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Related Concept Videos

Acute Pyelonephritis I: Introduction01:27

Acute Pyelonephritis I: Introduction

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Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
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Acute Pyelonephritis II: Diagnostic Studies and Management01:28

Acute Pyelonephritis II: Diagnostic Studies and Management

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Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
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Acute Pancreatitis II: Clinical Manifestations and Management01:30

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Acute pancreatitis presents a complex medical emergency characterized by rapid onset inflammation of the pancreas, demanding timely diagnosis and management to prevent complications. The condition primarily manifests through severe upper abdominal pain that often radiates to the back. This pain intensifies following the consumption of fatty foods. Accompanying symptoms such as nausea, vomiting, abdominal distention, fever, dyspnea, cyanosis, and jaundice can vary in intensity but significantly...
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Aneurysm II: Clinical Manifestations and Diagnostic Studies01:21

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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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Endocarditis II: Clinical Features of Infective Endocarditis01:25

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Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...
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Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations01:26

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Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
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Medullary abscess: a rare clinical presentation.

Pavels Muranovs1, Claire Gillon2, John Norris2

  • 1Neurosurgery, Royal Sussex County Hospital, Brighton, UK pavels.muranovs@nhs.net.

BMJ Case Reports
|March 13, 2020
PubMed
Summary

Brainstem abscesses, often fatal if untreated, are rare infections. Prompt diagnosis and surgical intervention for brain abscesses, like this medullary case from dental infection, are crucial for patient survival and recovery.

Keywords:
adult intensive carebrain stem / cerebellumcranial nervesinfection (neurology)neuroimaging

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Area of Science:

  • Neurology
  • Neurosurgery
  • Infectious Diseases

Background:

  • Brain abscesses are localized brain infections, with brainstem abscesses being rare and typically fatal if untreated.
  • Streptococcus intermedius is a frequent cause of brain abscesses, leading to significant patient morbidity.

Observation:

  • A case report details a 68-year-old patient with a medullary abscess secondary to a dental infection.
  • The patient exhibited symptoms including headaches, flu-like illness, left hemiparesis, and declining consciousness and bulbar function.

Findings:

  • Emergency posterior fossa craniectomy and abscess drainage were performed, followed by antibiotic treatment.
  • The case highlights the importance of prompt diagnosis and early surgical intervention in managing brain abscesses.

Implications:

  • Effective management requires a combination of early surgical intervention, maximal antibiotic therapy, and comprehensive rehabilitation for optimal neurological outcomes.
  • Medical practitioners must consider brain abscesses in patients with rapidly worsening neurological deficits, necessitating urgent neuroimaging and neurosurgical consultation.