MedWorm: Osteomyelitis

Woman gets artificial jawbone transplant

NHS News Feed — Tue, 07 Feb 2012 18:00:00 +0100

An 83-year-old woman has been implanted with the world’s first “3D printer-created jaw”. Using cutting-edge laser manufacturing techniques, doctors and metal experts were able to build up layers of titanium to form a custom metal jawbone to exactly fit her face. The metal jawbone was then inserted into her lower jaw, replacing a large section of bone that was destroyed by a chronic infection. The technique of 3D printing has been used to build prototype products for some time, but in recent years scientists have begun experimenting with the medical possibilities offered by the process. In this case, a specialist metalwork company called Layerwise was able to translate 3D bone scans into a custom jaw. The company had previously used the process to make bone-shaped prostheses and denta...

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Actinomycetoma of the chest wall attributed to Nocardia nova after reconstructive surgery.

Dermatol Online J — Mon, 06 Feb 2012 12:54:18 +0100

Authors: Antunes J, Pacheco D, Travassos R, Sequeira H, Filipe P, Marques MS Abstract A 29-year-old man, presented with multiple ulcers, nodules, abscesses, fistulae, and atrophic scars, over the right chest wall. Six years prior, the patient had a car accident, which resulted in skin loss of the right arm, shoulder, thoracic wall. In addition, he suffered a supracondylar fracture; orthopedic surgery and skin grafts were required. Material discharging from sinus tracts was obtained for mycological and bacteriological studies. Direct microscopic examination revealed small white grains. Cultures on Sabouraud and Lowenstein-Jensen media isolated orange-white colonies suggestive of Nocardia. PCR assay identified Nocardia nova. Thoracic and right upper limb CT showed signs of chronic os...

Enhancing Braden pressure ulcer risk assessment in acutely ill adult veterans

Wound Repair and Regeneration — Fri, 03 Feb 2012 05:00:00 +0100

This study sought to determine if a parsimonious pressure ulcer (PU) predictive model could be identified specific to acute care to enhance the current PU risk assessment tool (Braden Scale) utilized within veteran facilities. Factors investigated include: diagnosis of gangrene, anemia, diabetes, malnutrition, osteomyelitis, pneumonia/pneumonitis, septicemia, candidiasis, bacterial skin infection, device/implant/graft complications, urinary tract infection, paralysis, senility, respiratory failure, acute renal failure, cerebrovascular accident, or congestive heart failure during hospitalization; patient's age, race, smoking status, history of previous PU, surgery, hours in surgery; length of hospitalization, and intensive care unit days. Retrospective chart review and logistic regression a...

Staphylococcus aureus Reactivation Osteomyelitis after 75 Years

New England Journal of Medicine — Wed, 01 Feb 2012 22:00:16 +0100

New England Journal of Medicine, Volume 366, Issue 5, Page 481-482, February 2012. (Source: New England Journal of Medicine)

Isolated tubercular scaphoid osteomyelitis: a case report

Orthopaedic Surgery — Wed, 01 Feb 2012 05:00:00 +0100

(Source: Orthopaedic Surgery)

Aortic Endograft Infection With Aortoduodenal Fistula Associated With Adjacent Vertebral Body Mycobacterial Osteomyelitis (Pott's Disease)

Annals of Vascular Surgery — Wed, 01 Feb 2012 05:00:00 +0100

Aortoenteric fistulas (AEFs) are a rare complication of infrarenal abdominal aortic aneurysm repair. They occur in (Source: Annals of Vascular Surgery)

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Calcaneal osteomyelitis due to Achromobacter xylosoxidans: a case report

Journal of Infection and Chemotherapy — Mon, 30 Jan 2012 06:32:02 +0100

Abstract Achromobacter xylosoxidans (A. xylosoxidans) has been described as an opportunistic pathogen causing infection. The case we describe is that of an elderly man who had osteomyelitis of calcaneal bone caused by A. xylosoxidans. As far as we are aware there are only 5 cases of osteomyelitis with A. xylosoxidans in the literature. Impaired defensive mechanism of the foot in direct contact with this waterborne bacterium can cause this disease. Because of the high level of antibiotic resistance of this bacterium, clinically more attention should be paid to patients who have impaired defensive mechanisms in their extremities, for example free flaps. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s10156-012-0373-zAuthors Kadri Ozer, Ankara Rese...

Severe florid cemento-osseous dysplasia: a case report treated conservatively and literature review

Oral and Maxillofacial Surgery — Tue, 17 Jan 2012 07:07:49 +0100

This report confirms that a diagnosis can be made with accurate clinical and radiographic assessment. The correct selection of treatment for FCOD depends on this information. Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s10006-012-0314-0Authors Dmitry José de Santana Sarmento, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, BrazilBárbara Vanessa de Brito Monteiro, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, BrazilAna Miryam Costa de Medeiros, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal, RN, BrazilEricka Janine Dantas da Silveira, Post-Graduate Program, Oral Pathology, Federal University of Rio Grande do Norte, Natal,...

A facial swelling with multiple discharging sinuses: a diagnostic conundrum

Oral and Maxillofacial Surgery — Fri, 13 Jan 2012 16:48:24 +0100

Discussion The investigations and the pathophysiology of dermatophytic infections and their management in a maxillofacial/oral medicine environment are discussed. Content Type Journal ArticleCategory Case ReportPages 1-2DOI 10.1007/s10006-012-0313-1Authors Joe Hennessy, Western Sussex NHS Trust, Chichester, West Sussex, UKAtul Kusanale, Western Sussex NHS Trust, Chichester, West Sussex, UKClive Pratt, Western Sussex NHS Trust, Chichester, West Sussex, UK Journal Oral and Maxillofacial SurgeryOnline ISSN 1865-1569Print ISSN 1865-1550 (Source: Oral and Maxillofacial Surgery)

Microbiologically and Clinically Diagnosed Vertebral Osteomyelitis: Impact of Prior Antibiotic Exposure.

Antimicrobial Agents and Chemotherapy — Mon, 09 Jan 2012 05:00:00 +0100

Authors: Kim CJ, Song KH, Park WB, Kim ES, Park SW, Kim HB, Oh MD, Kim NJ Abstract We retrospectively reviewed medical records to identify the factors that affect the results of culture in patients with pyogenic vertebral osteomyelitis. In multivariate analysis, presence of paravertebral abscess was associated with positive results of microbiologic culture. Prior antibiotic exposures, especially of longer duration, was strongly associated with negative results. PMID: 22232286 [PubMed - as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

Osteomyelitis of the Patella in Eight Foals

Veterinary Surgery — Fri, 06 Jan 2012 05:00:00 +0100

ConclusionsPrompt medical and surgical therapy for osteomyelitis of the patella can result in a good prognosis for soundness and a potential athletic career. Concurrent septicemia or other systemic perinatal disease can result in prolonged therapy and delayed recovery. (Source: Veterinary Surgery)

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Pathologic Fractures in Children with Acute Staphylococcus aureus Osteomyelitis.

The Journal of Bone and Joint Surgery. American volume — Wed, 04 Jan 2012 05:00:00 +0100

CONCLUSIONS: Staphylococcus aureus osteomyelitis is a serious infection that may predispose children to pathologic fractures. Protected weight-bearing and activity restriction are recommended in children with Staphylococcus aureus osteomyelitis who have the risk factors demonstrated in this study. LEVEL OF EVIDENCE: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. PMID: 22218380 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Posterior Mediastinotomy as an Unordinary Method of Mediastinal Drainage in Patient with Descending Necrotizing Mediastinitis: A Case Report.

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

Authors: Dzian A, Stiegler P, Smolár M, Hamzik J, Mistuna D Abstract The authors present a case report of severe descending necrotizing mediastinitis (DNM) of posterior mediastinum, etiologically of vertebral osteomyelitis treated by the drainage through the posterior mediastinotomy. Mediastinitis caused by vertebral osteomyelitis is very rare. The most important diagnostic and surveillance tool for descending mediastinitis is a CT scan of chest and neck. Every surgical approach to the mediastinum has its advantages and disadvantages, so each patient has to be treated individually and the most suitable type of drainage must be chosen. The posterior mediastinotomy is an unusual alternative of drainage of pre- and paravertebrally localized DNM in posterior mediastinum but it is not ...

Posterior Mediastinotomy as an Unordinary Method of Mediastinal Drainage in Patient with Descending Necrotizing Mediastinitis: A Case Report

The Thoracic and Cardiovascular Surgeon — Tue, 03 Jan 2012 05:00:00 +0100

Thorac cardiovasc SurgDOI: 10.1055/s-0031-1295576The authors present a case report of severe descending necrotizing mediastinitis (DNM) of posterior mediastinum, etiologically of vertebral osteomyelitis treated by the drainage through the posterior mediastinotomy. Mediastinitis caused by vertebral osteomyelitis is very rare. The most important diagnostic and surveillance tool for descending mediastinitis is a CT scan of chest and neck. Every surgical approach to the mediastinum has its advantages and disadvantages, so each patient has to be treated individually and the most suitable type of drainage must be chosen. The posterior mediastinotomy is an unusual alternative of drainage of pre- and paravertebrally localized DNM in posterior mediastinum but it is not recommended as a routine stra...

Using extended pedicle lateral gastrocnemius muscle flap with antibiotic-impregnated calcium sulfate to salvage distal femur chronic osteomyelitis: a case report

European Journal of Plastic Surgery — Mon, 02 Jan 2012 06:58:17 +0100

Content Type Journal ArticleCategory Case ReportPages 1-4DOI 10.1007/s00238-011-0656-0Authors Chih-Hsun Lin, Yuanshan Veterans General Hospital, Yilan, TaiwanWen-Hao Tzou, Orthopedic Surgery, Yuanshan Veterans General Hosiptal, Yilan, TaiwanHsu Ma, Plastic and Reconstructive Surgery, Taipei Veterans General Hospital, Taipei, Taiwan Journal European Journal of Plastic SurgeryOnline ISSN 1435-0130Print ISSN 0930-343X (Source: European Journal of Plastic Surgery)

Bisphosphonate‐induced osteonecrosis of the jaw in a rat model arises first after the bone has become exposed. No primary necrosis in unexposed bone

Journal of Oral Pathology and Medicine — Sun, 01 Jan 2012 05:00:00 +0100

Conclusion: Bisphosphonates and dexamethasone caused no osteocyte death in uninjured bone, but large ONJ‐like lesions after tooth extraction. Osteonecrosis of the jaw appears to arise first after the bone has been exposed. Possibly, bisphosphonates hamper the necessary resorption of bone that has become altered because of infection. (Source: Journal of Oral Pathology and Medicine)

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[Therapy of chronic osteomyelitis : Soft tissues as "key to success"].

Der Orthopade — Sun, 01 Jan 2012 05:00:00 +0100

[Therapy of chronic osteomyelitis : Soft tissues as "key to success"]. Orthopade. 2012 Jan;41(1):43-50 Authors: Sellei RM, Kobbe P, Knobe M, Lichte P, Dienstknecht T, Lemmen SW, Pape HC Abstract Chronic osteomyelitis is a severe complication characterized by soft tissue and bone pathogenic infection resulting in osseous destruction. Surgical management is demanding and poses a challenge in achieving the goals of treatment, which are control of infection, bone healing as well as satisfactory functional outcome. Therapeutic strategies are based on a combined application of radical surgery and systemic antibiotic therapy. The bony defects which remain after extensive debridement have to be reconstructed with bone grafting after soft tissue coverage and the healing process is d...

Chronic Recurrent Multifocal Osteomyelitis with Concomitant Features of Juvenile Idiopathic Arthritis

Journal of Biomedicine and Biotechnology — Thu, 29 Dec 2011 16:36:22 +0100

We report a case of a 13-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) who developed severe arthritis in four different joints within the first year from the onset of the disease. Her multiple vertebrae lesions showed significant amelioration after a 2-month treatment with prednisolone. In parallel, the initial severe symmetrical arthritis of both knees showing overt synovitis and joint effusion, in the absence of lesions in the metaphyses of the femur or the tibia, responded remarkably well in intra-articular triamcinolone hexacetonide injections. However, upon discontinuation of prednisolone, the patient developed severe arthritis of her right ankle and the proximal interphalangeal joint of her right middle finger. Thus, prednisolone was reinitiated combined with m...

