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Biomedical subjects

Lorenzo Nanni

Publications and source records attributed to Lorenzo Nanni.

5 recordsLinked to original sources

Deep neck infection complicating lymphadenitis caused by Streptococcus intermedius in an immunocompetent child.

BACKGROUND: Streptococcus intermedius belongs to the Streptococcus anginosus group. It is part of the normal flora of the human mouth, but it can be etiologically associated with deep-site infections. CASE PRESENTATION: We present a case of deep neck infection complicating Streptococcus intermedius lymphadenitis, which developed in an immunocompetent 14-year-old boy with a history of recent dental work. The infection was ultimately eradicated by a combined medical and surgical approach. CONCLUSION: Our report suggests that combined medical and surgical therapy is essential for the complete resolution of deep infections caused by Streptococcus intermedius. Molecular biological techniques can be useful in guiding the diagnostic investigation and providing insight into the possibility of occult abscesses, which are particularly common with Streptococcus intermedius infections.

Adolescent↗

Complete epididymal separation presenting as polyorchidism.

We describe an unusual case of a 21-month-old boy with complete separation of the testis and epididymis. Two homogeneous structures were observed in the scrotum of a newborn boy in addition to a third structure. Polyorchidism was suspected, but follow-up sonographic studies showed a decrease in the echogenicity of the left scrotal structure. Surgical exploration revealed the testis and epididymis to be completely separated, with no duplicated testis. Orchidopexy was then performed.

Diagnosis, Differential↗

Cystic dysplasia of the rete testis associated to cryptorchidism: a case report.

A case of cystic dysplasia of the rete testis (CDRT) is reported. Nine months after right orchidopexy, a 10-year-old boy presented a palpable mass in the ipsilateral hemi-scrotum. Preoperative ultrasound showed a cystic lesion involving almost the whole testis. Radical orchidectomy was performed and at gross examination a hilar multiloculated cystic lesion was confirmed; microscopic examination showed cystic spaces lined by benign appearing monostratified epithelium with atrophy of the surrounding testicular parenchyma. These findings were consistent with the diagnosis of cystic dysplasia of the rete testis. Immunohistochemical investigation evidenced a pattern similar to that of a normal rete testis. Renal ultrasound and DTPA scintigraphy performed after pathological diagnosis documented the absence of the ipsilateral kidney. CDRT is a rare cause of scrotal swelling in the pediatric patient. When diagnosis is suspected, based on clinical and sonographic findings, conservative surgery may be considered.

Abnormalities, Multiple↗

Mortality and long term morbidity in esophageal atresia: the reduced impact of low birth weight and maturity on surgical outcome.

Progress in perinatal and postoperative techniques has reduced the prognostic role of traditional risk factors in esophageal atresia (EA). This paper reports on 75 cases of esophageal anomalies observed between 1992 and 2002 and followed after surgery from a minimum of six months to a maximum of ten years (mean five years). The impact on survival of birth weight, week of delivery, associated anomalies and need of ventilatory support at birth are discussed. Twenty-four patients were born before 37 weeks of gestation, 18 weighed less than 2000 g.; major anomalies affected 11 neonates, 23 cases required mechanical ventilation at birth. Seventy-four patients were operated on with a 90.6% survival rate; no deaths were related to surgical treatment. Three cases required reoperation for postoperative complications. Birth weight and week of delivery did not seem to influence outcome; this is affected by severe associated cardiovascular anomalies and the need of ventilation at birth. Follow up at 24 months on 51 patients, revealed respiratory problems in 12 cases and severe gastro-esophageal reflux in 16. This affected quality of life of EA patients and required long term medical attention; improvement with growth was observed. No correlation between perinatal conditions and late sequelae could be demonstrated in our series.

Birth Weight↗

Laparoscopic approach to müllerian derivatives in a male with mixed gonadal dysgenesis.

Müllerian derivatives are a frequent finding in patients with external genital ambiguity. In cases in which their removal is indicated, traditional surgical approaches are both invasive and associated with risks. We report a case of mixed gonadal dysgenesis in which a large prostatic utricle was successfully removed via laparoscopy.

Gonadal Dysgenesis, Mixed↗