UNASSIGNED: An intramuscular abscess of the subscapularis is a rare phenomenon but important pathology for surgeons to be aware of because clinical deterioration can be rapid and diagnosis difficult. The presentation often mimics other common shoulder pathologies with subacute shoulder pain and stiffness. Early diagnosis, antibiotics and surgical drainage are critical to reduce the spread and joint destruction.
UNASSIGNED: A search of PubMed and Google Scholar databases identified cases of subscapular intramuscular abscess. Data collected about each case included patient demographics, presentation, pathology, surgical treatment and outcome. The authors report one additional subscapular abscess case.
UNASSIGNED: Data from 17 cases of subscapular abscess were found, 16 in the literature and one case described by the authors. Sixteen of 17 cases (94.1%) presented with shoulder pain and reduced range of motion worsening over a mean of 6.7 days prior to presentation. Surgical approaches utilised included a posterior inferomedial approach, deltoid-pectoral approach and one posterior inferolateral approach.
UNASSIGNED: From the limited data available regarding subscapular intramuscular abscess, the authors make the following recommendations: (1) Empirical antibiotics covering Staphylococcus aureus +/- methicillin-resistant Staphylococcus aureus, (2) drainage is indicated in all cases; and (3) tendon-sparing approaches can access an abscess in most locations within the subscapular space.

We investigated a skin abscess caused by Trueperella bernardiae in a patient with comorbidities. Initial empirical therapy with Clindamycin did not yield a response, and follow-up culture revealed the presence of T. bernardiae through MALDI-TOF and NGS. Since no CLSI or FDA breakpoints have been published for this strain, resistant gene screening of the genetic sequence showed the presence of the erm(X) gene (with 95 % identity). This gene confers resistance to erythromycin, clindamycin, lincomycin, pristinamycin, quinupristin, and virginiamycin. Subsequent therapy with oral amoxicillin/clavulanate led to complete healing.

BACKGROUND: Primary breast sarcoma (PBS), excluding phyllodes tumors, is an extremely rare and heterogeneous group of cancers, accounting for <1 % of all breast cancers. PBS is typically diagnosed in the fifth or sixth decades of life. There are no pathognomonic clinical or radiological features. Diagnosis is generally established through a microbiopsy. For young women, the diagnosis can be confused with a benign pathology.
METHODS: Our patient was 27 years old, with no family or personal history of breast cancer, which was initially brought to the emergency department with a breast abscess. The clinical diagnosis of abscessed mastitis was made. The patient underwent tissue excision with evacuation of blood clots and necrotic tissue. Histopathological examination revealed a primary breast sarcoma. An MRI showed locally advanced retro-glandular tumor. An abdominal and pelvic CT scan performed showed no evidence of secondary locations. Therefore, the patient was referred for neoadjuvant radiotherapy and chemotherapy. After the third course of chemotherapy, the patient died following cardiogenic shock.
CONCLUSIONS: The PBS in younger women is extremely rare. The etiopathogenesis remains undetermined. The clinical and radiological characteristics of PBS mimic breast adenocarcinoma. Mastectomy is the treatment of choice but in the case of locally advanced tumor, the use of neoadjuvant chemotherapy can be indicated. PBS presents a significantly poorer prognosis.
CONCLUSIONS: Breast sarcomas are rare malignant tumors for which treatment protocols are not well-established. Further research efforts are needed to improve the understanding and treatment of PBS.

Thyroid abscess is a rare entity, commonly experienced by immunocompromised patients, or those who have anatomical abnormalities or a pre-existing thyroid disease. An early diagnosis continued by treatment with antibiotics and drainage of the abscess is the recommended therapeutic strategy for such cases. The present study describes a clinical case of this rare event, and also provides a brief literature review. The present study describes the case of a 48-year-old healthy male with no medical antecedents, apart from acute prostatitis treated with antibiotics for 6 days prior, who visited the Emergency Department of the authors\' hospital with neck pain and progressive swelling of the mass. Diagnostic imaging confirmed the authors\' suspicion of an abscess and revealed the lesion displacing the airway to the contralateral side. This restricted the mobility of the neck of the patient. As an emergency measure, the patient was then taken to the operating room for a neck examination. A hemithyroidectomy was finally performed. Following a prolonged hospital duration, he was discharged from the hospital and his recovery was uneventful without any voice alterations, hypocalcemia or recurrence.

UNASSIGNED: Laparoscopic cholecystectomy (LC) represents one of the most commonly performed routine abdominal surgeries. Nevertheless, besides bile duct injury, problems caused by lost gallstones represent a heavily underestimated and underreported possible late complication after LC.
UNASSIGNED: Case report of a Clavien-Dindo IVb complication after supposedly straightforward LC and review of all published case reports on complications from lost gallstones from 2000-2022.
UNASSIGNED: An 86-year-old patient developed a perihepatic abscess due to lost gallstones 6 months after LC. The patient had to undergo open surgery to successfully drain the abscess. Reactive pleural effusion needed additional drainage. Postoperative ICU stay was 13 days. The patient was finally discharged after 33 days on a geriatric remobilization ward and died 12 months later due to acute cardiac decompensation.
UNASSIGNED: Intraabdominal abscess formation due to spilled gallstones may present years after LC as a late complication. Surgical management in order to completely evacuate the abscess and remove all spilled gallstones may be required, which could be associated with high morbidity and mortality, especially in elderly patients. Regarding the overt underreporting of gallstone spillage in case of postoperative gallstone-related complications, focus need be put on precise reporting of even apparently innocuous complications during LC.

