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Osteomyelitis

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https://www.readbyqxmd.com/read/28343329/stress-fractures-of-the-foot-and-ankle-part-2-site-specific-etiology-imaging-and-treatment-and-differential-diagnosis
#1
Jacob C Mandell, Bharti Khurana, Stacy E Smith
Stress fractures of the foot and ankle are a commonly encountered problem among athletes and individuals participating in a wide range of activities. This illustrated review, the second of two parts, discusses site-specific etiological factors, imaging appearances, treatment options, and differential considerations of stress fractures of the foot and ankle. The imaging and clinical management of stress fractures of the foot and ankle are highly dependent on the specific location of the fracture, mechanical forces acting upon the injured site, vascular supply of the injured bone, and the proportion of trabecular to cortical bone at the site of injury...
March 25, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28342819/ankylosis-of-the-knee-after-septic-arthritis-following-anterior-cruciate-ligament-reconstruction-in-a-13-year-old-male
#2
Bastian Mester, Falk Ullerich, Tobias Ohmann, Martin Glombitza, Christian Schoepp
We present the case of an adolescent male developing anankylosis of the knee after septic arthritis following anterior cruciate ligamentreconstruction (ACLR).The patientwas shifted to our institutionwithpostoperative septic arthritis associated with a systemic septic condition. Before, repeated arthroscopic surgery had beenconductedwithoutany improvement. MRI showed a concomitant osteomyelitis. The infection (Gächter IV, S. aureus) was controlled by an open surgical approach and graft removal.An increasing joint stiffness wasdocumented...
March 22, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28342676/-role-of-nuclear-medicine-in-the-differential-diagnosis-of-bone-infarction-and-osteomyelitis-in-drepanocytosis
#3
Cristina Sandoval-Moreno, Lourdes Castillejos-Rodríguez, M Pilar García-Alonso, Bárbara Rubio-Gribble, Francisco Javier Penín-González
No abstract text is available yet for this article.
March 22, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28341493/procalcitonin-as-a-biomarker-for-predicting-amputation-level-in-lower-extremity-infections
#4
Matthew M Reiner, Wissam E Khoury, Michael B Canales, Richard A Chmielewski, Kartick Patel, Mark C Razzante, Coleman O Cloughtery, Douglas Y Rowland
Inflammatory markers are essential tools in the decision-making process for lower extremity infections. When coupled with objective findings, clinicians can more accurately diagnose and treat these entities. Typically, markers such as the white blood cell count, erythrocyte sedimentation rate, and C-reactive protein are used to initially assess these patients or monitor the progression of medical or surgical therapy. Procalcitonin is a newer inflammatory marker that is specific for an infectious process. Originally, procalcitonin was used to monitor antibiotic therapy and sepsis for patients in the intensive care setting, but it has now been expanded to other facets of medicine...
March 21, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28341229/assessment-of-the-extension-of-pressure-ulcers-into-soft-tissue-and-osteomyelitis-diagnosis-using-18-f-fdg-pet-ct
#5
J R Garcia, M Soler, P Bassa, M Minoves, E Riera
The precise assessment of pressure ulcer extension in patients with neurological diseases has crucial therapeutic implications, especially in the early detection of fistula to interior structures and osteomyelitis. Two case reports are presented on patients with a similar ischial ulcer, in whom an (18)F-FDG PET/CT study enabled a precise assessment of infectious complications in underlying tissues. These cases support the implementation of (18)F-FDG PET/CT as a first-line technique in their management.
March 21, 2017: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/28336328/bone-healing-is-achievable-despite-extensive-wound-dehiscence-and-wide-plate-and-screws-exposure-in-children
#6
Elias Melhem, Wael Bayoud, Ismat Ghanem
BACKGROUD: Extensive wound dehiscence and wide plate and screw exposure in the early weeks following orthopaedic surgery in children is usually managed either by extensive debridement, lavage and secondary closure or hardware removal and external fixation. PATIENTS: Three children with LCP plate and screws exposure were managed by simple repetitive debridement and local wound care without any IV antibiotics, nor secondary closure or hardware removal. All three cases occurred in the tibia, one following tibial osteotomy in lateral hemimelia with a long history of previous surgeries, one following wide excision of a tibial Ewing sarcoma with chemo and radiotherapy, and the third following wide excision of a 12cm necrotic tibial segment due to chronic osteomyelitis...