Neck abscess: an unusual presentation of actinomycosis

Journal of Pakistan Medical Students — Thu, 29 Dec 2011 05:00:00 +0100

CONCLUSION Cervicofacial AM is an uncommon disease. However, it can mimic various other common conditions. A high index of suspicion, proper investigations and long term treatment are needed for complete eradication. Therefore, AM should be suspected in any soft tissue swelling not responding to conventional treatment REFRENCES Miller M, Haddad AJ. Cervicofacial actinomycosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85:496-508. Bennhoff DF. Actinomycosis: diagnostic and therapeutic considerations and a review of 32 cases. Laryngoscope. 1984; 94:1198-217. Honda H, Bankowski MJ, Kajioka EH, Chokrungvaranon N, Kim W, Gallacher ST. Thoracic vertebral actinomycosis: Actinomyces israelii and Fusobacterium nucleatum. J Clin Microbiol. 2008; 46:2009-2014. Lancella A, Abba...

Bactericidal activity of Musca domestica cecropin (Mdc) on multidrug-resistant clinical isolate of Escherichia coli.

Applied Microbiology and Biotechnology — Wed, 28 Dec 2011 05:00:00 +0100

Authors: Lu X, Shen J, Jin X, Ma Y, Huang Y, Mei H, Chu F, Zhu J Abstract The housefly (Musca domestica) larvae have been used clinically to cure osteomyelitis, decubital necrosis, lip boil, ecthyma and malnutritional stagnation ever since the Ming/Qing Dynasty (1368 Anno Domini) till now, in China. In prior research, we have cloned and characterized a new gene of antimicrobial peptide cecropin from M. domestica larvae. This peptide was potently active against Gram-positive and Gram-negative bacteria standard strain. In the present study, we evaluated the possibility of Mdc to be a potential bactericidal agent against clinical isolates of multidrug-resistant (MDR) Escherichia coli and to elucidate the related antimicrobial mechanisms. Antimicrobial activity assays indicated a minim...

Prognostic Difference Between Soft Tissue Abscess and Osteomyelitis of the Foot in Patients with Diabetes: Data from a Consecutive Series of 452 Hospitalized Patients

Journal of Foot and Ankle Surgery — Sun, 25 Dec 2011 16:56:24 +0100

This study demonstrates that the severity of a foot soft tissue abscess is not comparable with that of a chronic osteomyelitis not only because of a higher rate of major amputation, but also because of a much more proximal level of minor amputation. (Source: Journal of Foot and Ankle Surgery)

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Community-Acquired Staphylococcal Musculoskeletal Infection in Infants and Young Children: Necessity of Contrast-Enhanced MRI for the Diagnosis of Growth Cartilage Involvement

American Journal of Roentgenology — Thu, 22 Dec 2011 05:00:00 +0100

CONCLUSION. Skeletal infection caused by community-acquired S. aureus in infants and young children manifests differently than in older children, including a propensity for involvement of the unossified growth cartilage and potentially occult nature of both cartilage and bone marrow involvement on unenhanced MRI sequences. (Source: American Journal of Roentgenology)

A multi‐disciplinary approach to the management of fungal osteomyelitis: Current concepts in post‐traumatic lower extremity reconstruction: A case report

Microsurgery — Thu, 22 Dec 2011 05:00:00 +0100

We report lower extremity salvage by radical bony debridement, free tissue transfer, distraction osteogenesis with bone‐docking, and a novel antifungal regimen in a clinical setting of infection with Scedosporium inflatum, historically requiring amputation in 100% of cases. We treated Scedosporium inflatum osteomyelitis of the tibia and calcaneus with radical debridement of infected bone, free partial medial rectus abdominis muscle flap coverage, transport distraction osteogenesis, and combination voriconazole/terbinafine chemotherapy, a novel antifungal regimen. We achieved successful control of the infection, limb salvage, and an excellent functional outcome through aggressive debridement of infected bone and soft tissue, elimination of dead space within the bony defect, the robust per...

An Analysis of Etiological Factors for Traumatic Mandibular Osteomyelitis.

Medicina (Kaunas) — Wed, 21 Dec 2011 10:12:03 +0100

CONCLUSION. Comparative analysis of factors influencing the treatment results revealed a great importance of immunological and dental status and microflora at the affected site. Insufficient or late reposition and fixation of fractured bone fragments play a significant role in the healing process. PMID: 22112987 [PubMed - as supplied by publisher] (Source: Medicina (Kaunas))

Brodie's abscess

Emergency Medicine Journal — Tue, 20 Dec 2011 05:00:00 +0100

A 42-year-old man presented to the emergency department with a 6-week history of knee pain that had increased in severity following a fall. On examination, the patient was tender over the proximal aspect of the left tibia. A knee radiograph showed a lesion within the proximal tibia of mixed sclerotic and lucent density (figure 1A). CT showed a large abscess cavity within the proximal tibia (figure 1B), which was confirmed on MRI to consist of a central fluid component with surrounding necrotic tissue and marrow oedema consistent with a Brodie's abscess caused by subacute osteomyelitis (figure 1C). Flucloxacillin-sensitive Staphylococcus aureus was isolated following surgical drainage of the abscess and a prolonged course of antibiotics was commenced. The patient remains well at follow-up. ...

Surgical Treatment of Limb- and Life-Threatening Infections in the Feet of Patients With Diabetes and at Least One Palpable Pedal Pulse: Successes and Lessons Learnt

The International Journal of Lower Extremity Wounds — Sun, 18 Dec 2011 05:00:00 +0100

Outcomes of surgically treated limb- and life-threatening infections in patients with diabetes and a well-vascularized foot based only on the palpation of foot pulses are not well known. The authors retrospectively studied a series of 173 patients with diabetes and limb- (moderate) or life- (severe) threatening infections with at least one palpable pedal pulse who were admitted to their department for the treatment of infected diabetic foot from January 1, 1998, to December 31, 2009. A total of 141 patients (81.5%) presented with limb-threatening/moderate infections and 32 (18.5%) with life-threatening/severe infections. In all, 49 patients (28.3%) presented with soft tissue infections only, 90 (52%) with osteomyelitis and 34 (19.7%) with a combined infection. Amputation was needed in 74 p...

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Never Amputate a Patient With Diabetes Without Consulting With a Specialized Unit

The International Journal of Lower Extremity Wounds — Sun, 18 Dec 2011 05:00:00 +0100

This study presents a case report of a patient who underwent a severe infection following revascularization because dry necrosis became infected. A major amputation had been indicated because the infection did not respond to antibiotics and advanced wound care with topical negative pressure wound therapy with silver. The patient did not accept the major amputation and attended the authors’ specialized unit. Persistent osteomyelitis was diagnosed with a simple X-ray, a cheap tool. Local surgery, antibiotics, appropriate wound care, and split-skin grafting achieved limb salvage in 12 weeks in this patient who had been scheduled for major amputation. Major amputation in patients with an infected foot can sometimes be avoided by correct diagnosis of infection and managing appropriately w...

Monoclonal gammopathy of undetermined significance and risk of infections: a population-based study.

Haematologica — Fri, 16 Dec 2011 05:00:00 +0100

Authors: Kristinsson SY, Tang M, Pfeiffer RM, Bjorkholm M, Goldin LR, Blimark C, Mellqvist UH, Wahlin A, Turesson I, Landgren O Abstract No comprehensive evaluation has been conducted to assess the risk of viral and bacterial infections among patients with monoclonal gammopathy of undetermined significance. Using population-based data from Sweden, we estimated risk of infections among 5,326 MGUS patients compared to 20,161 matched controls. Patients with monoclonal gammopathy of undetermined significance had a 2-fold increased risk (P<0.05) of developing any infection at 5 and 10 years of follow-up. More specifically, patients with monoclonal gammopathy of undetermined significance had an increased risk (P<0.05) of bacterial infections (pneumonia, osteomyelitis, septicemia, p...

Skin Lesions in the Diabetic Foot.

Actas Dermo-Sifiliograficas — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Boada A Abstract In diabetic foot syndrome, a series of complications of late-stage diabetes affect the foot. These complications, which culminate in foot amputation, include peripheral vascular disease and neuropathy, Charcot arthropathy, plantar ulceration, and osteomyelitis. In recent years, the medical community has paid greater attention to diabetic foot syndrome, and our understanding of its pathophysiology and management has advanced. Although the podiatrist is charged with caring for the diabetic foot, as dermatologists we occasionally act as consultants. This review therefore offers dermatologists an update on the causes and management of skin lesions in the diabetic foot. PMID: 22176859 [PubMed - as supplied by publisher] (Source: Actas Dermo-Sifiliograficas)

Osteomyelitis of the spine caused by mycobacterium avium complex in an immunocompetent patient

Journal of Orthopaedic Science — Wed, 14 Dec 2011 16:40:35 +0100

Content Type Journal ArticleCategory Case ReportPages 1-6DOI 10.1007/s00776-011-0183-7Authors Tetsuya Suzuki, Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 JapanHajime Murai, Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 JapanNaohisa Miyakoshi, Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 JapanMichio Hongo, Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543 JapanEiji Itoi, Department of Orthopaedic Surgery, Tohoku University School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574 JapanYoichi Shimada, Department of Orthopedic Surgery, ...

Impact of sub-inhibitory antibiotics on fibronectin-mediated host cell adhesion and invasion by Staphylococcus aureus

BMC Microbiology - Latest articles — Wed, 14 Dec 2011 05:00:00 +0100

Conclusion: Our findings demonstrate that several antibiotics at sub-MICs modulate fibronectin binding in S. aureus in a drug-specific fashion. However, hyper- and hypo- adhesive phenotypes observed in controlled in vitro conditions were not fully confirmed in whole cell infection assays. The relevance of adhesion modulation during in vivo infections is thus still uncertain and requires further investigations. (Source: BMC Microbiology - Latest articles)

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Role of Gallium-67 scintigraphy in the evaluation of occult sepsis in the medical ICU

Internal and Emergency Medicine — Tue, 13 Dec 2011 17:06:13 +0100

Abstract Patients in intensive care units (ICUs) frequently have multiple infections or persistent fever despite management. The aim of this study was to evaluate the diagnostic contribution of gallium-67 scintigraphy in ICU patients with suspected occult sepsis. One hundred and seventeen patients (>18 years) who had undergone gallium-67 scintigraphy in the ICU of our medical center over a 3-year period were retrospectively reviewed and analyzed. Patients were categorized into Group 1 (n = 84), those with a known infectious source, but who still had persistent fever or sepsis despite antibiotic treatment or abscess drainage; or Group 2 (n = 33), those without an evident infectious source after clinical, physical, and imaging studies. Among the 117...

Mutation in FAM134B causing severe hereditary sensory neuropathy

Journal of Neurology, Neurosurgery and Psychiatry — Tue, 13 Dec 2011 05:00:00 +0100

The hereditary sensory and autonomic neuropathies (HSAN) are rare inherited neuropathies presenting with sensory loss and complications, including ulcers, infections, osteomyelitis and amputations. Usually, sensory symptoms predominate although motor involvement can occur. Autonomic features may be minimal (then hereditary sensory neuropathy, HSN, is preferred). HSAN has been classified into five subtypes depending on clinical presentation.1 Hereditary sensory and autonomic neuropathy II (HSANII or HSNII) is an early onset, autosomal recessive sensory neuropathy with ulcero-mutilating complications due to mutations in the HSN2 isoform of the WNK1 gene.2 Recently, a similar phenotype was described in a Saudi-Arabian family, and a homozygous nonsense mutation found in a new gene, FAM134B (fa...

Does osteomyelitis in the feet of patients with diabetes really recur after surgical treatment? Natural history of a surgical series

Diabetic Medicine — Sat, 10 Dec 2011 08:32:23 +0100

Conclusion: A low rate of recurrence of osteomyelitis after surgical treatment for osteomyelitis was achieved. Despite new episodes, our approach to managing this cohort of patients with diabetes and foot osteomyelitis achieved 98.6% limb salvage.© 2011 The Authors. Diabetic Medicine© 2011 Diabetes UK (Source: Diabetic Medicine)

Vancomycin-loaded nano-hydroxyapatite pellets to treat MRSA-induced chronic osteomyelitis with bone defect in rabbits

Inflammation Research — Sat, 10 Dec 2011 06:42:29 +0100

Conclusions The results demonstrate that vancomycin-loaded nHA pellets successfully repair bone defects and control infection in MRSA-induced chronic osteomyelitis. In addition, nHA is an effective and safe controlled-release vancomycin carrier for chronic osteomyelitis with bone defects that is induced by MRSA. Content Type Journal ArticleCategory Original Research PaperPages 1-9DOI 10.1007/s00011-011-0402-xAuthors Ji-Le Jiang, Orthopedic Surgery, Zhongshan Hospital of Fudan University, Shanghai, ChinaYun-Fei Li, Orthopedic Surgery, Jiading Centre Hospital, Shanghai, ChinaTao-Lin Fang, Orthopedic Surgery, Zhongshan Hospital of Fudan University, Shanghai, ChinaJian Zhou, Orthopedic Surgery, Zhongshan Hospital of Fudan University, Shanghai, ChinaXi-Lei Li, Orthopedic...

