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https://www.readbyqxmd.com/read/28538361/characteristics-of-and-risk-factors-for-severe-neurological-deficit-in-patients-with-pyogenic-vertebral-osteomyelitis-a-case-control-study
#1
Adrien Lemaignen, Idir Ghout, Aurélien Dinh, Guillaume Gras, Bruno Fantin, Virginie Zarrouk, Robert Carlier, Jean-Edouard Loret, Eric Denes, Alix Greder, François-Xavier Lescure, David Boutoille, Pierre Tattevin, Bertrand Issartel, Jean-Philippe Cottier, Louis Bernard
Severe neurological deficit (SND) is a rare but major complication of pyogenic vertebral osteomyelitis (PVO). We aimed to determine the risk factors and the variables associated with clinical improvement for SND during PVO.This case-control study included patients without PVO-associated SND enrolled in a prospective randomized antibiotic duration study, and patients with PVO-associated SND managed in 8 French referral centers. Risk factors for SND were determined by logistic regression.Ninety-seven patients with PVO-associated SND cases, and 297 controls were included...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28533166/risk-factors-for-30-day-mortality-in-patients-with-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#2
Pedro Ayau, Ana C Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler C Prentiss, Mary B Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J Zervos
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI. METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records...
May 19, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28504498/-pediatric-case-report-spinal-epidural-abscess
#3
Mauricio Pons, Leila Pérez, Facundo Juárez
Spinal epidural abscess is an uncommon pathology. It has an incidence of one case per 100 000 individuals. An increase is observed due to the raise of risk factors such as diabetes mellitus, spinal abnormalities, tattoos, acupuncture, epidural analgesia, and a greater availability of imaging methods. It is a purulent collection located between the dura and the medullary canal. The most common germs are Staphylococcus aureus and Gram-negative bacteria. Without timely treatment, it evolves to medullary compression and permanent neurological sequelae...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28492440/diskitis-osteomyelitis-spinal-epidural-abscess-meningitis-and-endocarditis-following-sacroiliac-joint-injection-for-the-treatment-of-low-back-pain-in-a-patient-on-therapy-for-hepatitis-c-virus
#4
Geeta Nagpal, John P Flaherty, Honorio T Benzon
OBJECTIVE: Sacroiliac joint injections are frequently performed procedures in the management of acute and chronic low-back pain, including patients with various immunocompromised states. Infectious complications following these procedures along with other spinal injections are rarely reported, but the true incidence is unknown. The purpose of this report is to highlight the devastating neurologic sequela that can occur, and to discuss potential future management strategies. CASE REPORT: We present a patient who developed diskitis, osteomyelitis, spinal epidural abscess, meningitis, and endocarditis from Staphylococcus aureus, all of which developed shortly after a sacroiliac joint injection...
May 10, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28482860/complicated-infective-endocarditis-a-case-series
#5
Joo Seop Kim, Min-Kyung Kang, A Jin Cho, Yu Bin Seo, Kun Il Kim
BACKGROUND: Infective endocarditis is associated with not only cardiac complications but also neurologic, renal, musculoskeletal, and systemic complications related to the infection, such as embolization, metastatic infection, and mycotic aneurysm. CASE PRESENTATION: We report three cases (the first patient is Chinese and the other two are Koreans) of complicated infective endocarditis; two of the cases were associated with a mycotic aneurysm, and one case was associated with a splenic abscess...
