Periurethral Abscess in a Neonate

Singh, Uday Pal; Mahajan, Jai Kumar

doi:10.21699/jns.v6i3.561

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…The most common route of parotid gland infection is by retrograde bacterial flow from the oral cavity into the gland via Stensten's duct; however in some cases, parotitis occurs via hematogenous in the con text of sepsis 7,13 . In our case, the presence of purulent discharge and the absence of bacterial isolation in the blood culture supports the diagnosis of suppurative parotitis via retrograde route of the oral cavity.…”

Section: Discussionmentioning

confidence: 99%

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A common diagnosis in an uncommon age: acute neonatal parotitis case report

Gameiro,

Leuzinger-Dias,

Camacho-Sampaio

et al. 2023

PJP

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Acute neonatal parotitis is a rare disease, usually with a clinical diagnosis. Parotid swelling and other inflammatory signs are essential characteristics. Purulent discharge of Stensen's duct is pathognomonic of suppurative parotitis. Staphylococcus aureus is the most common pathogen, although other organisms may also be involved. We describe the case of a 10-day-old term newborn who presented with subtle preauricular swelling and erythema. In this case, the ultrasound was essential since obvious inflammatory signs and purulent drainage only occurred later, and there were no known risk factors. No microorganism was isolated since it was not feasible to collect an uncontaminated sample. Empiric antimicrobial therapy was initiated, with consequent clinical improvement. This condition should be considered in the differential diagnosis of parotid region swelling. Early suspicion, diagnosis and appropriate combined antibiotics are essential for a rapid and complicationsfree recovery.

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Section: Discussionmentioning

confidence: 99%

“…Cultures of blood and purulent material from Stensen's duct are useful for diagnosis and therapy guidance 15 . Breast milk culture should be performed when there is a history of mastitis or maternal breast abscess, as it may be the source of the infection 3,13 .…”

Section: Discussionmentioning

confidence: 99%

A common diagnosis in an uncommon age: acute neonatal parotitis case report

Gameiro,

Leuzinger-Dias,

Camacho-Sampaio

et al. 2023

PJP

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“…[4] The incidence of periurethral abscess is higher in men (Table 1), potentially because of a longer, more tortuous urethra, along with higher rates of stricture/stenosis, which may cause higher intraurethral pressure and subsequent epithelial disruption allowing progression of infection into the periurethral glands. [6] In women, an emerging trend of "sterile abscess" formation after transurethral injections of bulking agents for stress uri-nary incontinence represents a contemporary risk factor. [19] It is likely that correct injection technique is of paramount importance in reducing the potential for such presentations.…”

Section: Sex and Urethral Pathologymentioning

confidence: 99%

“…[2] Delayed detection and treatment may lead to complications such as urethral fistula, stricture, and, rarely, extensive cellulitis, or necrotizing fasciitis. [4][5][6] Historical mortality rates have been as high as 47% to 50% in the context of delayed presentations and consequent phlegmon formation. [7] It has been proposed that abscess formation is preceded by urethritis and associated with etiological factors such as urinary obstruction, trauma (including surgery and/or instrumentation), urethral diverticula, and urethral carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Periurethral abscess etiology, risk factors, treatment options, and outcomes: A systematic review

Tariq¹,

Stewart²,

Desai³

et al. 2022

Curr Urol

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ObjectivesThis study aimed to describe patterns of presentation, etiology, risk factors, management, and treatment outcomes of periurethral abscesses using a systematic review framework.Materials and methodsAfter prospective registration on the PROSPERO database (CRD42020193063), a systematic review of Web of Science, Embase, PubMed, and Cochrane scientific databases was performed. Articles published between 1900 and 2021 were considered. Extracted data included symptoms, etiology, medical history, investigations, treatment, and outcomes. Collated data were analyzed using univariate methods.ResultsSixty articles met the inclusion criteria reporting on 270 patients (211 male, 59 female) with periurethral abscess. The most common clinical features were pain (41.5%), pyuria (41.5%), dysuria (38.5%), urinary frequency (32.3%), fever (25%), and a palpable mass (23%). Predisposing risk factors included the presence of a sexually transmitted infection or urinary tract infection (55.0%), urethral strictures (39.6%), and recent urethral instrumentation (18.7%). Management approaches included open incision and drainage (64.3%), conservative management with antibiotics (29.8%), and minimally invasive techniques (needle aspiration, endoscopic drainage). Time trend analysis of etiology revealed a decreased incidence of infection (sexually transmitted infection/urinary tract infection, human immunodeficiency virus) and higher incidence of diabetes mellitus and periurethral bulking injections in recent years.ConclusionsPeriurethral abscesses may display a wide range of clinical features. Presentation, risk factors and underlying etiology vary with sex. The optimal management technique is guided by abscess size. Open incision and drainage combined with antibiotics continues to be the mainstay of management. However, minimally invasive techniques are gaining favor. To the authors' knowledge, this is the first systematic appraisal and management algorithm for periurethral abscess.

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