[Tibiocalcaneal arthrodesis using retrograde insertion of a compression nail.]

Operative Orthopadie und Traumatologie — Fri, 09 Dec 2011 05:00:00 +0100

Authors: Bölderl A, Dallapozza C, Wille M Abstract OPERATION GOAL: Arthrodesis of the upper and lower ankle joint because of problematic bone positioning or failed arthrodesis. Osteosynthesis procedure using a retrograde compression nail. To achieve stable, fully weight-bearing osteosynthesis for early, pain-free mobilization. INDICATIONS: Rearthrodesis because of failure of the conventional arthrodesis technique and development of osteoarthritis of the lower ankle joint. Painful osteoarthritis of the upper ankle joint because of inadequate perfusion or a major bone defect because of sclerosis or necrosis. Primary arthrodesis because of facture of the lower leg (pilon tibial) with joint involvement and preexisting osteoarthritis. ...

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Safety and efficacy of daptomycin for the treatment of hospitalized adult patients in Taiwan with severe staphylococcal infections.

Journal of Microbiology, Immunology, and Infection — Tue, 06 Dec 2011 05:00:00 +0100

CONCLUSION: The results support daptomycin as an effective and safe treatment for staphylococcal infections in Taiwanese populations. PMID: 22153759 [PubMed - as supplied by publisher] (Source: Journal of Microbiology, Immunology, and Infection)

Effectiveness of muscle coverage to manage osteomyelitis of very late onset in the irradiated chest wall

Surgery Today — Mon, 05 Dec 2011 17:40:14 +0100

Abstract Radiation therapy for breast cancer has improved survival rates; however, a consequence of this is treatment-induced complications in longer-living patients. Decades after chest wall irradiation, very late onset radiation-induced osteomyelitis can develop, caused by osteoradionecrosis. This may lead to the development of small, but very refractory, skin ulcers. Many reports recommend well-vascularized tissue coverage after appropriate debridement for irradiation ulcers; however, when the ulcers are of very late onset, this sometimes causes recurrence of ulceration in non-muscle-covered areas after flap transfer. Thus, for very late onset cases, we propose treatment with an absolute muscle flap to cover both the obviously infected focus and the surrounding irradiat...

Characterization of clinical strains of MSSA, MRSA and MRSE isolated from skin and soft tissue infections and the antibacterial activity of ZnO nanoparticles

World Journal of Microbiology and Biotechnology — Fri, 02 Dec 2011 18:09:56 +0100

Abstract Staphylococcus aureus, particularly methicillin-resistant S. aureus (MRSA), is an important cause of pyogenic skin and soft tissue infections (SSTIs). MRSA is an important pathogen in the healthcare sector that has neither been eliminated from the hospital nor community environment. In humans, S. aureus causes superficial lesions in the skin and localized abscesses, pyogenic meningitis/encephalitis, osteomyelitis, septic arthritis, invasive endocarditis, pneumonia, urinary tract infections and septicemia. Investigations focused in the search of other alternatives for the treatment of MRSA infections are in progress. Among the range of compounds whose bactericidal activity is being investigated, ZnO nanoparticles (ZnO–NPs) appears most promising new unconventiona...

Epididymo-orchitis: An unusual manifestation of salmonellosis.

Journal of Microbiology, Immunology, and Infection — Fri, 02 Dec 2011 05:00:00 +0100

Authors: Bansal N, Kaistha N, Chander J Abstract Salmonellosis continues to be a major public health problem, especially in developing countries. The formation of focal abscesses may occur following either hematogenous or lymphatic spread. There are large number of serious and life-threatening clinical manifestations of Salmonella spp., ranging from osteomyelitis to infective endocarditis and meningitis. However, even though Salmonella epidydimo-orchitis is a relatively rare clinical manifestion, it can present, most often in male babies and adolescent boys, following contact with nontyphoidal Salmonella. Here, we report a case of epididymo-orchitis due to Salmonella Paratyphi A that presented in an otherwise healthy 63-year-old man in order to highlight this organism's unusual cli...

A novel mutation of IL1RN in the deficiency of interleukin‐1 receptor antagonist syndrome: Description of two unrelated cases from Brazil

Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

ConclusionThe presence of the same homozygous novel mutation in IL1RN in 2 unrelated Brazilian patients suggests that this genetic variant may be a founder mutation that has been introduced in the Brazilian population. (Source: Arthritis and Rheumatism)

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The first reported case of compound heterozygous IL1RN mutations causing deficiency of the interleukin‐1 receptor antagonist

Arthritis and Rheumatism — Thu, 01 Dec 2011 05:00:00 +0100

We report the case of a 2‐week‐old male who presented with a swollen, erythematous left index finger and elevated serum markers of inflammation. He later developed cyclical fevers, diffuse pustular skin lesions, and thrombus formation. After not responding to broad‐spectrum antimicrobial therapy and achieving only moderate success with systemic steroid therapy, he was ultimately treated with recombinant IL‐1Ra, anakinra, and experienced significant clinical improvement. Sequencing of his IL1RN gene revealed that the patient was compound heterozygous for a known mutation (E77X) associated with IL‐1Ra deficiency and a novel mutation in exon 2 of the gene (c.140delC; p.T47TfsX4). His case highlights IL‐1Ra deficiency as an autoinflammatory disease that is distinct from neonatal‐...

DRIL Procedure for Radial-Basilic Forearm Transposition Arteriovenous Fistula

Journal of Vascular Surgery — Thu, 01 Dec 2011 05:00:00 +0100

A 61-year-old male presented with a 3-month history of a non-healing ulceration of his left middle finger. He had a history of end stage renal disease and had undergone a left forearm autogenous radial-basilic forearm transposition arteriovenous fistula for hemodialysis access four years prior to presentation. Steal syndrome was suspected and an arch aortogram and left upper extremity arteriogram were performed which confirmed our suspicion as retrograde flow from the radial artery into the fistula was demonstrated. Revascularization of his left hand was achieved by performing a left forearm DRIL (Distal Revascularization and Interval Ligation) procedure. A 15cm segment of great saphenous vein was harvested from his left thigh and used as a conduit for a radio-radial artery bypass. The pro...

The transpubic approach for the correction of complex anorectal and urogenital malformations

Journal of Pediatric Surgery — Thu, 01 Dec 2011 05:00:00 +0100

Conclusion: The transpubic approach should be considered for the repair of complex anorectal and urogenital malformations, especially when adequate exposure cannot be achieved with an abdominal, perineal, or posterior sagittal approach. Another ideal indication is in patients with a normal rectum who were born with a complex urogenital sinus or underwent a failed attempted repair but were left with problems requiring reoperation in a scarred and fibrotic pelvis. (Source: Journal of Pediatric Surgery)

Bilateral skull base osteomyelitis in an immunocompetent patient.

Ear, Nose and Throat Journal — Thu, 01 Dec 2011 05:00:00 +0100

Authors: Leventhal D, Willcox TO, Evans JJ, Finden SG Abstract A 75-year-old immunocompetent man presented to our office with right otalgia. After a comprehensive workup, he was found to have right temporal bone osteomyelitis and was treated with intravenous antibiotics. He then began to experience left-sided otalgia and was diagnosed with and treated for left temporal bone osteomyelitis. Subsequently, he began to exhibit myelopathic symptoms, and imaging revealed a C2 inflammatory process. The patient underwent endoscopic transoral odontoidectomy with resection of a large C1 to C2 pannus and recovered with no neurologic deficit. Skull base osteomyelitis is an uncommon condition that usually occurs in immunocompromised patients. Prompt diagnosis and appropriate treatment are of utm...

External auditory canal cholesteatoma and keratosis obturans: The role of imaging in preventing facial nerve injury.

Ear, Nose and Throat Journal — Thu, 01 Dec 2011 05:00:00 +0100

Authors: McCoul ED, Hanson MB Abstract We conducted a retrospective study to compare the clinical characteristics of external auditory canal cholesteatoma (EACC) with those of a similar entity, keratosis obturans (KO). We also sought to identify those aspects of each disease that may lead to complications. We identified 6 patients in each group. Imaging studies were reviewed for evidence of bony erosion and the proximity of disease to vital structures. All 6 patients in the EACC group had their diagnosis confirmed by computed tomography (CT), which demonstrated widening of the bony external auditory canal; 4 of these patients had critical erosion of bone adjacent to the facial nerve. Of the 6 patients with KO, only 2 had undergone CT, and neither exhibited any significant bony eros...

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Neglected esophageal perforation after upper thoracic vertebral fracture

The Spine Journal — Thu, 01 Dec 2011 05:00:00 +0100

Conclusions: Esophageal perforation after upper thoracic vertebral fracture can develop when the fracture fragment pierces the posterior wall of the esophagus. In addition to periesophageal-free air, crushing, distortion, or marked displacement of the esophagus at the cervicothoracic junction on CT or MRI is a clue to potential esophageal injury. If not identified early, patients may present with chronic osteomyelitis extending to adjacent vertebrae. (Source: The Spine Journal)

Bilateral polymicrobial osteomyelitis with Candida tropicalis and Candida krusei: a case report and an updated literature review

International Journal of Infectious Diseases — Wed, 30 Nov 2011 05:00:00 +0100

Conclusions: Candida osteomyelitis should be considered when a patient presents with risk factors and pain without previous trauma, because Candida, despite being part of the normal flora, is the fourth leading cause of hematogenous nosocomial infections. The recommended treatment is surgery and fluconazole as monotherapy or initially combined with a fungicidal agent, either a different amphotericin B formulation or an echinocandin. (Source: International Journal of Infectious Diseases)

Imaging of acute head and neck infections.

Radiologic Clinics of North America — Sun, 27 Nov 2011 21:31:20 +0100

Authors: Gonzalez-Beicos A, Nunez D Abstract Tonsillar infection is the most common cause of infections of the neck in children and young adults whereas odontogenic infection is the most common cause in older population groups. Other sources of neck infection include the salivary glands, nasal sinuses, middle ear and mastoids, cervical lymph nodes, and trauma. Computed tomography and magnetic resonance imaging have excellent sensitivity for the recognition of deep infections, particularly for the identification of abscess formation and its precise location and extension of disease. A careful assessment of potential severe complications, such as vascular compromise, osteomyelitis, and airway narrowing, should be performed routinely. PMID: 22099488 [PubMed - in process] (Source: ...

Association of tibial osteomyelitis and pneumonitis due to miliary tuberculosis in a patient with systemic lupus erythematosus

Revista Brasileira de Reumatologia — Fri, 25 Nov 2011 22:38:28 +0100

In conclusion, bone tuberculosis, although rare, should always be remembered as a differential diagnosis of patients with SLE and osteomyelitis, mainly those with history of pulmonary tuberculosis. (Source: Revista Brasileira de Reumatologia)

Mycobacterium marinum osteomyelitis of the first metatarsal

European Journal of Orthopaedic Surgery and Traumatology — Fri, 25 Nov 2011 17:58:47 +0100

We report a case of osteomyelitis of the first metatarsal bone caused by MM after accidental puncture injury by a sea urchin requiring surgical treatment in a not immunosuppressed patient. Content Type Journal ArticleCategory Up-to date Review and Case ReportPages 1-4DOI 10.1007/s00590-011-0909-4Authors Ibon López Zabala, Department of Orthopaedic Surgery, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, SpainDaniel Poggio Cano, Department of Orthopaedic Surgery, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, SpainRubén García-Elvira, Department of Orthopaedic Surgery, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, SpainJordi Asunción Márquez, Department of Orthopaedic Surgery, Hospital Clínic, C/Villarroel 170, 08036 Barcelona, Spain Journal European J...

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Treatment of osteoarticular infections with daptomycin, UK experience: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

We present the data from the first 2.5 years of DAP use for the treatment of osteoarticular infections in the UK since marketing authorisation in January 2006. Data from eight participating UK institutions were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from January 2006 until August 2009. All received at least one dose of DAP. Outcomes were assessed by investigators as cured, improved, failure and non-evaluable. (Source: Journal of Infection)

Bacteraemia And Subsequent Vertebral Osteomyelitis: A Retrospective Review Of 125 Patients: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

The objective was to describe a series of patients with VO and to search for a relationship between preceding bacteraemia and subsequent VO with the same pathogen. To achieve this aim, a retrospective study of all treated cases of VO in a tertiary hospital over a ten year period was carried out. (Source: Journal of Infection)

Clinical experience with daptomycin in the United Kingdom: Category: Scientific free paper

Journal of Infection — Fri, 25 Nov 2011 11:05:45 +0100

We present the data from the first 2.5 years of daptomycin use for the treatment of Gram-positive infections in the UK since marketing authorisation in January 2006. These data were taken from all UK institutions (13) participating in the EU-CORESM. Data were collected on patient demographics, antibiotic usage, microbiological and clinical outcomes and adverse events from pts treated with DAP between January 2006 and August 2009. Patients (pts) with single or multiple infections were categorised by type of infection. Pts were grouped as follows: endocarditis, osteomyelitis, bacteraemia, other [foreign body, septic arthritis, pyelonephritis/UTI, necrotising fasciitis], cSSTI, uncomplicated skin and soft tissue infection [uSSTI]). All pts included in the registry had received at least one do...

