Pelvic inflammatory disease (PID) is one of the most commonly encountered serious infectious disease entities in gynecology. The past decade has witnessed many advances in our understanding of the pathogenesis of PID. It is now evident that such pelvic infections are largely polymicrobial in origin, with major involvement by anaerobic organisms. Salpingo-oophoritis is a part of the spectrum of PID. Included among this group of infections are tubo-ovarian abscesses, traditionally referred to as either gonococcal or non-gonococcal in origin. Within the latter group of infections the importance of anaerobic organisms has also been elucidated. Of particular interest is the reported observation of an increased frequency of salpingo-oophoritis among users of intrauterine devices (IUDs). These reports have noted the specific occurrence of serious pelvic infections due to Actinomyces species, and this will be the topic of the infectious disease conference. Our patient presented with a chronic illness characterized by lethargy, back pain, fever, and anemia; subsequently evaluation disclosed the presence of a large pelvic mass which was confirmed as a tubo-ovarian abscess at surgery. Histological evaluation demonstrated involvement by Actinomyces species. This patient's illness is discussed as a complication of chronic IUD usage with reference to specific management for this emerging problem.

Abscess↗

PubMedDate not supplied

Influence of head and neck position on endotracheal tube tip position on chest x-ray examination: a potential problem in the infant undergoing intubation.

Complications related to endotracheal tubes are frequent in small children and infants. We report a case of a burned 12-month-old child in whom frequent manipulation of the endotracheal tube was required because of recurrent atelectasis and changing position of the endotracheal tube on chest x-ray film. It was then determined that because of variations in head and neck position while chest x-ray films were obtained, the endotracheal tip changed position in the trachea greater than 2.7 cm (greater than 1 inch), although endotracheal tube position was maintained at the level of the teeth. Airway care and gas exchange were subsequently improved by ensuring that patient care and chest x-ray films were performed with the head and neck in similar (neck slightly flexed, head neutral) position.

Bronchial Spasm↗