BACKGROUND: Splenic abscess is a serious complication associated with infective endocarditis. There is still contradicting evidence regarding the optimal treatment pathway including timing of valve intervention and the approach for managing splenic foci.
METHODS: We present a case of a hybrid staged approach in which we successfully performed a laparoscopic splenectomy following percutaneous abscess drainage and a delayed aortic valve replacement.
CONCLUSIONS: A multidisciplinary teamwork is fundamental in providing optimal care for patients with distant complications associated with infective endocarditis. Our hybrid approach seems safe and feasible.

Surgically treated intracranial infections are among the common disease entities seen in neurosurgical practice. Several microbiological agents such as bacteria and fungi have been identified as responsible for intracranial infection. It affects all age groups, though microbial agents and risk factors vary with age. Presentation is non-specific and it requires a high index of suspicion, especially with a background febrile illness such as in the setting of poorly-treated meningitis and immunosuppressive conditions such as retroviral illness. Contrast-enhanced magnetic resonance imaging (MRI) scan is the diagnostic tool of choice; it helps to confirm the diagnosis and exclude other ring-enhancing lesions such as glioblastoma and metastatic brain tumours. Treatment involves medical and/or surgical treatment with clear indications. Surgical treatment includes the drainage of abscess via a twist drill or burrhole craniostomy, and craniotomy for recurrent cases. The advances recorded in the evolution of antibiotics and neuroimaging have helped to improve the outcomes of these patients with intracranial infection.
Les infections intracrâniennes traitées chirurgicalement font partie des entités pathologiques courantes rencontrées en pratique neurochirurgicale. Plusieurs agents microbiologiques tels que les bactéries et les champignons ont été identifiés comme responsables des infections intracrâniennes. Cela affecte tous les groupes d\'âge, bien que les agents microbiens et les facteurs de risque varient avec l\'âge. La présentation est non spécifique et nécessite un haut degré de suspicion, surtout en présence d\'une maladie fébrile sous-jacente, comme dans le cas d\'une méningite mal traitée et de conditions immunosuppressives telles que l\'infection rétrovirale. L\'imagerie par résonance magnétique (IRM) avec contraste est l\'outil diagnostique de choix ; elle aide à confirmer le diagnostic et à exclure d\'autres lésions à rehaussement annulaire telles que le glioblastome et les tumeurs cérébrales métastatiques. Le traitement implique un traitement médical et/ou chirurgical avec des indications claires. Le traitement chirurgical comprend le drainage de l\'abcès par une trépanation ou une craniostomie à trou de trepan, et la craniotomie pour les cas récurrents. Les progrès enregistrés dans l\'évolution des antibiotiques et de la neuro-imagerie ont contribué à améliorer les résultats de ces patients atteints d\'infections intracrâniennes. MOTS-CLÉS: intracrânien, infection, abcès, antibiotiques, chirurgie.

A deep neck abscess is a relatively rare bacterial infection in infants that can rapidly progress to life-threatening complications. Mostly, the patients present with fever and neck pain. Some may present with dysphonia, sore throat, torticollis, trismus, or neck swelling. Early diagnosis and management can prevent life-threatening complications, such as airway obstruction, mediastinitis, and tracheitis. In this report, we present a case of a six-month-old infant presenting with retropharyngeal and parapharyngeal abscesses with prompt diagnosis leading to complete recovery of the patient.

BACKGROUND: Vacuum sealing drainage is a novel technique for wound treatment that is characterized by adequate drainage and promotes wound healing. We report a case in which negative pressure sealing drainage was applied to treat a deep cervical abscess and achieved a good therapeutic effect.
METHODS: The abscess in the neck will go down.
METHODS: Deep neck abscess.
METHODS: The usual surgical approach to treating this condition is to make a small incision to incise and drain the patient infected area where it is most visibly swollen or fluctuating, and to place a negative pressure drainage device.
RESULTS: Eleven days after the operation, the patient neck recovered well, there was no infection in the operation area, and the patient was discharged from the hospital with improved symptoms.
CONCLUSIONS: This proves that the negative pressure closed drainage technique has potential in the treatment of deep neck abscesses and is also an effective choice in promoting wound healing, which is expected to bring better therapeutic effects to patients treated for deep neck abscesses.

BACKGROUND: Early diagnosis of muscular tuberculosis (TB) without coexistent active skeletal involvement is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of muscular TB, we present a case of multiple tuberculous muscle abscesses in a systemic lupus erythematosus (SLE) female, but without pulmonary tuberculosis (PTB), in order to increase awareness of and stress the need of early detection of muscular TB.
METHODS: A 44-year-old woman with a 6-year history of SLE who had been treated with methylprednisolone for a long time complained of erythema on her trunk and extremities for five months, along with edema and myalgia for two months, and fever for one month. The patient was first misdiagnosed as SLE overlap dermatomyositis. However, an ultrasound-guided drainage of muscle abscesses revealed positive acid-fast staining combined with positive deoxyribonucleic acid fragment of Mycobacterium tuberculosis using metagenomic next-generation sequencing (mNGS). The patient was cured and released following standard anti-tuberculosis medication, local puncture drainage, and an intravitreal injection of streptomycin. Literature search found only 19 cases of tuberculous muscle abscesses occurring in the extremities reported from 1999 to 2023.
CONCLUSIONS: Extrapulmonary TB with predominantly muscle involvement is rare and with no specific clinical presentation. Muscular tuberculosis may be disdiagnosed for dermatomyositis due to the high muscle enzyme levels, delaying diagnosis and treatment. mNGS technology is helpful in the early and rapid diagnosis of muscular TB. On the basis of traditional anti-tuberculosis treatment, an ultrasound-guided percutaneous puncture drainage and intracavitary injection of streptomycin for the treatment of tuberculous muscle abscess is easy to operate, safe and effective, which is worthy of clinical popularization and application.