Sternoclavicular Osteomyelitis: A New Complication of Misplaced Tracheostomy Tube [CASE REPORTS]

The Annals of Thoracic Surgery — Wed, 23 Nov 2011 05:00:00 +0100

We report a patient who presented with erythema and swelling over the chest and neck several days after the placement of a tracheostomy tube. Sternoclavicular osteomyelitis and anterior mediastinal abscess occurred, as complications of inadvertent pretracheal tracheostomy tube placement, which were treated with right sternoclavicular resection and mediastinal drainage. (Source: The Annals of Thoracic Surgery)

A Possible Mechanism for Treating Staphylococcus aureus-Induced Chronic Osteomyelitis in Rats Using 808-nm Light

Photomedicine and Laser Surgery — Tue, 22 Nov 2011 17:21:48 +0100

Photomedicine and Laser Surgery , Vol. 0, No. 0. (Source: Photomedicine and Laser Surgery)

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Surgical treatment of neurogenic thoracic outlet syndrome secondary to the clavicle haematogenic subacute osteomyelitis.

Hand Surgery — Tue, 22 Nov 2011 02:06:03 +0100

Authors: Martins K, Lahiri A, Pupelis G Abstract A rare case of neurogenic thoracic outlet syndrome secondary to subacute osteomyelitis (SOM) of clavicle is presented. It was treated successfully with scalenectomy combined with clavicle and first rib resection and reconstruction of the clavicle using vascularised seventh rib transfer. Various issues involved in the diagnosis and management of such a case are discussed. PMID: 21548151 [PubMed - indexed for MEDLINE] (Source: Hand Surgery)

Onychodystrophy With Associated Polymicrobial Distal Phalanx Osteomyelitis [Correspondence]

Archives of Dermatology — Mon, 21 Nov 2011 05:00:00 +0100

(Source: Archives of Dermatology)

Imaging of Acute Head and Neck Infections

Radiologic Clinics of North America — Sat, 19 Nov 2011 20:49:46 +0100

Tonsillar infection is the most common cause of infections of the neck in children and young adults whereas odontogenic infection is the most common cause in older population groups. Other sources of neck infection include the salivary glands, nasal sinuses, middle ear and mastoids, cervical lymph nodes, and trauma. Computed tomography and magnetic resonance imaging have excellent sensitivity for the recognition of deep infections, particularly for the identification of abscess formation and its precise location and extension of disease. A careful assessment of potential severe complications, such as vascular compromise, osteomyelitis, and airway narrowing, should be performed routinely. (Source: Radiologic Clinics of North America)

Vertebral osteomyelitis: eight years’ experience of 100 cases

Rheumatology International — Fri, 18 Nov 2011 06:53:42 +0100

Abstract To evaluate the etiology and characteristics of vertebral osteomyelitis cases in our country, patients with vertebral osteomyelitis between January 2000 and December 2007 were included in this study. Clinical and laboratory data of the patients were collected from the medical records retrospectively. Of these 100 patients, 44 had pyogenic, 24 had brucellar, and 32 had tuberculous spondylodiscitis. The age of the patients ranged from 13 to 82 years, with a mean of (SD±) 55 ± 15.6 years. Within the pyogenic group, 10 (22.7%) patients had a spinal surgery history, and in 18 patients of the pyogenic group, an etiological agent was isolated. Ten (56%) of these 18 were methicillin-sensitive Staphylococcus aureus. While all of the patients included i...

Blistering Digital Dactylitis Complicated by Osteomyelitis and Amputation in an HIV-Positive Infant

Journal of the International Association of Physicians in AIDS Care (JIAPAC) — Fri, 18 Nov 2011 05:00:00 +0100

HIV infection is rapidly emerging as a predominant cause of morbidity and mortality in children from developing countries. This probably accounts for the many reports that have emanated from resource-limited settings in the last decade. Reports highlighting bone infections and untoward complications in HIV-infected children are rare. This informed our decision to report the case of a 9-month-old HIV-positive Nigerian girl who presented with blistering dactylitis of the right middle finger. Plain radiograph of the right hand showed amputation of the terminal phalanx and changes consistent with osteomyelitis in the middle phalanx of the third finger. The case is discussed with a view of highlighting this rare complication and the challenges associated with management in a resource-limited se...

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Xanthogranulomatous Osteomyelitis Presenting as Swelling in Right Tibia

Diagnostic and Therapeutic Endoscopy — Thu, 17 Nov 2011 14:07:27 +0100

We present a case of xanthogranulomatous osteomyelitis occurring in the distal part of tibia. This case presented as swelling in a 13-year-old boy. Simple curettage proved to be curative in the present case. (Source: Diagnostic and Therapeutic Endoscopy)

Biofilm growth on implants: bacteria prefer plasma coats.

The International Journal of Artificial Organs — Thu, 17 Nov 2011 05:00:00 +0100

Conclusions: Bacterial adherence to surfaces is determined by a variety of factors such as temperature, the presence of nutrients, the absence of host defense systems and the configuration of the covered surface. In vivo, adherence to non-biological surfaces is also influenced by the microenvironment, especially plasma proteins, promoting biofilm formation. PMID: 22094560 [PubMed - as supplied by publisher] (Source: The International Journal of Artificial Organs)

Emerging pathogenetic mechanisms of the implant-related osteomyelitis by Staphylococcus aureus.

The International Journal of Artificial Organs — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Montanaro L, Testoni F, Poggi A, Visai L, Speziale P, Arciola CR Abstract Implant-related osteomyelitis is a severe and deep infection of bone that arises and develops all around an implant. Staphylococcus aureus is the first cause of osteomyelitis, whether implant-related or not. Bone is an optimal substratum for S. aureus, since this bacterium expresses various adhesins by which can adhere to bone proteins and to the biomaterial surfaces coated with the proteins of the host extracellular matrix. S. aureus is able not only to colonize bone tissues, but also to invade and disrupt them by entering bone cells and inducing cell death and osteolysis. Here we illustrate the pathogenetic mechanisms that can explain how the osteomyelitis sets in and develops around an implant. ...

Concise survey of Staphylococcus aureus virulence factors that promote adhesion and damage to peri-implant tissues.

The International Journal of Artificial Organs — Thu, 17 Nov 2011 05:00:00 +0100

Authors: Arciola CR, Visai L, Testoni F, Arciola S, Campoccia D, Speziale P, Montanaro L Abstract Staphylococcus aureus is the leading cause of infection in orthopedic implants and of osteomyelitis consequent to it. Here we focus on the wide array of virulence factors that endow S. aureus with its abilities to colonize peri-prosthesis tissues and to attack and damage them. Following an infective strategy orchestrated by agr locus, Staphylococcus aureus first deploys virulence factors for adhesion to the prosthesis and peri-prosthesis tissues and then launches its attack by delivering destructive factors. PMID: 22094556 [PubMed - as supplied by publisher] (Source: The International Journal of Artificial Organs)

What Evidence Supports Prescription Lengths of Antibiotic Treatment for Septic Arthritis/ Osteomyelitis in the Neonate?

The West London Medical Journal — Sun, 13 Nov 2011 11:51:00 +0100

This article is currently available as a free download on ingentaconnect (Source: The West London Medical Journal)

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Local Antibiotic Delivery with Bovine Cancellous Chips

Journal of Biomaterials Applications — Fri, 11 Nov 2011 05:00:00 +0100

This study demonstrates that the xenograft material tested can be loaded with gentamicin and release clinically relevant levels of the drug for at least 14 days in vitro allowing for the inhibition of bacterial growth on the graft. This study also demonstrates that the levels of gentamicin released did not have an adverse effect on primary osteoblast cell proliferation or ability to generate alkaline phosphatase. This bone void filler may represent a viable alternative to current methods of local antibiotic delivery in orthopedic applications. (Source: Journal of Biomaterials Applications)

Musculoskeletal Infection in Acquired Immunodeficiency Syndrome

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

This article reviews the clinical manifestations of musculoskeletal infection together with reported causative organisms. We discuss the role of imaging and present radiological examples.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Seminars in Musculoskeletal Radiology)

Musculoskeletal Fungal Infections

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

Semin Musculoskelet Radiol 2011; 15: 506-510DOI: 10.1055/s-0031-1293496ABSTRACTFungal infections of the musculoskeletal system are uncommon. They are often found in immunosuppressed or patients with the acquired immunodeficiency syndrome or in patients with a history of travel to an endemic region. Infections often present with multifocal chronic osteomyelitis or chronic mono- or polyarthritis resembling osteoarticular tuberculosis. A clinical clue to the correct diagnosis is the presence of overlying skin sinuses. Radiologists can suggest the correct diagnosis with a good clinical history, although a biopsy and/or fungal culture is usually necessary before beginning treatment.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents | Abstract | Full text ...

Musculoskeletal Brucellosis

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

Semin Musculoskelet Radiol 2011; 15: 470-479DOI: 10.1055/s-0031-1293493ABSTRACTBrucellosis is a zoonosis of worldwide distribution caused by small gram-negative nonencapsulated coccobacilli of the genus Brucella. It is characterized by a granulomatous reaction in the reticuloendothelial system. Because it affects several organs and tissues, it may have various clinical manifestations. Musculoskeletal involvement is one of the most common locations, and the frequency of bone and joint (osteoarticular) involvement of brucellosis varies between 10% and 85%. Osteoarticular involvement includes spondylitis, sacroiliitis, osteomyelitis, peripheral arthritis, bursitis, and tenosynovitis. The most common osteoarticular finding in children is monoarticular arthritis, mostly located in the knees and...

Tuberculous Osteomyelitis and Spondylodiscitis

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

This article reviews the radiologic features of diverse forms of osseous TB and the diagnostic value of the different imaging techniques. It also reviews the imaging differential diagnoses, including other infections and malignancies/metastases. Conventional radiography is of key value in the diagnosis of musculoskeletal TB. Computed tomography, magnetic resonance imaging, and bone scintigraphy also play key roles in the early detection of disease and in demonstrating the extent of disease process and soft tissue involvement. Because delay in treatment significantly reduces the cure rate and increases the rate of complications and morbidity, early radiological diagnosis of TB is of paramount importance for appropriate management.[...]© Thieme Medical PublishersArticle in Thieme eJournals:...

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Musculoskeletal Melioidosis

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

Semin Musculoskelet Radiol 2011; 15: 480-488DOI: 10.1055/s-0031-1293494ABSTRACTMelioidosis is an infectious disease caused by Burkholderia pseudomallei, mostly affecting patients in Southeast Asia and northern Australia. The disease has been increasingly recognized around the world due to the increased levels of travel and population movement. Clinical manifestations of melioidosis range from fulminant septicemic illness to an indolent local infection. The disease often involves multiple organs, including the lung, spleen, liver, and other visceral organs. Musculoskeletal infection is usually seen as a part of multiorgan involvement, but localized musculoskeletal involvement may occur. The most common manifestation of musculoskeletal melioidosis is septic arthritis, followed by osteomyelit...

Musculoskeletal Hydatid Disease

Seminars in Musculoskeletal Radiology — Fri, 11 Nov 2011 05:00:00 +0100

This article reviews the pathological basis and the clinical and imaging features of musculoskeletal hydatid disease.[...]© Thieme Medical PublishersArticle in Thieme eJournals:Table of contents | Abstract | Full text (Source: Seminars in Musculoskeletal Radiology)

Xanthogranulomatous osteomyelitis

Journal of Orthopaedics and Traumatology — Thu, 10 Nov 2011 16:51:42 +0100

We describe the case of a 14-year-old Afghan boy presenting with pain in right shoulder and left leg with prior history of trauma. Fever, limitation in right shoulder range of motion, and tenderness in right shoulder and left thigh were detected following examination. Mild leukocytosis, elevated alkaline phosphatase, and increased erythrocyte sedimentation rate with negative C-reactive protein (CRP) were revealed. X-ray imaging showed mixed density, periosteal reaction, and cortical disruption. Computed tomography (CT) scan revealed lesions involving medulla and cortex, periosteal reaction with soft tissue component, and bone marrow infiltration in right humerus and left fibula. On magnetic resonance imaging (MRI), signal abnormalities in medulla, metaphysis, and diaphysis of the lef...

