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pelvic osteomyelitis

Jinhee Lee, Chai Ho Jeong, Myun Hee Lee, Eun Gyo Jeong, Youn Jeong Kim, Sang Il Kim, Yang Ree Kim
Emphysematous osteomyelitis, especially that involving the extra-axial skeleton, is an extremely rare presentation but associated with significant morbidity and mortality. Here, we report a case in which a 58-year-old female patient with diabetes mellitus presented with emphysematous osteomyelitis that involved the sternum, clavicle, and pelvic bone and was caused by Escherichia coli via hematogenous spread of urinary tract infection. We successfully treated her with urgent and aggressive surgical drainage with prolonged antibiotics therapy...
February 7, 2017: Infection & Chemotherapy
Charlotte de Bodman, Dimitri Ceroni, Justine Dufour, Pierre-Alex Crisinel, Aline Bregou-Bourgeois, Pierre-Yves Zambelli
RATIONALE: Obturator pyomyositis is a rare condition in children. Diagnosis is often delayed because of its rarity, and the vagaries of its presentation cause it to be easily be missed. Physicians should therefore familiarize themselves with this condition and consider it as a possible differential diagnosis in patients presenting with an acutely painful hip. Inflammatory syndrome is also frequent among sufferers and the MRI is a very sensitive diagnostic tool for obturator pyomyositis...
March 2017: Medicine (Baltimore)
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
March 2017: Annals of the Royal College of Surgeons of England
F Fridrich, V Báča, V Džupa
Purulent inflammation of the pubic symphysis is a rare condition involving the symphysis and parasymphyseal parts of the pubic bones. It is usually found in immuno-compromised patients and its most frequent cause is Staphylococcus aureus. Conservative treatment is based on long-term administration of antibiotics and has been efficient, as reported, in about 50% of the patients. The authors treated five patients with a late diagnosis of purulent infection of the pubic symphysis in whom the antibiotic therapy had to be completed by surgical intervention...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Sherif I Heiba, Lewen Stempler, Timothy Sullivan, Dov Kolker, Lale Kostakoglu
INTRODUCTION: The successful management of infected pelvic pressure ulcer patients (PPUP) depends on the distinction between infections limited to soft tissue (STI) and those with underlying osteomyelitis (OM), which can be difficult to determine clinically. Dual-isotope (DI) comprehensive imaging has excellent accuracy in localizing diabetic foot infection and differentiating OM from STI with SPECT/CT utilization. In this study, we assess the accuracy and confidence of the different DI SPECT/CT imaging steps in PPUP with confirmed diagnoses...
February 2017: Nuclear Medicine Communications
Zerwa Farooq, Brooke Devenney-Cakir
Viridans group streptococcus is an infrequent cause of osteomyelitis that is found in association with infective endocarditis. Only a few studies report viridans osteomyelitis in the absence of endocarditis. Vertebral pyogenic osteomyelitis can sometimes be complicated by psoas or paraspinal abscesses. These intra-abdominal and/or pelvic collections can very rarely result in venous thrombosis. A paraspinal abscess resulting in inferior vena cava (IVC) thrombosis has only been reported once in the literature...
December 2016: Radiology case reports
Wayne Hoskins, Andrew Bucknill, James Wong, Edward Britton, Rodney Judson, Kellie Gumm, Roselyn Santos, Rohan Sheehy, Xavier Griffin
BACKGROUND: External fixation is commonly used as a means of definitive fixation of pelvic fractures. Pin site infection is common, with some cases of osteomyelitis and inpatient nursing can be challenging. The aim of this study is to report the outcomes and complications of an alternative minimally invasive technique, known as INFIX, utilising spinal pedicle screws inserted into the supra-acetabular bone and connected by a subcutaneous rod. METHODS: A single-centre prospective case series was performed...