March 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28336046/charcot-arthropathy-versus-osteomyelitis-evaluation-and-management
#7
REVIEW
John Womack
Charcot arthropathy of the foot and ankle is a severe complication of peripheral neuropathy and is most commonly seen in the developed world in association with diabetes mellitus. Correct diagnosis and differentiation from osteomyelitis of the foot and ankle are critical to guide treatment. It can exist concomitantly with osteomyelitis, typically in the setting of an advanced midfoot ulcer. Simple plain radiographs and contrasted MRI studies often yield inconclusive or confusing data. Correct use of imaging studies and a clinical algorithm can be effective tools to help make accurate and early diagnoses and guide clinical interventions for these conditions...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336045/atypical-hand-infections
#8
REVIEW
Edward Chan, Mark Bagg
Atypical infections of the hand are caused by organisms such as Mycobacterium, fungi, and viruses, and often do not respond to conventional management. They exist within a wide spectrum of presentations, ranging from cutaneous lesions to deep infections such as tenosynovitis and osteomyelitis. Having a high clinical suspicion for atypical hand infections is vital because diagnosis often requires special tests and/or cultures. Obtaining a detailed medical, work, and travel history is extremely important. An indolent clinical course, late diagnosis, and delayed treatment are common...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336042/acute-hematogenous-osteomyelitis-in-children-pathogenesis-diagnosis-and-treatment
#9
REVIEW
Shawn S Funk, Lawson A B Copley
Acute hematogenous osteomyelitis (AHO) in children is an ideal condition to study due to its representation of a wide spectrum of disorders that comprise pediatric musculoskeletal infection. Proper care for children with AHO is multidisciplinary and collaborative. AHO continues to present a significant clinical challenge due to evolving epidemiology and complex pathogenesis. A guideline-driven, multidisciplinary approach has been introduced and shown to effectively reduce hospital stay, improve the timing and selection of empirical antibiotic administration, reduce delay to initial MRI, reduce the rate of readmission, and shorten antibiotic duration...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336039/the-antibiotic-nail-in-the-treatment-of-long-bone-infection-technique-and-results
#10
REVIEW
Kenneth L Koury, John S Hwang, Michael Sirkin
Antibiotic cement nails provide a useful and relatively simple technique to treat intramedullary osteomyelitis of the long bones. These devices provide stability as well as local, targeted antibiotics, which are both critical aspects of osteomyelitis management. Additionally, the use of a threaded core is a critical component of successful cement nail assembly. With adherence to the simple principles outlined in this review, surgeons can expect reliably good results using these drug-delivery implants.
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28331952/diagnostic-strategies-for-posttraumatic-osteomyelitis-a-survey-amongst-dutch-medical-specialists-demonstrates-the-need-for-a-consensus-protocol
#11
G A M Govaert, A W J M Glaudemans, J J W Ploegmakers, A R Viddeleer, K W Wendt, I H F Reininga
INTRODUCTION: Posttraumatic osteomyelitis (PTO) is a feared complication after surgical fracture care. Late diagnosis can result in interrupted and prolonged rehabilitation programmes, inability to work, medical dependency, unnecessary hospital admissions, and high medical and non-medical costs. Primary aim of this study was to assess preferred diagnostic imaging strategies for diagnosing PTO amongst orthopaedic and trauma surgeons, radiologists, and nuclear medicine physicians. Secondary aims were to determine the preferred serum inflammatory marker for diagnosing PTO and the existence of a local hospital protocol to diagnose and manage PTO...
March 22, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28331805/prevotella-osteomyelitis-after-dental-capping-procedure
#12
Alexander Williams, Thomas Kerkering
We present a 49 year old man who presented to the emergency department with severe lower back pain of 5 days duration. One week prior he had been diagnosed with a right psoas muscle abscess and was discharged with a 28 day course of moxifloxacin after the preliminary culture from the psoas grew an anaerobic organism. MRI of the lumbar spine showed marrow edema in the L2 body, occupying most of the anterior two thirds of the body, with cortical erosion at the anteroinferior aspect of L1. Blood cultures were negative and bone biopsy of L2 showed neutrophilic invasion and reactive changes...