Video-assisted surgery for gastric carcinoma arising in a gastric tube reconstructed retrosternally

Surgery Today — Thu, 10 Nov 2011 16:50:09 +0100

Abstract Advances in diagnostic and surgical techniques have improved the prognosis of esophageal cancer, but there is growing concern about gastric tube cancer after esophagectomy. Gastric carcinoma arising in tubes that were reconstructed retrosternally is usually resected through a median sternotomy; however, this is invasive and carries a risk of osteomyelitis after suture-line failure. We performed video-assisted gastric tube resection, eliminating the need for sternotomy by using a sternal lifting method, on a 71-year-old man who had previously undergone esophagectomy and reconstruction retrosternally. The tumor was a Borrmann type 1 advanced cancer located near the esophagogastric anastomosis. Neck collar and upper abdominal incisions were made, and the sternum was ...

Audit of acute Charcot’s disease in the UK: the CDUK study

Diabetologia — Mon, 07 Nov 2011 16:59:56 +0100

Conclusions/interpretation The median time to resolution was longer than in earlier series. Although limited by being observational and non-randomised, these data suggest that the use of non-removable off-loading at presentation may shorten the time to resolution. They provide no evidence to indicate that the use of bisphosphonates is beneficial. Content Type Journal ArticleCategory Short CommunicationPages 1-4DOI 10.1007/s00125-011-2354-7Authors F. L. Game, Foot Ulcer Trials Unit, Department of Diabetes and Endocrinology, Nottingham University Hospitals Trust, City Hospital Campus, Hucknall Road, Nottingham, NG5 1PB UKR. Catlow, East Lancashire Healthcare Trust, Blackburn, UKG. R. Jones, East Lancashire Healthcare Trust, Blackburn, UKM. E. Edmonds, Kings College Ho...

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Clinical findings of vertebral osteomyelitis: Brucella spp. versus other etiologic agents

Rheumatology International — Sat, 05 Nov 2011 17:07:53 +0100

Abstract We aimed to evaluate patients with vertebral osteomyelitis (VO) in our region and to compare the clinical and laboratory parameters of brucellar and non-brucellar VO patients (NBVO). This retrospective study included 80 patients with VO followed in our hospital between August 2004 and September 2010. The distribution of gender was 43 females (53.8%) and 37 males (46.2%) with average age of 52.5. Patients with brucellar vertebral VO (BVO; n = 30) accounted for 37.5% of all patients, and the rest (n = 50) were with NBVO. Co-morbidities existed in 32.5% of patients. In statistical comparison of VO patients who had the Brucella spp. as the infectious agent with patients of VO by non-brucellar pathogens, the following factors were found out to be signi...

Sequelae of osteomyelitis variolosa: a case report

Rheumatology International — Sat, 05 Nov 2011 17:07:48 +0100

Abstract Osteomyelitis variolosa is an osteoarticular complication of small pox infection. We are presenting a case of osteomyelitis variolosa, who presented to us with fracture of ankle on the involved side with other orthopedic sequelae of small pox infection, which he contracted during his childhood period. We have discussed the distinguishing clinical and radiological features of osteomyilitis variolosa. Content Type Journal ArticleCategory Original ArticlePages 1-3DOI 10.1007/s00296-011-2194-2Authors Sandeep Nema, Department of Orthopedics, Gajara Raja Medical College, Gwalior, IndiaG. S. Vyas, Department of Orthopedics, Gajara Raja Medical College, Gwalior, IndiaSunil Kukreja, Department of Orthopedics, Gajara Raja Medical College, Gwalior, India Journal R...

Treatment of chronic heel osteomyelitis in vasculopathic patients. Can the combined use of Integra®, skin graft and negative pressure wound therapy be considered a valid therapeutic approach after partial tangential calcanectomy?

International Wound Journal — Fri, 04 Nov 2011 04:00:00 +0100

Osteomyelitis of the calcaneus is a difficult problem to manage. Patients affected by osteomyelitis of the calcaneus often have a below‐the‐knee amputation because of their comorbidity. In this article, we present seven cases of heel ulcerations with chronic osteomyelitis treated with Integra® Dermal Regeneration Template, skin graft and negative pressure wound therapy after partial tangential calcanectomy, discussing the surgical and functional results. In this casuistic of patients, all wounds healed after skin grating of the neodermis generated by Integra®, with no patient requiring a below‐knee amputation. (Source: International Wound Journal)

Orofacial manifestations of hematological disorders: Anemia and hemostatic disorders

Table of Contents : Indian Journal of Dental Research : 2006 - 17(3) — Thu, 03 Nov 2011 04:00:00 +0100

Titilope A Adeyemo, Wasiu L Adeyemo, Adewumi Adediran, Abd Jaleel A Akinbami, Alani S AkanmuIndian Journal of Dental Research 2011 22(3):454-461The aim of this paper is to review the literature and identify orofacial manifestations of hematological diseases, with particular reference to anemias and disorders of hemostasis. A computerized literature search using MEDLINE was conducted for published articles on orofacial manifestations of hematological diseases, with emphasis on anemia. Mesh phrases used in the search were: oral diseases AND anaemia; orofacial diseases AND anaemia; orofacial lesions AND anaemia; orofacial manifestations AND disorders of haemostasis. The Boolean operator "AND" was used to combine and narrow the searches. Anemic disorders associated with orofacial sig...

Ertapenem for Treatment of Osteomyelitis: A Case Series

BMC Research Notes — Wed, 02 Nov 2011 04:00:00 +0100

Conclusions: In this case series of mostly community-acquired, lower extremity osteomyelitis, bone biopsy was infrequent, and an average six-week course of empiric ertapenem was well-tolerated with curative rates of 50% at one year. (Source: BMC Research Notes)

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Role of Nasal Endoscopy in Chronic Osteomyelitis of Maxilla and Zygoma: A Case Report

Gastroenterology Research and Practice — Tue, 01 Nov 2011 23:06:17 +0100

We present a case of osteomyelitis of left maxilla and zygoma with oroantral fistula in an immunocompetent adult male caused by dentogenic infection. The complete resolution of infection was gained with surgical treatment using nasal endoscope and antibiotic therapy. The aims of this paper are to illustrate diagnostic patterns, to report radiographic findings and surgical treatment using nasal endoscope in a case of osteomyelitis of maxilla and zygoma. The prognosis and cosmetic results are discussed. (Source: Gastroenterology Research and Practice)

Successful Reconstruction of Sternum With a Scapular Autograft Segment: 5-Year Follow-Up [CASE REPORTS]

The Annals of Thoracic Surgery — Tue, 01 Nov 2011 04:00:00 +0100

We report on a new technique of an osteocutaneous flap from the scapula providing thoracic stability and protective coverage of mediastinal organs, and additionally allowing removal of osteosynthesis material. A 5-year follow-up demonstrates excellent durability and outcome. (Source: The Annals of Thoracic Surgery)

Percutaneous vertebral body cement augmentation for back pain related to occult osteomyelitis/diskitis.

Orthopedics — Tue, 01 Nov 2011 04:00:00 +0100

This article emphasizes the need for clinical reevaluation and scrutiny in the interpretation of imaging studies, including for infection in patients with continued pain after spinal procedures. The differential diagnosis of infectious etiology is an important consideration prior to vertebral cement augmentation for presumed fragility fracture. PMID: 22049968 [PubMed - in process] (Source: Orthopedics)

Osteomyelitis: what you should know.

American Family Physician — Tue, 01 Nov 2011 04:00:00 +0100

Authors: PMID: 22046944 [PubMed - in process] (Source: American Family Physician)

Diagnosis and management of osteomyelitis.

American Family Physician — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Hatzenbuehler J, Pulling TJ Abstract The incidence of chronic osteomyelitis is increasing because of the prevalence of predisposing conditions such as diabetes mellitus and peripheral vascular disease. The increased availability of sensitive imaging tests, such as magnetic resonance imaging and bone scintigraphy, has improved diagnostic accuracy and the ability to characterize the infection. Plain radiography is a useful initial investigation to identify alternative diagnoses and potential complications. Direct sampling of the wound for culture and antimicrobial sensitivity is essential to target treatment. The increased incidence of methicillin-resistant Staphylococcus aureus osteomyelitis complicates antibiotic selection. Surgical debridement is usually necessary in chro...

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Defining osteonecrosis of the jaw

Dental Abstracts — Tue, 01 Nov 2011 04:00:00 +0100

Osteonecrosis of the jaw (ONJ) is an uncommon occurrence that is primarily seen in patients with cancer who are receiving osteoclast inhibition using high-potency bisphosphonates. Because of this association, the term bisphosphonate-related osteonecrosis of the jaw has been used. Over the course of 3 years, a working definition of ONJ was developed that included exposure to bisphosphonate therapy, but not head and neck irradiation, and cited duration of at least 8 weeks. Using this definition, ONJ was distinguished from osteomyelitis and osteoradionecrosis. As time has passed, further information has been gathered, suggesting that the definition be further refined. (Source: Dental Abstracts)

Osteomyelitis

Dental Abstracts — Tue, 01 Nov 2011 04:00:00 +0100

is an inflammatory bone condition that begins as an infection of the medullary cavity but quickly spreads to the haversian systems and the periosteum of the affected site. However, antibiotics have made the characteristic nonhealing compound fractures of the long bones a thing of the past. Today, osteomyelitis is generally considered a subchronic condition seen in debilitated, immunosuppressed, or medically compromised individuals. Acute osteomyelitis is diagnosed on the basis of time: a maximum of 1 month after symptoms appear it is acute osteomyelitis, thereafter it is chronic osteomyelitis. Presenting features include presence of a virulent infection with intense pain, inflammation, and redness. This could be life-threatening because of the toxic effects of the bacteria, but symptoms c...

Disseminated Mycobacterium abscessus Infection and Showerheads, Taiwan.

Emerging Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

We describe a case of osteomyelitis and soft tissue infection with Mycobacterium doricum after trauma in a previously healthy adult. PMID: 22099106 [PubMed - in process] (Source: Emerging Infectious Diseases)

Mycobacterium doricum Osteomyelitis and Soft Tissue Infection.

Emerging Infectious Diseases — Tue, 01 Nov 2011 04:00:00 +0100

We describe a case of osteomyelitis and soft tissue infection with Mycobacterium doricum after trauma in a previously healthy adult. PMID: 22099105 [PubMed - in process] (Source: Emerging Infectious Diseases)

Pott's puffy tumor in a 5-year-old boy: The role of ultrasound and contrast-enhanced CT imaging—Surgical case report

International Journal of Pediatric Otorhinolaryngology Extra — Fri, 28 Oct 2011 04:00:00 +0100

We report the case of a Pott's puffy tumor, a subperiosteal abscess of the frontal bone associated with an underlying frontal osteomyelitis, in a 5-year-old boy. Pott's puffy tumor is a complicated infection that requires adequate treatment consisting of prompt surgical management and strict antibiotic therapy. Early diagnosis is critical to prevent severe complications and sequelae. In our patient ultrasonography played a crucial role in the diagnosis, suggesting the presence of a Pott's puffy tumor with epidural abscess by showing a subperiosteal abscess associated with erosion of the frontal bone. Subsequently, the diagnosis of Pott's puffy tumor with epidural abscess was confirmed by contrast-enhanced CT scan. Prompt surgical intervention with drainage of abscesses and debridement of b...

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Distraction osteogenesis using a longitudinal corticotomy

International Orthopaedics — Thu, 27 Oct 2011 15:45:52 +0100

Conclusion The S-Z osteotomy safely reduces consolidation time of regenerative bone during distraction osteogenesis in the tibia relative to a transverse corticotomy. Content Type Journal ArticleCategory Original PaperPages 1-5DOI 10.1007/s00264-011-1383-7Authors Ma’ad F. Al-Saati, Orthopaedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, FranceRobert A. Magnussen, Orthopaedic Surgery, The Ohio State University School of Medicine, Columbus, OH, USASebastien Lustig, Orthopaedic Surgery, Centre Albert Trillat, Hôpital de la Croix-Rousse, Lyon, FranceRodolphe Testa, Université de Lyon, F-69000; Ifsttar, UMR T9406, LBMC, Université Lyon 1, Lyon, FranceGazal Al-Saati, Georgetown University Medical Center, Washington, DC, USAFaisal Al-Saati, Saati...

Pyogenic spondylitis

International Orthopaedics — Thu, 27 Oct 2011 15:45:49 +0100

Abstract Pyogenic spondylitis is a neurological and life threatening condition. It encompasses a broad range of clinical entities, including pyogenic spondylodiscitis, septic discitis, vertebral osteomyelitis, and epidural abscess. The incidence though low appears to be on the rise. The diagnosis is based on clinical, radiological, blood and tissue cultures and histopathological findings. Most of the cases can be treated non-operatively. Surgical treatment is required in 10–20% of patients. Anterior decompression, debridement and fusion are generally recommended and instrumentation is acceptable after good surgical debridement with postoperative antibiotic cover. Content Type Journal ArticleCategory Review ArticlePages 1-8DOI 10.1007/s00264-011-1384-6Authors W. Y. ...