November 8, 2016: Journal of Orthopaedic Surgery and Research
Tugce Tural Kara, Halil Ozdemir, Suat Fitoz, Ergin Ciftci, Erdal Ince
Pelvic osteomyelitis is a rare infection. Ilium, ischium, pubis and acetabulum are commonly affected sites. Pelvic radiography, pelvic magnetic resonance and scintigraphy are useful imaging techniques for diagnosis. However, diagnoses should be confirmed with bone biopsy from the lesion. Sometimes diagnosis is delayed because of deep localization of infection site. Here in, we report a 15-year-old girl with left groin pain who was diagnosed as pelvic osteomyelitis one month after initial symptoms. Patient was successfully treated with antibiotics for 8 weeks...
October 1, 2016: Archivos Argentinos de Pediatría
Amanda V Jenson M D, Robert Scranton, Danielle D Antosh, Richard K Simpson
Lumbosacral osteomyelitis and discitis are usually a result of hematogenous spread; rarely it can result from direct inoculation during a surgical procedure. Bacteria may also track along implanted devices to a different location. This is a rare complication seen from pelvic organ prolapse surgery with sacral colpopexy. A 67-year-old female developed increasing lower back pain four months following a laparoscopic sacral colpopexy. Imaging revealed lumbar 5-sacral 1 (L5-S1) osteomyelitis and discitis with associated phlegmon confirmed by percutaneous biopsy and culture...
2016: Curēus
M T Alif Adlan, W A K Wan Mohd Rasis, M D Mohd Ramadhan
Staphylococcus Aureus is a Gram-positive cocci bacteria which had been found to be the causative organism in over 88% of patients with primary iliopsoas abscess. We report the case of a 53-year-old diabetic woman with end-stage renal failure diagnosed with left iliopsoas abscess with a catheter-related infection. Computed tomogram (CT) of abdomen and pelvis revealed hypodense lesions of left psoas, iliacus and quadratus lumborum suggestive of psoas abscesses. In addition, osteomyelitis changes at left sacroiliac and hip joint were seen...
April 2016: Medical Journal of Malaysia
Cezary Kocialkowski, William Ryan, Naomi Davis
INTRODUCTION: Osteomyelitis of the pelvis can be a difficult condition to diagnose and can present in a number of different ways. The ilium is the bone most frequently affected and staphylococcus aureus is the organism most commonly responsible. CASEREPORT: This case report describes a six year old girl, who presented with right sided hip pain, fevers and altered weight bearing. She was initially diagnosed with septic arthritis of the hip and underwent open joint washout...
October 2014: Journal of Orthopaedic Case Reports
J C Teng, S M Lingaratnam, J A Trubiano, K A Thursky, M A Slavin, L J Worth
Pristinamycin has been used to treat a range of Gram-positive infections, but reported experience in patients with malignancy is limited. This study aimed to evaluate the use of pristinamycin in patients with cancer at an Australian centre. All patients commenced on oral pristinamycin therapy at the Peter MacCallum Cancer Centre between January 2005 and December 2014 were identified using the hospital pharmacy dispensing system. Information on demographics, co-morbidities, cancer diagnosis, infection characteristics, pristinamycin regimen, pristinamycin tolerability and outcomes was collected...
May 2016: International Journal of Antimicrobial Agents
Daniel A Kaufman, Brendan M Browne, Leonard N Zinman, Alex J Vanni
OBJECTIVE: To describe a novel, organ-sparing approach for reconstruction of radiation-induced anterior prostato-symphyseal fistulas (PSFs) at our institution over a consecutive 10-year period. MATERIALS AND METHODS: We performed a retrospective review of patients undergoing surgical reconstruction for anterior PSF between January 1, 2006 and October 31, 2015. Patient demographics as well as preoperative, operative, and postoperative data were reviewed, including etiology of fistula, surgical management, and outcomes...
June 2016: Urology
Panagiotis Korovessis, Thomas Repantis
Total hip arthroplasty (THA) performed in patients with osteonecrosis, caused by sickle cell disease, carries a higher risk of medical and orthopedic complications, than those observed after THA for osteonecrosis related to other conditions. 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...