May 8, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28473276/cardiac-tamponade-secondary-to-purulent-pericarditis-diagnosed-with-the-aid-of-emergency-department-ultrasound
#6
Mackenzie Gabler
Purulent pericarditis is a rare but devastating disease process and even when treated, carries a poor prognosis. Cardiac tamponade is the most severe complication of purulent pericarditis and without acute surgical intervention, is often fatal. Diagnosis requires pericardiocentesis; however, early consideration of the disease and its complications in the emergency department (ED) can be life-saving. Here, we present a case of an intravenous drug user who presented with altered mental status and a rectal temperature of 105...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28466149/potentially-modifiable-factors-contributing-to-sepsis-associated-encephalopathy
#7
Romain Sonneville, Etienne de Montmollin, Julien Poujade, Maïté Garrouste-Orgeas, Bertrand Souweine, Michael Darmon, Eric Mariotte, Laurent Argaud, François Barbier, Dany Goldgran-Toledano, Guillaume Marcotte, Anne-Sylvie Dumenil, Samir Jamali, Guillaume Lacave, Stéphane Ruckly, Bruno Mourvillier, Jean-François Timsit
PURPOSE: Identifying modifiable factors for sepsis-associated encephalopathy may help improve patient care and outcomes. METHODS: We conducted a retrospective analysis of a prospective multicenter database. Sepsis-associated encephalopathy (SAE) was defined by a score on the Glasgow coma scale (GCS) <15 or when features of delirium were noted. Potentially modifiable risk factors for SAE at ICU admission and its impact on mortality were investigated using multivariate logistic regression analysis and Cox proportional hazard modeling, respectively...
May 2, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28332157/systematic-overdosing-of-oxa-and-cloxacillin-in-severe-infections-treated-in-icu-risk-factors-and-side-effects
#8
Mathilde Neuville, Najoua El-Helali, Eric Magalhaes, Aguila Radjou, Roland Smonig, Jean-François Soubirou, Guillaume Voiriot, Alban Le Monnier, Stéphane Ruckly, Lila Bouadma, Romain Sonneville, Jean-François Timsit, Bruno Mourvillier
BACKGROUND: Oxacillin and cloxacillin are the most frequently used penicillins for the treatment of severe methicillin-susceptible Staphylococcus aureus infections in intensive care units (ICUs), especially endocarditis. International recommendations do not suggest any adaptation of the dosage in case of renal impairment. We wanted to assess the risk factors for overdosing in ICU and the related observed side effects. METHODS: All patients with a therapeutic drug monitoring of oxa- or cloxacillin between 2008 and 2014 were included...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28320357/outcome-of-neurological-early-rehabilitation-patients-carrying-multi-drug-resistant-bacteria-results-from-a-german-multi-center-study
#9
MULTICENTER STUDY
J D Rollnik, M Bertram, C Bucka, M Hartwich, M Jöbges, G Ketter, B Leineweber, M Mertl-Rötzer, D A Nowak, T Platz, K Scheidtmann, R Thomas, F von Rosen, C W Wallesch, H Woldag, P Peschel, J Mehrholz, M Pohl
BACKGROUND: Colonization or infection with multi-drug resistant (MDR) bacteria is considered detrimental to the outcome of neurological and neurosurgical early rehabilitation patients. METHODS: In a German multi-center study, 754 neurological early rehabilitation patients were enrolled and and reviewed in respect to MDR status, length of stay (LOS) and the following outcome variables: Barthel Index (BI), Early Rehabilitation Index (ERI), Glasgow Outcome Score Extended (GOSE), Coma Remission Scale (CRS), Functional Ambulation Categories (FAC)...
March 20, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28284111/characteristics-and-predictors-of-outcome-of-spontaneous-spinal-epidural-abscesses-treated-conservatively-a-retrospective-cohort-study-in-a-referral-center
#10
Nikolaos Spernovasilis, Stelios Demetriou, Maria Bachlitzanaki, Ioannis Gialamas, Kalliopi Alpantaki, Georgios Hamilos, Apostolos Karantanas, Achilleas Gikas
OBJECTIVE: Recent studies have shown that in carefully selected patients, conservative treatment alone can be an option in the management of spinal epidural abscess (SEA). The aim of this study was to identify prognostic factors of outcome in patients with spontaneous SEA treated conservatively. PATIENTS AND METHODS: A retrospective cohort study of all patients with spontaneous SEA treated with antibiotics alone from January 2012 to December 2015 was conducted in a 1200-bed tertiary referral center...
