprofloxacin has good diagnostic and prognostic applications in deep-seated covert skeletal microbial infections. However, the persistence of a focal concentration detected by the 99mTC methylene diphosphonate scan was attributed to the inflammatory and not the infective pathology.
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PMID:Technetium-99m ciprofloxacin imaging in the diagnosis of postsurgical bony infection and evaluation of the response to antibiotic therapy: A case report. 1613 86

Complications of laser resurfacing include infections, scarring, hyperpigmentation, hypopigmentation, and delayed healing. Postoperative infections cause pain, prolonged healing, and can result in scarring. Ablative laser techniques cause partial- or full-thickness wounds, whereas so-called "nonablative procedures" may cause "spotty" epidermal wounds. Antibiotic prophylaxis is necessary when the risk for postoperative infection is significant or when the risk of infection is moderate but the consequences of infection are significant. Prophylactic antibiotic agents should have a broad spectrum of activity, be well-tolerated and be safe. The most appropriate choice is a broad-spectrum agent such as cefdinir, even for patients allergic to penicillin. Additionally, all patients should be treated prospectively with antivirals to prevent activation and dissemination of herpes simplex virus type I. Treatment of infections in patients who have and have not received prophylactic antibiotics requires identification of the causative factor and appropriate treatment. Nonablative treatments such as photodynamic therapy do not usually require antibiotic prophylaxis, although a few patients treated for acne may acquire a secondary bacterial infection that should be treated.
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PMID:Prophylaxis for and treatment of uncomplicated skin and skin structure infections in laser and cosmetic surgery. 1630 Feb 26

We report a case with recurrent orbital pain and unilateral cranial nerve paresis mimicking Tolosa-Hunt syndrome. However, these features were most likely caused by bacterial infection because of beneficial response to antibiotics therapy. A 32-year-old man developed severe right orbital pain and diplopia. Neurological examination revealed right oculomotor paresis and 1st division of the right trigeminal nerve dysfunction. MR imaging revealed thickness of right cavernous sinus region with marked gadolinium enhancement. Cerebrospinal fluid (CSF) examination was initially normal. Treatment with steroid showed marked improvement. However soon after tapering of steroid dosage, his symptoms recurred and deteriorated. He was referred to our hospital because of second opinion. Neurological examination still showed right oculomotor paresis and 1st division of the right trigeminal nerve dysfunction with orbital and retro-orbital pain. Re-examination of CSF showed pleocytosis with neutrocytes dominancy and elevated protein concentration. Intravenous treatment with penicillin was initiated with marked improvement. There have been reported cases with bacterial infection resulting pseudo Tolosa-Hunt syndrome, which have good response to antibiotics treatment with excellent prognosis. It is speculated that bacterial infection might cause clinical features mimicking Tolosa-Hunt syndrome in our case.
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PMID:[A case of pseudo Tolosa-Hunt syndrome with bacterial infection and literature review]. 1637 93

Necrotizing fasciitis (NF) is a potentially life-threatening bacterial infection of the skin, deep subcutaneous tissue, and fascia. Early symptoms may be misdiagnosed as cellulitis. A hallmark symptom that distinguishes NF from cellulitis is severe local pain that is out of proportion to the size and type of the wound present. Early diagnosis and treatment of NF is imperative for a patient's survival. This article describes the pathophysiologic mechanisms, clinical manifestations, and treatment of NF, as well as implications for perioperative nursing.
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PMID:Necrotizing fasciitis--the importance of early diagnosis and debridement. 1647 83

We here describe a case of multiple pyomyositis in a 62-year-old man who had systemic chemotherapy for recurrent lung cancer. His initial symptoms consisted of fever and general fatigue, followed by progressive pain and swelling in his extremities, which mimicked deep venous thrombosis along with bacterial infection. He was admitted to the hospital for intravenous administration of antibiotics. MRI appeared very useful to find the intramuscular fluid collections with circumferential inflammatory changes, which confirmed diagnosis of the multiple pyomyositis. Surgical drainage as well as intravenous administration of antibiotics worked very well and improved clinical symptoms in a few weeks after the treatments. He could resume normal activities with minimum functional impairments in the extremities. Pyomyositis should be kept in mind as one of the adverse effects after chemotherapy for malignant tumors.
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PMID:[A case of multiple pyomyositis after chemotherapy for lung cancer]. 1677 Jan 9

In the case reported, neurological complaints were pain and dysaesthesiae in the lower back and thigh, as well as paresis of the ileopsoas muscle. MRI of the lumbar spine showed an intradural-extramedullary mass at the level of L1 homogeneously enhancing with gadolinium. This mass was situated at the tip of an intrathecal catheter implanted 11 years before for a morphine trial infusion as therapy for phantom pain after amputation of the right arm. Now, removal of the catheter was performed. Cultures of lumbar CSF and the catheter tip demonstrated coagulase negative staphylococcus. Antibiotic medication with cephalosporines was given for 6 weeks. After removal of the catheter, the patient was free of pain and he progressively regained full neurological function. Although most catheter-associated granulomas reported so far were sterile in nature, bacterial infection should still be considered even years after catheter placement.
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PMID:Late bacterial granuloma at an intrathecal drug delivery catheter. 1679 32