Preventable long-term complications of suprapubic cystostomy after spinal cord injury: Root cause analysis in a representative case report.

Patient Safety in Surgery — Thu, 27 Oct 2011 04:00:00 +0100

CONCLUSION: Suprapubic catheter should be anchored securely to prevent migration of the tip of catheter into urethra and accidental dislodgment of catheter. While changing the suprapubic catheter, correct placement of Foley catheter inside the urinary bladder must be ensured. In case of difficulty, it is advisable to perform exchange of catheter over a guide wire. Ultrasound examination of urinary bladder is useful to check the position of the balloon of Foley catheter. PMID: 22032689 [PubMed - as supplied by publisher] (Source: Patient Safety in Surgery)

Patient With AML Develops Fungal Pneumonia and Osteomyelitis Following Treatment

Cancer Network — Mon, 24 Oct 2011 12:00:00 +0100

A 58-year-old man developed acute myeloid leukema. After responding to remission-induction high-dose chemotherapy, he received an allogeneic stem cell transplant that was complicated by a graft-versus-host reaction. While being treated for the latter with prednisone, tacrolimus (Prograf), and mycophenolate mofetil (CellCept), he developed both fungal pneumonia and osteomyelitis caused by Fusarium species. (Source: Cancer Network)

Hyperbaric Oxygen Therapy as an Adjunctive Treatment for Sternal Infection and Osteomyelitis after Sternotomy and Cardiothoracic Surgery

Journal of Cardiothoracic Surgery — Mon, 17 Oct 2011 04:00:00 +0100

Conclusions: In addition to primary treatment with debridement and antibiotic use, HBO2 therapy may be used as an adjunctive and safe treatment to improve clinical outcomes in patients with sternal infection and osteomyelitis after sternotomy and cardiothoracic surgery. (Source: Journal of Cardiothoracic Surgery)

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How Can We Diagnose and Treat Osteomyelitis of the Jaws as Early as Possible?

Oral and Maxillofacial Surgery Clinics — Wed, 12 Oct 2011 07:56:23 +0100

Osteomyelitis of the jaws is an uncommon infection of the maxillofacial area. The disease is often difficult to diagnose, and thus delays in treatment are common, increasing its morbidity. The clinical, radiographic, and laboratory findings of the disease; its forms; and treatment modalities are reviewed. Suggestions for contemporary diagnosis and surgical treatment of acute and chronic suppurative osteomyelitis are discussed. (Source: Oral and Maxillofacial Surgery Clinics)

Prednisone: Fusarium falciforme epidural abscess and osteomyelitis?: case report

Reactions — Wed, 12 Oct 2011 06:03:59 +0100

(Source: Reactions)

Telavancin for the treatment of methicillin-resistant Staphylococcus aureus osteomyelitis

Journal of Antimicrobial Chemotherapy — Wed, 12 Oct 2011 04:00:00 +0100

(Source: Journal of Antimicrobial Chemotherapy)

A severe case of paediatric group A streptococcal osteomyelitis in varicella

Infection — Tue, 11 Oct 2011 05:50:26 +0100

Content Type Journal ArticleCategory CorrespondencePages 1-3DOI 10.1007/s15010-011-0195-4Authors E. Bozzola, Department of Paediatrics, Paediatric and Infectious Disease Unit, Children Hospital Bambino Gesù, Rome, ItalyA. Krzystofiak, Department of Paediatrics, Paediatric and Infectious Disease Unit, Children Hospital Bambino Gesù, Rome, ItalyL. Lancella, Department of Paediatrics, Paediatric and Infectious Disease Unit, Children Hospital Bambino Gesù, Rome, ItalyA. Quondamcarlo, Department of Paediatrics, Paediatric and Infectious Disease Unit, Children Hospital Bambino Gesù, Rome, ItalyA. Villani, Department of Paediatrics, Paediatric and Infectious Disease Unit, Children Hospital Bambino Gesù, Rome, Italy Journal InfectionOnline ISSN 1439-0973Print ISSN 0300-8126 (Source...

Remission after treatment of osteoarticular infections due to Pseudomonas aeruginosa versus Staphylococcus aureus: a case-controlled study

International Orthopaedics — Sat, 08 Oct 2011 05:53:05 +0100

Conclusions Despite a similar number of surgical interventions and longer antibiotic treatment, osteoarticular infections due to P. aeruginosa tended towards a lower remission rate than infections due to S. aureus in general or MRSA in particular. Content Type Journal ArticleCategory Original PaperPages 1-7DOI 10.1007/s00264-011-1366-8Authors Khalid Seghrouchni, Orthopedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211 Geneva 14, SwitzerlandChristian van Delden, Service of Infectious Diseases, Geneva University Hospitals & Faculty of Medicine, University of Geneva, Geneva, SwitzerlandDennis Dominguez, Orthopedic Surgery Service, Geneva University Hospitals, 4, Rue Gabrielle Perret-Gentil, 1211 Geneva 14, SwitzerlandMohamed Benkabouc...

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[Upper leg amputation : Transfemoral amputation.]

Operative Orthopadie und Traumatologie — Fri, 07 Oct 2011 04:00:00 +0100

[Upper leg amputation : Transfemoral amputation.] Oper Orthop Traumatol. 2011 Oct 7; Authors: Baumgartner R Abstract OBJECTIVE: Amputation through the diaphysis of the femur at the most peripheral level possible. The stump, covered with soft tissue flaps, is free from pain. It can be fitted with a total contact prosthetic socket. The hip joint is preserved with its full range of motion. INDICATIONS: When no possibility to amputate at a more distal level through the tibia or the knee joint exists. CONTRAINDICATIONS: When it is possible to amputate at a more distal level. SURGICAL TECHNIQUE: Symmetrical flaps in the frontal plane are recommended. Asymmetrical flaps and flap...

A case of systemic brucellosis with spondylodiscitis mimicking postoperative spondylodiscitis after lumbar disc surgery

Journal of Neurology, Neurosurgery and Psychiatry — Thu, 06 Oct 2011 04:00:00 +0100

Introduction Postoperative spondylodiscitis is a well-known complication of lumbar disc surgery, affecting between 0.1 and 1.7% of patients.1 It is usually due to contamination by skin flora. Usual pathogens are Staphylococcus aureus and Staphylococcus epidermidis. In industrialised countries, brucellosis is a rare condition, almost exclusively found in cattle-exposed patients such as farmers, shepherds and veterinarians. Brucella osteomyelitis is rarer still, although it mostly affects the spine. History and presentation A 43-year-old man had undergone dorsolateral transmuscular sequestrectomy and nucleotomy including Nebacetin-irrigation L3/4 for an extraforaminal left-sided herniated lumbar disc (figure 1A). The early postoperative course was uneventful. Two months later, he appeared wi...

Total dislocation of the talus

European Journal of Orthopaedic Surgery and Traumatology — Sat, 01 Oct 2011 06:43:59 +0100

Abstract Total talar dislocations, in which the talus is dislodged from all three of its articulations are rare, comprising only 3.4% of all major talar injuries. The most common complications are osteomyelitis and avascular necrosis. The current literature on total talar dislocations is based on small series and case reports. This literature review outlines the anatomy and blood supply to the talus and discusses the mechanism of injury, presentation, treatment and complications associated with total dislocations of the talus. Content Type Journal ArticleCategory General ReviewPages 1-5DOI 10.1007/s00590-011-0881-zAuthors Benjamin Johnson, The Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, SY10 7AG UKNick Rouholamin, The R...

Magnetic Resonance Imaging Bone Edema Is Not a Major Feature of Gout Unless There Is Concomitant Osteomyelitis: 10-year Findings from a High-prevalence Population.

J Rheumatol — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSION: MRI reveals that gout affects the joints, bones, and tendons. Bone edema in patients with chronic tophaceous gout is frequently mild and this contrasts with the "severe bone edema" observed in patients with concomitant osteomyelitis. PMID: 21965640 [PubMed - as supplied by publisher] (Source: J Rheumatol)

Innovation in oral maxillofacial surgery

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Reconstruction of the bony defects in the mandible following sequestrectomy needs to be bridged properly to avoid disabling functional and cosmetic results. This case report describes an innovative method of reconstruction in a case of chronic suppurative osteomyelitis of mandible which is simple and effective and gives good long term results. (Source: International Journal of Oral and Maxillofacial Surgery)

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Chronic osteomyelitis of the mandible in sickle cell anaemic patient

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Published literature indicates that the prevalence of osteomyelitis in sickle cell anaemic patients is up to 29%. While sickle cell osteomyelitis is more commonly seen in long bones, its occurrence in the jaw bones remain relatively rare, with scientific literature reports few cases occurring mainly in young adults. The pathogenesis of jaw osteomyelitis is usually caused by intravascular sickling, which leads to ischaemic infarction and necrosis of bone, which in turn create a favourable environment for bacterial growth from the oral region. Jaw osteomyelitis in sickle cell anaemic patients tends to occur more commonly in mandible with the mandibular molar region being most commonly involved area. This poster presentation describes a clinical case of a 23-years old male sickle cell anaemic...

Osteomyelitis of the temporomandibular joint secondary to dental extraction

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

The term osteomyelitis, from the Greek (osteos=bone+myelós=marrow), describes an inflammatory process caused by infection in the cortical and cancellous bone. The diagnosis is based on a combination of clinical, bacteriological and images data. In the maxillofacial region, most affected bone is the mandible. The compromise of its condylar portion is described in the literature as a very rare condition. The authors report a female patient with condylar osteomyelitis of the right temporomandibular joint secondary to dental extraction. Condilectomy for removal of the necrotic tissue and long-term antibiotherapy was performed. No alloplastic reconstruction was recommended until now. In 22 months follow-up, the patient presents no symptomatology and total functional recovery. (Source: Internat...

Primary frontal sinus carcinoma with extradural anterior cranial fossa involvement.

Ear, Nose and Throat Journal — Sat, 01 Oct 2011 04:00:00 +0100

We report the case of a 48-year-old woman with a carcinoma that originated in the frontal sinus. Computed tomography and magnetic resonance imaging demonstrated bony destruction with intracranial extension but no involvement of the bulbus. The patient underwent a frontal craniotomy, tumor excision, and postoperative radiotherapy. One year later, she remained symptom-free. PMID: 22033970 [PubMed - in process] (Source: Ear, Nose and Throat Journal)

Retrospective Observational Study Comparing Vancomycin Versus Daptomycin as Initial Therapy for Staphylococcus aureus Infections.

Clinical Therapeutics — Sat, 01 Oct 2011 04:00:00 +0100

CONCLUSION: In this setting, in which the majority of S aureus infections had vancomycin MIC values of 2 mg/L, we found the median antibiotic-related length of stay to be significantly shorter with daptomycin than with vancomycin. Prospective studies are needed to determine whether daptomycin confers benefits over vancomycin in specific infection types under conditions that are unfavorable for vancomycin, such as higher vancomycin MICs. PMID: 22015328 [PubMed - in process] (Source: Clinical Therapeutics)

Gaucher disease and bone

Best Practice and Research. Clinical Rheumatology — Sat, 01 Oct 2011 04:00:00 +0100

Gaucher disease (GD) is an inherited lysosomal storage disorder affecting multiple organs. Non-neuronopathic GD, the most common form, can present with hepatosplenomegaly, anaemia, bleeding tendencies, thrombocytopenia, skeletal pathologies, growth retardation and, in severe cases, with pulmonary disease. The bone manifestations include bone infarcts, avascular bone necrosis, lytic lesions, osteosclerosis, fractures due to osteoporosis and, rarely, acute osteomyelitis. Bone pain of varying intensity, fractures and joint collapses increase the patients’ morbidity and impair their mobility and quality of life.Currently available therapies – enzyme replacement therapy and substrate reduction therapy – have shown to improve blood count and the visceral manifestations within a short time....

