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Raviprasad A, Pierre K, Kang D, Turetsky J, Thakkar R, Batmunh B, Quisling R, Rees J, Lanier L, Slater RM, Sistrom CL, Sharma PG, Rajderkar DA, Mancuso AA. An assessment of radiology resident competency in identifying suppurative retropharyngeal lymphadenitis: an examination using the WIDI SIM platform. Emerg Radiol 2024; 31:187-192. [PMID: 38340256 DOI: 10.1007/s10140-024-02210-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 01/29/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND AND PURPOSE Suppurative retropharyngeal lymphadenitis is a retropharyngeal space infection almost exclusively seen in the young (4-8 years old) pediatric population. It can be misdiagnosed as a retropharyngeal abscess, leading to unnecessary invasive treatment procedures. This retrospective study aims to assess radiology residents' ability to independently identify CT imaging findings and make a definitive diagnosis of suppurative retropharyngeal lymphadenitis in a simulated call environment. MATERIALS AND METHODS The Wisdom in Diagnostic Imaging Emergent/Critical Care Radiology Simulation (WIDI SIM) is a computer-aided emergency imaging simulation proven to be a reliable method for assessing resident preparedness for independent radiology call. The simulation included 65 cases across various imaging modalities of varying complexity, including normal studies, with one case specifically targeting suppurative retropharyngeal adenitis identification. Residents' free text responses were manually scored by faculty members using a standardized grading rubric, with errors subsequently classified by type. RESULTS A total of 543 radiology residents were tested in three separate years on the imaging findings of suppurative retropharyngeal lymphadenitis using the Wisdom in Diagnostic Imaging simulation web-based testing platform. Suppurative retropharyngeal lymphadenitis was consistently underdiagnosed by radiology residents being tested for call readiness irrespective of the numbers of years in training. On average, only 3.5% of radiology residents were able to correctly identify suppurative retropharyngeal lymphadenitis on a contrast-enhanced computed tomography (CT). CONCLUSIONS Our findings underscore a potential gap in radiology residency training related to the accurate identification of suppurative retropharyngeal lymphadenitis, highlighting the potential need for enhanced educational efforts in this area.
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Affiliation(s)
- Abheek Raviprasad
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA.
| | - Kevin Pierre
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Dahyun Kang
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Jordan Turetsky
- Department of Medicine, University of Florida College of Medicine, Gainesville, FL, USA
| | - Rajvi Thakkar
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Bayar Batmunh
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Ronald Quisling
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - John Rees
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Linda Lanier
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Roberta M Slater
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Christopher L Sistrom
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Priya G Sharma
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Dhanashree A Rajderkar
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
| | - Anthony A Mancuso
- Department of Radiology, University of Florida College of Medicine, PO Box 100374, Gainesville, FL, 32610, USA
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Yankov YG. The Etiological Bacterial Spectrum of Neck Abscesses of Lymph Node Origin - Gram-Positive and Gram-Negative Bacteria. Cureus 2023; 15:e46940. [PMID: 38021983 PMCID: PMC10640683 DOI: 10.7759/cureus.46940] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 12/01/2023] Open
Abstract
According to our medical practice as maxillofacial and oral surgeons, operated patients with purulent infections of the cervical lymph nodes are not many in number. On the other hand, the presence of a purulent infection requires not only the surgical evacuation of the pus but also the application of antimicrobial preparations. This necessitates good knowledge of the spectrum of the bacterial causative agents of the disease, the determination and analysis of which is the purpose of this original article. The bacteria studied in 181 patients with a mean age of 26.25 years, ranging between 29 days and 82 years, who underwent surgery for suppurating cervical lymph nodes, were retrospectively analyzed over a period of eight years. No bacteria were found in 69 of them. In 83 (74.11%) of the remaining 112 studied patients, the isolated microorganisms were of the gram-positive spectrum - Staphylococcus aureus (n=34), gram-positive resident microflora represented by more than one bacterial species (n=21), Staphylococcus hemolyticus (n=10), Staphylococcus epidermidis (n=9) and beta-hemolytic streptococci (n=9). Gram-negative bacteria were 25.89% (n=29) - Klebsiella pneumoniae (n=8), Bartonella henselae (n=7), Klebsiella oxytoca (n=6), Enterobacter cloacae (n=5) and Flavimonas oryzihabitans (n=3). No anaerobic and fungal microorganisms were isolated. Therefore, antimicrobial therapy in these patients should be directed against both gram-positive and gram-negative bacteria, which in our study were represented in a ratio of approximately three to one in favor of gram-positive microorganisms. Otherwise, we create a prerequisite for the formation of phlegmon on the neck, which hides real chances for the lives of patients.
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Affiliation(s)
- Yanko G Yankov
- Department of General and Operative Surgery, Medical University "Prof. Dr. Paraskev Stoyanov", Varna, BGR
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Selvam K, Ganapathy T, Najib MA, Khalid MF, Abdullah NA, Harun A, Wan Mohammad WMZ, Aziah I. Burden and Risk Factors of Melioidosis in Southeast Asia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15475. [PMID: 36497549 PMCID: PMC9741171 DOI: 10.3390/ijerph192315475] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/13/2022] [Accepted: 11/15/2022] [Indexed: 06/17/2023]
Abstract
This scoping review aims to provide a comprehensive overview of human melioidosis in Southeast Asia as well as to highlight knowledge gaps in the prevalence and risk factors of this life-threatening disease using available evidence-based data for better diagnosis and treatment. Preferred Reporting Items for Systematic Review and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) was used as the guideline for this review. The literature search was conducted on 23 March 2022 through two electronic databases (PubMed and Scopus) using lists of keywords referring to the Medical Subject Headings (MeSH) thesaurus. A total of 38 articles related to human melioidosis were included from 645 screened articles. These studies were carried out between 1986 and 2019 in six Southeast Asian countries: Thailand, Cambodia, Malaysia, Myanmar, Singapore, and Vietnam. Melioidosis has been reported with a high disease prevalence among high-risk populations. Studies in Thailand (48.0%) and Cambodia (74.4%) revealed disease prevalence in patients with septic arthritis and children with suppurative parotitis, respectively. Other studies in Thailand (63.5%) and Malaysia (54.4% and 65.7%) showed a high seroprevalence of melioidosis among Tsunami survivors and military personnel, respectively. Additionally, this review documented soil and water exposure, diabetes mellitus, chronic renal failure, thalassemia, and children under the age of 15 as the main risk factors for melioidosis. Human melioidosis is currently under-reported in Southeast Asia and its true prevalence is unknown.
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Affiliation(s)
- Kasturi Selvam
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Thanasree Ganapathy
- School of Health Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Mohamad Ahmad Najib
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Muhammad Fazli Khalid
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Nor Azlina Abdullah
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Azian Harun
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital Universiti Sains Malaysia, Jalan Raja Perempuan Zainab 2, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wan Mohd Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Ismail Aziah
- Institute for Research in Molecular Medicine (INFORMM), Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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