Spondylodiscitis is a rare bacterial infection of the spine with an inflammatory, destructive course. To obtain further information on the therapeutic management and clinical course of spondylodiscitis, we retrospectively investigated 78 patients after surgical intervention. Mean age was 64 years (+/-4.6 years; range 21-80 years), the mean length of stay 49 days (+/-8.2 days; 3-121 days) including 24 days (+/-4.7 days; 0-112 days) in ICU. In hospital mortality was 9%. The cervical spine was affected in 10%, the thoracic spine in 35% and the lumbar/sacral spine in 55% of patients. Abscess formation occurred in 65% and destruction of the vertebral body in 74%. A total of 75% of patients presented with neurological deficits which could be improved by surgical intervention in 82% of cases. 24 patients were treated by ventral debridement and stabilization alone, 20 patients with a combined dorsoventral method. Most patients (n=34) were stabilized via dorsal bridging instrumentation without ventral debridement of the focus. Of this group, 23 patients were initially scheduled for secondary ventral debridement but complete healing was achieved prior to this, so further surgical therapy was unnecessary. Successful cure was obtained in 92% of cases. Based on our findings, we favor a split surgical approach: initially with dorsal internal fixation only. Abscesses can be drained percutaneously. Ventral debridement and stabilization is only recommended if insufficient stability can be obtained by dorsal fixation alone, as shown by the persistence of infection or pain.
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PMID:[Surgical management of spondylodiscitis. An analysis of 78 cases]. 1689 28

Prostatitis is a common medical diagnosis. The etiology of this symptomatic syndrome can be an acute or chronic bacterial infection, a noninfectious initiator (the most common cause), or iatrogenic heat or radiation; the syndrome may coexist with benign prostatic hyperplasia. Alpha-blockers have a role in the treatment of the prostatitis syndromes. In Category I, acute bacterial prostatitis, alpha-blockers have been shown to possibly ameliorate obstructive and irritative voiding symptoms. In Category II, chronic bacterial prostatitis, alpha-blockers seem to reduce the risk of clinical and bacteriological recurrence. In Category III, chronic pelvic pain syndrome, alpha-blockers improve symptoms and quality of life. Alpha-blockers also seem to ameliorate the symptoms and reduce the risk of acute urinary retention in patients who suffer from either heat- or radiation-induced prostatic inflammation. Alpha-blockers improve lower urinary tract symptoms, including pain, in patients who are diagnosed with both prostatitis and benign prostatic hyperplasia. Evidence has proven there is definitely a role for alpha-blockers in the management of the prostatitis syndromes.
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PMID:Alpha-blockers for the treatment of prostatitis-like syndromes. 1721 98

Herpes zoster is an infection caused by reactivation of the latent varicella virus in the sensory ganglia. The mechanisms responsible for Varicella zoster virus (VZV) reactivation are poorly understood. Yet, it is believed that decreased cellular immunity can be a trigger for it's reactivation. The occurrence of herpes zoster in young people may point to an underlying immunodeficiency. Therefore, the possibility of concomitant HIV infection must be eliminated. Herpes zoster manifests as a vesicular rash along a sensory dermatome, usually preceded by pain or paresthesia of the involved cutaneous area. The most commonly affected dermatomes are those of the thorax and abdomen, followed by the cranial nerves, especially the trigeminal nerve. The maxillary nerve is the least frequently affected branch of the trigeminal nerve and only rarely causes ocular injury. This is a case history of a young patient infected with VZV involving the maxillary branch of the trigeminal nerve, complicated by secondary bacterial infection of the ipsilateral hemiface. The literature regarding the epidemiology, pathogenesis, complications and the proper treatment of herpes zoster is reviewed with an emphasis on the involvement of cranial nerves.
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PMID:[Varicella zoster virus infection involving the maxillary branch of the trigeminal nerve]. 1735 73

The irritable bowel syndrome is the most frequent and most important functional bowel disease. It is characterized by a combination of abdominal pain, alterations of bowel habits (diarrhea, constipation) and meteorism. Probably, visceral hypersensitivity, motility disturbances, food intolerance, immunologic and microbiologic alterations and psychosomatic influences contribute to symptoms. In a relevant subgroup of patients the disease is triggered by bacterial infection. These patients usually have diarrhea-predominant disease. Irritable bowel syndrome can be diagnosed if typical symptoms are present and after relevant organic differential diagnoses have been excluded by selective biochemical investigations, abdominal ultrasonography and, if applicable, by colonoscopy. These diagnostic procedures are an important basis for therapeutic interventions and need to be complemented by clear information about the diagnosis and the benign long-term course of the disease. Medical therapy concentrates on treatment of predominant symptoms, i.e. pain, diarrhea, constipation and meteorism.
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PMID:[Therapy of functional bowel disorders]. 1736 33


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