M Stillwell | PubMed Health

PubMed1996

Efficacy of nuclear scintigraphy in the diagnosis and management of sinusitis.

OBJECTIVE: The purpose of this study was to determine whether or not nuclear scintigraphy is useful in the diagnosis and management of chronic sinusitis. The ideal isotope(s) and drawbacks of the different isotopes in different clinical situations are reviewed and discussed. DESIGN: A retrospective review of patients undergoing nuclear medicine studies to aid in the diagnosis and management of sinus disease was carried out. METHOD: Ideal candidates were chosen from both previously operated and unoperated patients whose computed tomography (CT) scan findings could not differentiate benign mucosal thickening from active inflammation. Nuclear scintigraphy scans using indium (In-111), gallium (Ga-67), and technetium (Tch-99m) were used to differentiate acute infection from chronic inflammation involving bone (osteitis) and/or mucosa. This information was then used to guide the management of their condition. Nuclear scintigraphy results were compared to findings on CT scan and during surgery. RESULTS: In-111 was found to be the best isotope for identifying pus or acute disease in the sinuses whereas Ga-67 was very good for identifying both chronic mucosal disease as well as acute disease. Tch-99m was very sensitive for identifying bony remodelling and was therefore not found to be useful if the patient had undergone previous sinus surgery. CONCLUSION: Although not to be considered, in our view, a first-line diagnostic test, nuclear scintigraphy, is useful in cases where CT results are nondifferentiating.

Adult↗

PubMed1991

Posttraumatic meningococcal meningitis: case report.

A case is described of fulminant meningococcal meningitis occurring 1 day after serious head and facial trauma. Although meningococcus is one of the most common causes of bacterial meningitis in general, it is distinctly rare as a cause of posttraumatic meningitis. A review of the literature is included.

Adult↗

PubMed1989

The septic multiple-trauma patient.

Sepsis in the multiple trauma patient is being seen with increased frequency now that more of these patients are surviving the initial period. Traumatic destruction of tissue barriers, the placement of various tubes and drains, and surgical repair with debridement all provide conduits for colonization and infection with pathogens. Many components of the host immune system also become altered after trauma and surgery, predisposing this population to infectious complications. The site of infection can be cryptic in the moribund trauma patient; locating it may require many special diagnostic procedures. Continuing close surveillance is important to prevent or to identify infections at the earliest possible time. The liberal use of antibiotics should be discouraged so that development of resistant organisms and superinfection is kept to a minimum. Handwashing between patient contacts may be the most important prophylaxis against the spread of pathogens within a trauma unit.

Bacterial Infections↗

PubMed1988

The septic multiple-trauma patient.

Sepsis in the multiple trauma patient is being seen with increased frequency now that more of these patients are surviving the initial period. Traumatic destruction of tissue barriers, the placement of various tubes and drains, and surgical repair with debridement all provide conduits for colonization and infection with pathogens. Many components of the host immune system also become altered after trauma and surgery, predisposing this population to infectious complications. The site of infection can be cryptic in the moribund trauma patient; locating it may require many special diagnostic procedures. Continuing close surveillance is important to prevent or to identify infections at the earliest possible time. The liberal use of antibiotics should be discouraged so that development of resistant organisms and superinfection is kept to a minimum. Handwashing between patient contacts may be the most important prophylaxis against the spread of pathogens within a trauma unit.

Bacterial Infections↗