November 2012: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
A-S Brunel, B Lamy, C Cyteval, H Perrochia, L Téot, R Masson, H Bertet, A Bourdon, D Morquin, J Reynes, V Le Moing
There is no consensus on a diagnostic strategy for osteomyelitis underlying pressure ulcers. We conducted a prospective study to assess the accuracy of multiple bone biopsies and imaging to diagnose pelvic osteomyelitis. Patients with clinically suspected osteomyelitis beneath pelvic pressure ulcers were enrolled. Bone magnetic resonance imaging (MRI) and surgical bone biopsies (three or more for microbiology and one for histology per ulcer) were performed. Bacterial osteomyelitis diagnosis relied upon the association of positive histology and microbiology (at least one positive culture for non-commensal microorganisms or three or more for commensal microorganisms of the skin)...
March 2016: Clinical Microbiology and Infection
Marcus D Mazur, Vijay M Ravindra, Andrew T Dailey, Sara McEvoy, Meic H Schmidt
BACKGROUND: Pelvic fixation with S2-alar-iliac (S2AI) screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis. PURPOSE: To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO) at the lumbosacral junction. STUDY DESIGN: Technical report...
2015: Frontiers in Surgery
Jennifer L Hurley-Sanders, R Scott Larsen, Brigid Troan, Michael Loomis
Over a 25-mo span from a single zoologic collection, two bufflehead ducklings (Bucephala albeola) presented with pelvic limb paresis and were euthanized. On postmortem examination, the first duckling had intralesional fungal hyphae consistent with Aspergillus sp. in the spinal vertebrae and within pulmonary granulomas. In the second duckling, evidence of a thoracic spinal lesion was detected antemortem by using thermographic imaging. At postmortem examination, fungal hyphae consistent with Mucor sp. were found within the vertebrae...
September 2015: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Phani Bodavula, Stephen Y Liang, Jiami Wu, Paige VanTassell, Jonas Marschall
Background.  Decubitus ulcers can become complicated by pelvic osteomyelitis. Little is known about the epidemiology of pressure ulcer-related pelvic osteomyelitis. Methods.  We performed a retrospective cohort study of adult patients with pressure ulcer and pelvic osteomyelitis admitted to an academic center from 2006 to 2011. Data on clinical presentation, diagnostic evaluation, and treatment during the index admission were collected. Outcome measures included length of hospital stay and number of readmissions in the subsequent year...
September 2015: Open Forum Infectious Diseases
Aleksandra Grajek, Jerzy Białecki, Wojciech Marczyński, Piotr Walczak, Julia Macias
BACKGROUND: Despite improvements in surgical techniques, aseptics and prevention of infections, hospital surgical site infections (SSI) still remain one of the main reasons for failure in therapeutic musculoskeletal surgery. This study aimed to conduct a retrospective analysis of microbiological examinations and determine pathogen sensitivity to antibiotics as the basis for selecting methods for preventing and treating complicating infections. MATERIAL AND METHODS: The study is a retrospective analysis of bacteriological tests performed in the departments of the Public Clinical Hospital of the Medical Centre of Postgraduate Education in Otwock...
May 2015: Ortopedia, Traumatologia, Rehabilitacja
Sho Ishiwata, Takashi Yanagawa, Kenichi Saito, Kenji Takagishi
Developments in radiation therapy modalities offer alternative treatments for unresectable malignant tumors in the pelvis and trunk. However, poor vascularity as a result of radiation therapy makes the treated lesion susceptible to infection, and there are no established treatments for pelvic osteomyelitis with a large dead space after radiation therapy. The authors report 2 cases of sacral osteomyelitis after radiation therapy that were treated successfully with a gluteus maximus turnover flap. To create the flap, the distal portion of the lower third of the muscle was detached from the trochanter...
July 1, 2015: Orthopedics
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