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Three cases of fever of unknown origin (FUO) with acute multifocal non-bacterial osteitis (NBO) as reactive osteomyelitis

Rheumatology International — Wed, 28 Sep 2011 05:48:27 +0100

We report on 3 cases of FUO with self-limited acute NBO as reactive osteomyelitis and suggest that this unique pattern on PET/CT would be helpful for FUO evaluation. Content Type Journal ArticleCategory Short CommunicationPages 1-5DOI 10.1007/s00296-011-2164-8Authors Young Hoon Hong, Division of Rheumatology, Department of Internal Medicine, Yeungnam University College of Medicine, 317-1, Daemyeong 5-Dong, Namgu, Daegu, South Korea Journal Rheumatology InternationalOnline ISSN 1437-160XPrint ISSN 0172-8172 (Source: Rheumatology International)

Impact of perioperative glycaemia and glycated haemoglobin on the outcomes of the surgical treatment of diabetic foot osteomyelitis

Diabetes Research and Clinical Practice — Wed, 28 Sep 2011 04:00:00 +0100

Abstract: Perioperative glycaemic control during admission was a predictive factor of amputation in a prospective cohort of 81 patients with diabetes who underwent surgical treatment for osteomyelitis. Glycaemic control before admission, as determined by glycosylated haemoglobin, did not have any influence on the outcomes. (Source: Diabetes Research and Clinical Practice)

Massive septic pelvic osteolysis following revision total hip arthroplasty in a patient with sickle cell anemia: clinical presentation and review of the literature

European Journal of Orthopaedic Surgery and Traumatology — Tue, 27 Sep 2011 06:17:15 +0100

We report such a case of a male patient, who underwent one-stage revision hip arthroplasty due to septic cup loosening after primary cementless THA and later developed severe septic osteomyelitis of the ipsilateral hemipelvis that had a fatal outcome. The relative literature regarding loosening and infection after THA in patients with sickle cell disease is thoroughly reviewed. Content Type Journal ArticleCategory Up-to date Review and Case ReportPages 1-5DOI 10.1007/s00590-011-0875-xAuthors Panagiotis Korovessis, Orthopaedic Department, General Hospital “Agios Andreas”, 1, Tsertidou Str, 26224 Patras, GreeceThomas Repantis, Orthopaedic Department, General Hospital “Agios Andreas”, 1, Tsertidou Str, 26224 Patras, Greece Journal European Journal of Orthopaedic Surge...

Multimodal therapy as an algorithm to limb salvage in diabetic patients with large heel ulcers

International Wound Journal — Mon, 26 Sep 2011 15:44:34 +0100

In many series of diabetic foot ulcer care, heel ulcers greater than 4 cm across have been identified as an independent predictor of limb loss. Therefore, we set out to pursue the most aggressive limb salvage algorithm in patients with heel ulcers greater than 4 cm in diameter. Over 5 years, we identified 21 patients, 39–84 years of age, all with diabetes mellitus, with heel ulcers greater than 4 cm in diameter and had magnetic resonance imaging or bone scan evidence of osteomyelitis. Seven of the 21 patients had end‐stage renal disease defined as being haemodialysis dependent. All patients had ankle brachial indices <0·4 or monophasic pulse volume recordings. All patients underwent distal bypass surgery with vein. After adequate perfusion was obtained, all patients underwent parti...

Atypical Focal Osteomyelitis as Initial Manifestation of AIDS

Advances in Pharmacological Sciences — Sun, 25 Sep 2011 18:34:37 +0100

Conclusion. Isolation of an atypical Mycobacterium haemophilum in any abscess should lead the physician to accomplish further investigations and look for AIDS even in young healthy subjects. (Source: Advances in Pharmacological Sciences)

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Differentiating Between Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Osteomyelitis in Children: An Evidence-Based Clinical Prediction Algorithm.

The Journal of Bone and Joint Surgery. American volume — Wed, 21 Sep 2011 04:00:00 +0100

CONCLUSIONS: Our proposed set of four predictors provided excellent diagnostic performance in differentiating between MRSA and MSSA osteomyelitis in children, and thus would be able to guide patient management and facilitate timely antibiotic selection. LEVEL OF EVIDENCE: Diagnostic Level IV. See Instructions to Authors for a complete description of levels of evidence. PMID: 21938373 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Evidence-Based Medicine and Surgical Decision-Making: MRSA and MSSA Osteomyelitis in Children: Commentary on an article by Kevin L. Ju, MD, et al.: "Differentiating Between Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Osteomyelitis in Children. An Evidence-Based Clinical Prediction Algorithm".

The Journal of Bone and Joint Surgery. American volume — Wed, 21 Sep 2011 04:00:00 +0100

Evidence-Based Medicine and Surgical Decision-Making: MRSA and MSSA Osteomyelitis in Children: Commentary on an article by Kevin L. Ju, MD, et al.: "Differentiating Between Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Osteomyelitis in Children. An Evidence-Based Clinical Prediction Algorithm". J Bone Joint Surg Am. 2011 Sep 21;93(18):e1091-2 Authors: Zaleske DJ PMID: 21938360 [PubMed - in process] (Source: The Journal of Bone and Joint Surgery. American volume)

Propionibacterium avidum Causing Native Breast Abscess

Clinical Microbiology Newsletter — Tue, 20 Sep 2011 05:24:09 +0100

Propionibacterium avidum is traditionally considered an organism of low pathogenicity and is seldom associated with human infection. Rare reports of breast abscess caused by P. avidum have been almost exclusively associated with immunosuppression or prior surgical intervention. There are a small number of reports of this organism causing splenic abscess, septic arthritis, sacroiliitis, and osteomyelitis, as well as one report of perianal abscess (). All these infections occurred in immunocompromised patients, patients with pre-existing medical conditions, or following a medical intervention (). The organism has also been associated rarely with breast abscess (), with only one such case being reported in a previously healthy individual who had no history of prior surgical intervention (). (...

50 Years Ago in CORR: Osteomyelitis Since the Advent of Antibiotics; A Study of Infants and Children Gordon M. Cottington, MD, Jay M. Riden, MD, and Albert B. Ferguson, Jr, MD CORR 1959;14:97-101.

Clinical Orthopaedics and Related Research — Sat, 17 Sep 2011 04:00:00 +0100

Authors: Brand RA PMID: 21927968 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

Vancomycin Containing PLLA/β-TCP Controls MRSA In Vitro.

Clinical Orthopaedics and Related Research — Thu, 15 Sep 2011 04:00:00 +0100

CONCLUSIONS: Vancomycin-containing PLLA/β-TCP composites release antibiotics in inhibitory doses after dip coating and appeared biocompatible based on adhesion, proliferation, and mineralization. CLINICAL RELEVANCE: Vancomycin-containing PLLA/β-TCP composites may be useful for controlling MRSA but will require in vivo confirmation. PMID: 21918801 [PubMed - as supplied by publisher] (Source: Clinical Orthopaedics and Related Research)

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Diagnosis and triage of a patient with an extra-osseous fat fluid level

Emergency Radiology — Tue, 13 Sep 2011 15:52:58 +0100

Abstract Extra-osseous fat fluid level is rarely seen in osteomyelitis, with only three magnetic resonance imaging (MRI) cases previously reported in the literature. The rarity of this finding is probably secondary to the extensive necrosis of bone marrow that needs to occur at a rapid phase for the fat to accumulate. However, an extra-osseous fat fluid level is a specific diagnostic sign of osteomyelitis in cases with otherwise equivocal imaging findings and should be reported as such, especially when associated with medullary bone destruction and in the absence of trauma. Content Type Journal ArticleCategory Case ReportPages 1-3DOI 10.1007/s10140-011-0984-1Authors Freddie R. Swain, Department of Radiology, Emory University Hospital Midtown, 550 Peachtree Street, NE,...

Combination of Activated Protein C and Topical Negative Pressure Rapidly Regenerates Granulation Tissue Over Exposed Bone to Heal Recalcitrant Orthopedic Wounds

The International Journal of Lower Extremity Wounds — Tue, 13 Sep 2011 04:00:00 +0100

Chronic wounds arising from orthopedic surgery present a major clinical challenge. Osteomyelitis may develop from polymicrobial infection, which can be unresponsive to treatment and lead to amputation. Topical negative pressure (TNP) is an effective treatment in wound management and is now used worldwide. Activated protein C (APC) is an anticoagulant with cytoprotective and healing properties. The aim of this study was to determine whether combined treatment of TNP and APC was tolerated and was efficacious for treatment of difficult-to-treat wounds. Four patients who presented to Royal North Shore Hospital with wounds that were not responsive to conventional therapy were studied. All cases showed a marked reduction in wound size and depth within 1 week of starting treatment and progressive...

Statistical Reliability of Bone Biopsy for the Diagnosis of Diabetic Foot Osteomyelitis

Journal of Foot and Ankle Surgery — Mon, 12 Sep 2011 04:00:00 +0100

The objective of the present study was to quantify the reliability of the histopathologic analysis of bone with respect to the diagnosis of diabetic foot OM. Four pathologists, kept unaware of the previous pathology reports and specific patient clinical characteristics, retrospectively reviewed 39 consecutive tissue specimens and were informed only that it was “a specimen of bone taken from a diabetic foot to evaluate for OM.” As a primary outcome measure, the pathologists were asked to make 1 of 3 possible diagnoses: (1) no evidence of OM, (2) no definitive findings of OM, but cannot rule it out, or (3) findings consistent with OM. There was complete agreement among all 4 pathologists with respect to the primary diagnosis in 13 (33.33%) of the 39 specimens, with a corresponding kappa ...

Chronic suppurative osteomyelitis of the mandible

Journal of Indian Society of Pedodontics and Preventive Dentistry — Fri, 09 Sep 2011 04:00:00 +0100

K Mallikarjun, Anil Kohli, Arvind Kumar, Amorgh TanwarJournal of Indian Society of Pedodontics and Preventive Dentistry 2011 29(2):176-179Osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium. Osteomyelitis, inflammatory process of the bone and its structures, can be acute or chronic. Taking a journey from a nonsurgical approach to a surgical one, it appeared to be one osteomyelitis revenge against all our efforts. The pain, the pus, the new bone formation, and all the trouble, this case showed it all. The injudicious use of antibiotics and delay in providing the requisite treatment can cause devastating effects as in the case of an 11-year-old child. A case report on treating osteomyelitis through medication and realizing that surgi...

Case Report: Injectable pentazocine abuse leading to necrotizing soft tissue infection and florid osteomyelitis

Hand — Thu, 08 Sep 2011 05:58:21 +0100

Content Type Journal ArticleCategory Case ReportsPages 1-3DOI 10.1007/s11552-011-9359-zAuthors Colin Mudrick, Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health Systems, 1200 East Broad Street, P.O. Box 980153, Richmond, VA 23298, USAJonathan Isaacs, Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health Systems, 1200 East Broad Street, P.O. Box 980153, Richmond, VA 23298, USAJessica Frankenhoff, Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health Systems, 1200 East Broad Street, P.O. Box 980153, Richmond, VA 23298, USA Journal HandOnline ISSN 1558-9455Print ISSN 1558-9447 (Source: Hand)

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Chronic osteomyelitis in the lower extremity predisposing to the unusual formation of keloids.

Singapore Medical Journal — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Orimolade EA, Olabanji JK, Oladele AO, Yusuf MB Abstract Keloids commonly occur in black and pigmented races as well as in young adults, but rarely affect Caucasians and albinos. While they have a predilection for the upper trunk as well as the head and neck regions, they seldom occur in the lower limbs. A six-year-old boy presented with multiple fibrous nodular swellings of the right leg and a discharging sinus over the ankle. Closer evaluation revealed underlying chronic osteomyelitis complicated by multiple huge keloids over the leg and ankle. Associated chronic inflammation had resulted in the huge keloids. Our patient's age, site of occurrence and presentation were not typical. In the event that a keloid is presented in isolation, chronic osteomyelitis should be consi...

Transomental Titanium Plates for Sternal Osteomyelitis in Cardiac Surgery

Journal of Cardiac Surgery — Thu, 01 Sep 2011 04:00:00 +0100

Conclusions: Omental flap transposition represents a good option in the treatment of sternal osteomyelitis. Partial or total sternal manubrium preservation and fixation are essential for the restoration of sternal stability. The use of transomental titanium plates provides chest wall stabilization when extensive sternal resection is required.(J Card Surg 2011;**:1‐4) (Source: Journal of Cardiac Surgery)

Chronic multifocal osteomyelitis: Is infectious causation a moot point?

Journal of Infection and Public Health — Thu, 01 Sep 2011 04:00:00 +0100

Highlights: ► Chronic multifocal osteomyelitis is a chronic illness with remitting bony lesions. ► The differential diagnosis for CMO is initially quite broad. ► Diagnosis is dependent on clinical course, pathology, and microbiology. ► Patients with CMO not uncommonly suffer from another concomitant inflammatory illness.Summary: Chronic multifocal osteomyelitis (CMO) is an uncommon disease entity with descriptions possibly emanating from the medical literature over one century ago, and there are numerous disease entities which have been historically detailed and which are probably synonymous. The illness is one of chronicity with exacerbating and remitting focal bony lesions. The differential diagnosis for a bony lesion which ultimately proves to be CMO is initially quite broad. Th...

New trends in diagnosis and control strategies for implant infections.

