William E. Wellman

Brain Abscess: A Review of Recent Experience

From 1961 through 1973, 60 patients with brain abscess were treated at the Mayo Clinic by surgical excision and antimicrobial therapy. The operative mortality was 17%, which was identical to a similar series reported in 1959. The patients who had the diagnosis of brain abscess confirmed at autopsy and who never underwent operation (24 patients) were more elderly than the group operated on, and a higher percentage had multiple brain abscess. Severe systemic disease or multisystem disease, or both, usually precluded a vigorous surgical approach among the nonsurgical group. Etiologic, diagnostic, and microbiologic factors were examined to develop an approach to antimicrobial therapy.

Salmonellosis Associated With Abdominal Aortic Aneurysm and Edema of Lower Extremities: Case Report

The incidence of infected aortic aneurysms with rupture can be expected to increase with the concomitant steady rise in the occurrence of both arteriosclerosis and salmonellosis.Although large elastic arteries are extremely resistant to infection, pathologic changes in a vessels wall may produce a suitable site for bacterial infection.The authors report a case of salmonellosis associated with infection in an abdominal aortic aneurysm that, preceding rupture, apparently had produced the rare complication of obstruction of the inferior vena cava and subsequent edema of the lower extremities.They also review the literature on salmonellosis, arteriosclerotic aneurysms, infection of aneurysms, and their complications.

LUDWIG'S ANGINA. CONCEPTS OF THERAPY, WITH REPORT OF A CASE.

Abstract A case of Ludwigs angina occurring in the course of a systemic hypersensitivity state has been presented. Presumably, a remission of the systemic disease was brought about by high doses of steroids. A brief historical review of Ludwigs angina was also presented, with emphasis on the changing concepts of therapy. It is our belief that establishment of an adequate airway by tracheotomy early in the course of the disease is mandatory. Control of sepsis can then be obtained by intensive antibiotic therapy. There is little rationale for the use of submandibular surgical incision or “decompression” of the phlegmon unless suppuration, which is a rare finding, supervenes.

Clinically Useful Antimicrobial Agents

The many new antimicrobial agents commercially available have created new problems for the clinician. This is the first in a series of five articles in which the authors consider the clinical application of the commonly used drugs and the problems involved in their use. Subsequent articles in this series will discuss the following aspects of antimicrobial therapy: part 2, dosage and mode of administration; part 3, untoward reactions; part 4, selection of regimen; and part 5, some current concepts of therapy.

Chronic Localized Brucellosis of the Spleen

Chronic localized brucellosis of the spleen possibly may exist as a clinical entity apart from detectable brucellar involvement of other reticuloendothelial organs. Apparently the infection may be restricted to the spleen in some cases, and antibiotic therapy may eradicate the infection in other organs but not in the spleen. Six cases are reported, and a series of 10 cases is reviewed.

Clinically Useful Antimicrobial Agents: 1. General Considerations

The many new antimicrobial agents commercially available have created new problems for the clinician. This is the first in a series of five articles in which the authors consider the clinical application of the commonly used drugs and the problems involved in their use. Subsequent articles in this series will discuss the following aspects of antimicrobial therapy: part 2, dosage and mode of administration; part 3, untoward reactions; part 4, selection of regimen; and part 5, some current concepts of therapy.