February 27, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28068970/quadriplegia-caused-by-an-epidural-abscess-occurring-at-the-same-level-of-cervical-destructive-spondyloarthropathy-a-case-report
#11
Jun-Seok Lee, Ji-Hyun Ryu, Jong-Tae Park, Ki-Won Kim
BACKGROUND: Destructive spondyloarthropathy (DSA) is one of the major complications in patients undergoing long-term hemodialysis. To the best of our knowledge, an epidural abscess occurring at the level of preexisting cervical DSA has not been well described in the literature. We report a unique case of quadriplegia caused by an epidural abscess occurring at the same level of preexisting cervical DSA. CASE PRESENTATION: A 49-year-old woman was transferred to our emergency department with 5 days of sepsis, drowsy mental status, and quadriplegia below the C5 level...
January 10, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28028447/spinal-epidural-abscess-in-a-patient-with-piriformis-pyomyositis
#12
Gerald S Oh, Hussam Abou-Al-Shaar, Gregory D Arnone, Ashley L Barks, Ziad A Hage, Sergey Neckrysh
BACKGROUND: Spinal epidural abscess resulting from piriformis pyomyositis is extremely rare. Such condition can result in serious morbidity and mortality if not addressed in a timely manner. CASE DESCRIPTION: The authors describe the case of a 19-year-old male presenting with a 2-week history of fever, low back pain, and nuchal rigidity. When found to have radiographic evidence of a right piriformis pyomyositis, he was transferred to our institution for further evaluation...
2016: Surgical Neurology International
https://www.readbyqxmd.com/read/28007393/fournier-s-gangrene-during-acth-therapy
#13
Shingo Numoto, Hirokazu Kurahashi, Yoshiteru Azuma, Atsushi Numaguchi, Kozaburo Nakahara, Takahisa Tainaka, Michihiko Takasu, Kiyoshi Yamakawa, Nozomi Nago, Taichiro Muto, Yoshiro Kitagawa, Akihisa Okumura
Fournier's gangrene is an infectious necrotizing fasciitis of the perineal, genital, or perianal regions and is uncommon in children. Adrenocorticotropic hormone (ACTH) is effective for the treatment of infantile spasms; however, suppression of immune function is one of the major adverse effects of this approach. We encountered a 2-month-old boy with infantile spasms that had been treated with ACTH and had developed complicating Fournier's gangrene. Strangulation of a right inguinal hernia was observed after ACTH treatment...
May 2017: Brain & Development
https://www.readbyqxmd.com/read/27688864/development-of-epidural-and-paraspinal-abscesses-after-insufficient-evaluation-and-treatment-of-acute-pyelonephritis-caused-by-staphylococcus-aureus
#14
Mi Jeoung Kim, Hyang Mo Koo, Woo Joo Lee, Jin Hwan Choi, Mi Nyong Choi, Sang Young Park, Woo Jung Kim, Seung Yeon Son
Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S...
September 2016: Korean Journal of Family Medicine
https://www.readbyqxmd.com/read/27649016/-surgical-treated-spondylodiscitis-epidemiological-study
#15
Joaquim Soares do Brito, António Tirado, Pedro Fernandes
INTRODUCTION: The term spondylodiscitis aims to describe any spinal infection. Medical treatment is the gold standard; nevertheless, surgical treatment can be indicated. The aim of this work was to study the epidemiological profile in a group of patients with spondylodiscitis surgically treated in the same medical institution between 1997 and 2013. MATERIAL AND METHODS: Eighty five patients with spondylodiscitis were surgically treated in this period. The authors analysed clinical data and image studies for each patient...