The International Journal of Artificial Organs — Thu, 01 Sep 2011 04:00:00 +0100

Authors: Arciola CR, Montanaro L, Costerton JW Abstract In implant infections, a quick and reliable identification of the etiological agent is crucial to realizing efficacious therapies. Among molecular methods, automated ribotyping has proven to be an accurate and rapid technique. More recently, MALDI-TOF/MS and PCR-electrospray ionization (ESI)/MS have been applied successfully to microbiological diagnosis. In implant infections, biofilm is still the major problem for bacterial persistence and recalcitrance to antibiotic therapy. Among biofilm-disrupting agents, enzymes promise the greatest therapeutic possibilities. DNase I degrades biofilm extracellular DNA and has been shown to sensitize biofilm to various biocides and anionic detergents, while dispersin B acts on biofilm exop...

Chronic refractory osteomyelitis as a part of synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome: a diagnostic challenge

ANZ Journal of Surgery — Wed, 31 Aug 2011 23:00:00 +0100

(Source: ANZ Journal of Surgery)

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Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression.

Clinical Immunology — Tue, 30 Aug 2011 04:00:00 +0100

Authors: Hofmann SR, Schwarz T, Möller JC, Morbach H, Schnabel A, Rösen-Wolff A, Girschick HJ, Hedrich CM Abstract Chronic non-bacterial osteomyelitis (CNO) is an auto-inflammatory disorder that affects the skeletal system. Interleukin (IL-)10 is an immune-modulatory cytokine that controls inflammation, and limits inflammatory cytokine responses. Dysregulation of IL-10 expression has been shown to result in autoimmune and infectious diseases. We investigated IL-10 expression by monocytic cells from CNO patients and controls. In response to stimulation with LPS, IL-10 expression from CNO monocytes was reduced (p<0.001). This was independent of IL10 promoter polymorphisms. Thus, we investigated Sp1 recruitment to the IL10 promoter and saw markedly reduced binding in CNO monocyte...

The role of diagnostic imaging in the evaluation of suspected osteomyelitis in the foot: A critical review

The Foot — Tue, 30 Aug 2011 03:02:28 +0100

Abstract: The early diagnosis of osteomyelitis in the foot from its clinical presentation alone can be difficult particularly in cases when the early signs are subtle. Early diagnosis and subsequent early intervention are imperative to reduce the risk of chronic infection, associated early lytic changes to bone and potential long term structural complications caused by subsequent deformity and lost anatomy.Diagnostic imaging has a major role to play in the early assessment and diagnosis of bone infection, yet the choice of approach can be controversial.Several imaging modalities have been advocated, imaging of the infected foot is complex and no single test is ideal for every situation. The clinician needs to be aware of the strengths and weaknesses of each imaging modality so that the mos...

Deficiency of interleukin‐1‐Receptor antagonist (DIRA): description of two unrelated cases from brazil with a novel mutation

Arthritis and Rheumatism — Mon, 29 Aug 2011 23:00:00 +0100

Conclusion:The same homozygous novel mutation in IL1RN in two unrelated Brazilian patients suggests that it may be a founder mutation that has been introduced in the Brazilian population. (Source: Arthritis and Rheumatism)

A clinical predicament—diagnosis and differential diagnosis of cutaneous facial sinus tracts of dental origin: a series of case reports

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics — Mon, 29 Aug 2011 04:00:00 +0100

This article presents 4 cases of facial lesions misdiagnosed as being of nonodontogenic origin. The correct diagnosis in each case was cutaneous sinus tract secondary to pulpal necrosis, suppurative apical periodontitis, and osteomyelitis. In all cases, facial sinus tracts of dental origin were excised and the source of infection eliminated. The purpose of this paper is to provide diagnostic guidelines and examination protocols for differential diagnosis of cutaneous facial sinus tracts of dental origin. (Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics)

Tubercular Osteomyelitis of the Second Metatarsal: A Case Report

Journal of Foot and Ankle Surgery — Sat, 27 Aug 2011 19:43:35 +0100

We describe a case of spina ventosa affecting the second metatarsal, with a review of the literature and description of the clinical manifestations, diagnostic images, and treatment of skeletal tuberculosis. (Source: Journal of Foot and Ankle Surgery)

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Microbiological and pharmacological tests on new antibiotic‐loaded PMMA‐based composites for the treatment of osteomyelitis

Journal of Orthopaedic Research — Sun, 21 Aug 2011 23:00:00 +0100

AbstractLocal antibiotic diffusion in rabbit femurs from two new PMMA‐based and nail‐shaped composites, enriched with β‐tricalcium phosphate (P‐TCP) and BaSO4 or only with BaSO4 (P‐BaSO4), and soaked in a solution of gentamicin (G) and vancomycin (V) was studied. Nails were implanted into the intramedullary cavity of healthy and osteomyelitic femurs to study the resolution of infection and to quantify the antibiotic penetration into bone by microbiological, pharmacological, and histological tests. A significant progression of osteomyelitis was recorded 7 weeks after MRSA inoculation, whereas no bacteria were found in animals treated with antibiotic‐loaded nails as confirmed by microbiology and histology (Smeltzer score). The release of both antibiotics from composites was high...

Viewpoint: Randomised controlled trials using invasive control interventions should be included in Cochrane Reviews.

Cochrane Database of Systematic Reviews — Sat, 20 Aug 2011 17:00:05 +0100

Authors: Kallmes DF, Buchbinder R, Miller FG Abstract We find it fascinating that both Cyna et al. and ourselves begin at the exact same point - that is, patient protection is paramount - yet we end up at diametrically opposing views regarding the use of invasive 'placebos' in randomised controlled trials (RCTs). Protection of patients in clinical practice requires that we determine whether treatments are effective and offer a favourable risk-benefit ratio. This determination requires research to evaluate treatments. In doing research, we need to be concerned about two, potentially competing, considerations: (1) protection of patient-participants, and (2) scientifically sound methodology to answer clinically important research questions. We believe that, in certain circumstances, t...

Management of thromboangiitis obliterans using distraction osteogenesis: A retrospective study

Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1) — Wed, 17 Aug 2011 23:00:00 +0100

Conclusion: The principle of the distraction osteogenesis including neoangiogenesis can be used for treatment of TAO and has an acceptable complication rate. (Source: Table of Contents : Indian Journal of Orthopaedics : 2007 - 41(1))

Primary sternal osteomyelitis due to Peptostreptococcus anaerobius

Infection — Wed, 17 Aug 2011 06:05:10 +0100

Abstract Primary sternal osteomyelitis (PSO) is a rare syndrome. In adults, it usually occurs with underlying predisposing factors, such as immunodeficiency, or intravenous (IV) drug abuse. The infecting organism in these patients is usually Staphylococcus aureus or Pseudomonas aeruginosa. Peptostreptococcus species are Gram-positive anaerobic cocci and are part of the normal flora of human mucocutaneous surfaces. Peptostreptococcus infection can occur in all body sites, including the central nervous system, head, neck, chest, abdomen, pelvis, skin, bone, joint, and soft tissue. Here, we report on a 32-year-old previously healthy Chinese man who was diagnosed with PSO and P. anaerobius was yielded in the bacterial culture. He was treated empirically with antibiotics, but these...

Vertebral Osteomyelitis: An Unusual Presentation of Bartonella henselae Infection

Seminars in Arthritis and Rheumatism — Tue, 16 Aug 2011 04:00:00 +0100

Conclusions: B henselae vertebral osteomyelitis can involve immunocompetent adults. In the case of vertebral osteomyelitis with negative blood cultures, recent history of local lymphadenopathy and cat exposure must be investigated and B henselae serology must be performed. Nevertheless, even if serology is positive, vertebral biopsy is required to rule out other pathogens or malignancy. B henselae infection can be confirmed by polymerase chain reaction performed on vertebral or lymph node biopsy. (Source: Seminars in Arthritis and Rheumatism)

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Acute Haematogenous Metacarpal Osteomyelitis in Children: A Case Report and Review of Literature

Infectious Diseases in Obstetrics and Gynecology — Mon, 15 Aug 2011 15:14:14 +0100

We present an infant affected by granulomatous chronic disease with acute haematogenous osteomyelitis of the fourth metacarpal. Serratia marcescens was found to be the pathogenic agent. Treatment was antibiotics and debridement. Bone healed with little length discrepancy but functional result was normal. (Source: Infectious Diseases in Obstetrics and Gynecology)

Arthritis, Osteomyelitis, Septicemia and Meningitis Caused by Klebsiella in a Low-Birth-Weight NewbornArthritis, Osteomyelitis, Septicemia and Meningitis Caused by Klebsiella in a Low-Birth-Weight Newborn

Medscape Today Headlines — Mon, 15 Aug 2011 11:04:47 +0100

This low-birthweight baby presented with multiple systemic infections. What was the optimal antibiotic therapy in this complex case? Journal of Medical Case Reports (Source: Medscape Today Headlines)

Osteoid osteoma of the great toe.

Orthopedics — Sat, 13 Aug 2011 16:16:12 +0100

This article presents a case of a 22-year-old man with osteoid osteoma in his distal phalanx of the hallux. A needle biopsy of his great toe revealed a small number of bacteria, so he was initially treated for osteomyelitis but with unsatisfactory results. The particular characteristics of clinical and imaging findings supported a diagnosis of osteoid osteoma in the distal phalanx of the hallux. After surgical removal of the tumor, his symptoms resolved. The pathological examination confirmed the suspected diagnosis.In a patient with chronic foot pain that changes to become nocturnal and disappears with NSAID administration, it is important to include osteoid osteoma as a differential diagnosis. A detailed assessment of both clinical and radiological features can lead to the correct diagno...

Management of Combined Bone Defect and Limb-length Discrepancy After Tibial Chronic Osteomyelitis.

Orthopedics — Sat, 13 Aug 2011 16:16:12 +0100

This study shows that distraction osteogenesis with an external fixator is an effective treatment for massive postosteomyelitis bone defects and leg shortening. PMID: 21815577 [PubMed - in process] (Source: Orthopedics)

Hemodialysis catheter infection with unusual presentation and grave outcome

Hemodialysis International — Thu, 11 Aug 2011 23:00:00 +0100

AbstractBacteremia from central venous catheter (CVC) infection causes morbidity and mortality in patients on hemodialysis (HD). Diagnosis of the infection can be difficult and may require special imaging. A 70‐year‐old man with diabetic nephropathy was on HD for 11 months through a permanent CVC. Because of symptomatic osteoporosis, he had kyphoplasty in three lumbar vertebrae (L2, L3, L4) 6 months after starting HD. Severe back pain persisted after kyphoplasty. Throughout the HD period, the exit site of the CVC had a clean appearance, there was no fever, and blood leukocyte counts were normal. During the 11th month of HD, he complained of subjective fever at home. Blood count revealed normal leukocyte count with neutrophilic predominance and blood cultures grew methicillin‐resistan...

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Outcome of patients with diabetes with negative percutaneous bone biopsy performed for suspicion of osteomyelitis of the foot

Diabetic Medicine — Thu, 11 Aug 2011 23:00:00 +0100

Conclusions: The results of the present study suggest that, of patients with diabetes with the suspicion of osteomylelitis and a negative percutaneous bone biopsy, only one out of four will develop osteomylelitis within 2 years of the biopsy. (Source: Diabetic Medicine)

Acute Haematogenous Metacarpal Osteomyelitis in Children: A Case Report and Review of Literature

Journal of Cancer Epidemiology — Thu, 11 Aug 2011 16:20:49 +0100

Culture-Negative Chronic Osteomyelitis of the Tibia With a Brodie’s AbscessCulture-Negative Chronic Osteomyelitis of the Tibia With a Brodie’s Abscess

Medscape Today Headlines — Thu, 11 Aug 2011 13:04:38 +0100

What was the cause of this patient's 1-year history of progressive leg pain? Applied Radiology (Source: Medscape Today Headlines)

Regeneration of the proximal tibial epiphysis during callus distraction for atrophic nonunion after infantile osteomyelitis

European Journal of Orthopaedic Surgery and Traumatology — Thu, 11 Aug 2011 05:54:21 +0100

Abstract The purpose of this study was to report a case with osteomyelitis of the proximal tibia as an infant leading to an atrophic nonunion with a segmental bone defect and limb shortening. The patient was treated by callus distraction with external fixator three times, and regeneration of the proximal tibia epiphysis appeared during the management. The activation of the resting mesenchymal stem cells might contribute to the regeneration of the epiphysis and osteogenesis in the sites of atrophic nonunion. Content Type Journal ArticlePages 1-4DOI 10.1007/s00590-011-0850-6Authors Tang Liu, Department of Orthopaedics, The 2nd Xiangya Hospital, Central South University, Changsha, 410011 Hunan, People’s Republic of ChinaDeyi Sun, Department of Orthopaedics, The 2nd Xian...