May 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27598716/staphylococcus-aureus-mediated-blood-brain-barrier-injury-an-in-vitro-human-brain-microvascular-endothelial-cell-model
#16
Alisha McLoughlin, Keith D Rochfort, Cormac J McDonnell, Steven W Kerrigan, Philip M Cummins
Blood-brain barrier (BBB) disruption constitutes a hallmark event during pathogen-mediated neurological disorders such as bacterial meningitis. As a prevalent opportunistic pathogen, Staphylococcus aureus (SA) is of particular interest in this context, although our fundamental understanding of how SA disrupts the BBB is very limited. This paper employs in vitro infection models to address this. Human brain microvascular endothelial cells (HBMvECs) were infected with formaldehyde-fixed (multiplicity of infection [MOI] 0-250, 0-48 hr) and live (MOI 0-100, 0-3 hr) SA cultures...
September 6, 2016: Cellular Microbiology
https://www.readbyqxmd.com/read/27512508/a-10-year-retrospective-review-of-pediatric-lung-abscesses-from-a-single-center
#17
Kavi Madhani, Eric McGrath, Lokesh Guglani
INTRODUCTION: Pediatric lung abscesses can be primary or secondary, and there is limited data regarding response to treatments and patient outcomes. OBJECTIVES: To assess the clinical and microbiologic profile of pediatric patients with lung abscess and assess the differences in outcomes for patients treated with medical therapy or medical plus surgical therapy. METHODS: A retrospective review of all pediatric patients ≤ 18 years of age that were treated as an inpatient for lung abscess between the dates of August 2004 and August 2014 was conducted...
July 2016: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/27506395/pneumonia-presenting-with-organ-dysfunctions-causative-microorganisms-host-factors-and-outcome
#18
Rosario Menéndez, Beatriz Montull, Soledad Reyes, Isabel Amara-Elori, Rafael Zalacain, Alberto Capelastegui, Javier Aspa, Luis Borderías, Juan J Martín-Villasclaras, Salvador Bello, Inmaculada Alfageme, Felipe Rodríguez de Castro, Jordi Rello, Luis Molinos, Juan Ruiz-Manzano, Antoni Torres
Community-acquired pneumonia (CAP) is a serious infection that may occasionally rapidly evolve provoking organ dysfunctions. We aimed to characterize CAP presenting with organ dysfunctions at the emergency room, with regard to host factors and causative microorganisms, and its impact on 30-day mortality. 460 of 4070 (11.3%) CAP patients had ≥2 dysfunctions at diagnosis, with a 30-day mortality of 12.4% vs. 3.4% in those with one or no dysfunctions. Among them, the most frequent causative microorganisms were Streptococcus pneumoniae, gram-negatives and polymicrobial etiology...
November 2016: Journal of Infection
https://www.readbyqxmd.com/read/27480551/-risk-factors-and-prognosis-of-neurological-complications-in-patients-with-infective-endocarditis
#19
H Wang, L L Guo, L G Fang, L Y Cui, Q Miao, T S Li, W L Zhu, Q Fang
OBJECTIVE: To identify risk factors of neurological complications (NC) in left-sided infective endocarditis (IE) and to assess its impact on the outcome and cardiac surgery. METHODS: Clinical data, NC, treatment and outcome of patients with definite left-sided IE admitted to our hospital during 2001-2012 were retrospectively analyzed. RESULTS: A total of 308 patients with age of (45.3±15.9) years were enrolled. Among them, 65 (21.1%) experienced at least one NC...
August 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27424376/methicillin-resistant-staphyloccocus-aureus-intracranial-epidural-abscess-with-osteomyelitis-during-pregnancy-a-case-report
#20
Vaya W Tanamai, Brandon-Luke L Seagle, Guoyang Luo
BACKGROUND: The incidence of community-acquired methicillin-resistant Staphylococcus aureus (MRSA) infection is increasing, and 0.5-4% of pregnant women are colonized. CASE: A 30-year-old pregnant woman at term presented with intractable headache 1 week after incision and drainage of a MRSA-positive axillary abscess. Imaging demonstrated a right-sided epidural abscess with midline shift and myositis of the overlying temporalis muscle. She underwent cesarean delivery followed by craniectomy of osteomyelitic bone and evacuation of the epidural abscess...
May 2016: Journal of Reproductive Medicine
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