2017: IDCases
https://www.readbyqxmd.com/read/28331309/in-vitro-and-in-vivo-drug-release-and-antibacterial-properties-of-the-novel-vancomycin-loaded-bone-like-hydroxyapatite-poly-amino-acid-scaffold
#13
Zhidong Cao, Dianming Jiang, Ling Yan, Jun Wu
Antibiotic-loaded carriers were developed to fill cavities and locally deliver antibiotics following implantation. However, the most commonly used antibiotic carrier, polymethyl methacrylate (PMMA), has many disadvantages including that it does not promote bone regeneration or conduction. Vancomycin-loaded bone-like hydroxyapatite/poly amino acid (V-BHA/PAA) was successfully fabricated by a homogeneous method, certified as biosafe and known to promote osteogenesis. To evaluate its drug-release features, the quantity of the vancomycin in the elution was obtained every 2 days after in vitro simulated body fluid immersion...
2017: International Journal of Nanomedicine
https://www.readbyqxmd.com/read/28329667/serious-infections-are-on-the-rise-in-us-inpatients-with-psoriasis
#14
Derek Y Hsu
Psoriasis is a chronic inflammatory skin disorder associated with immune dysregulation and use of systemic immunosuppressive treatments that may predispose toward serious infections. We sought to determine the rates of serious infections in hospitalized patients with psoriasis. We analyzed data from the 2002-2012 Nationwide Inpatient Sample, containing a 20% sample of all US hospitalizations. Psoriasis was determined by a validated algorithm using ICD-9-CM codes. In multivariate logistic regression models adjusting for socio-demographics, psoriasis was associated with multiple serious infections, including methicillin-resistant Staphylococcus aureus (odds ratio [95% confidence intervals] 1...
September 15, 2016: Dermatology Online Journal
https://www.readbyqxmd.com/read/28329521/a-rare-case-of-cutaneous-acanthamoebiasis-in-a-renal-transplant-patient
#15
Frank Winsett, Jessica Dietert, Jaime Tschen, Michael Swaby, Carolyn A Bangert
A 35-year-old woman receiving immunosuppressionfor renal transplantation presented with a onemonthhistory of tender skin nodules on herbilateral upper extremities. A skin biopsy revealedgranulomatous inflammation in the deep dermisand the subcutaneous fat with foci of necrosis.Within the foci of necrosis were large histiocytoidstructures with prominent nuclei. Periodic acid-Schiffstain revealed a round organism with a thick capsule,consistent with amoebal trophozoites. Testing withthe Center for Disease Control revealed the organismto be Acanthamoeba...
March 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/28326215/osteoradionecrosis-of-the-temporal-bone-leading-to-cerebellar-abscess
#16
Thomas B Layton
Squamous cell carcinoma of the temporal bone is a rare and destructive malignancy and represents both diagnostic and therapeutic challenge. The complex regional anatomy of the temporal bone requires equally intricate surgical techniques to adequately resect the tumour mass during surgical excision. Adjuvant radiotherapy is offered to patients with advanced disease and has been showed to confer a survival benefit in carefully selected patients. One feared complication of radiotherapy is osteoradionecrosis and is a major obstacle faced in the treatment of head and neck cancers...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28326157/partial-calcanectomy-and-ilizarov-external-fixation-may-reduce-amputation-need-in-severe-diabetic-calcaneal-ulcers
#17
Mehmet Orçun Akkurt, Ismail Demirkale, Ali Öznur
Objective: The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers...
2017: Diabetic Foot & Ankle
https://www.readbyqxmd.com/read/28325766/staphylococcal-%C3%AE-toxin-modulates-human-aortic-endothelial-cell-and-platelet-function-through-sphingomyelinase-and-biofilm-ligase-activities
#18
Alfa Herrera, Katarina Kulhankova, Vijay K Sonkar, Sanjana Dayal, Aloysius J Klingelhutz, Wilmara Salgado-Pabón, Patrick M Schlievert
Staphylococcus aureus causes many infections, such as skin and soft tissue, pneumonia, osteomyelitis, and infective endocarditis (IE). IE is an endovascular infection of native and prosthetic valves and the lining of the heart; it is characterized by the formation of cauliflower-like "vegetations" composed of fibrin, platelets, other host factors, bacteria, and bacterial products. β-Toxin is an S. aureus virulence factor that contributes to the microorganism's ability to cause IE. This cytolysin has two enzymatic activities: sphingomyelinase (SMase) and biofilm ligase...
March 21, 2017: MBio
https://www.readbyqxmd.com/read/28322345/nursing-staff-fluctuation-and-pathogenic-burden-in-the-nicu-effective-outbreak-management-and-the-underestimated-relevance-of-non-resistant-strains
#19
Kai O Hensel, Rhea van den Bruck, Ingo Klare, Michael Heldmann, Beniam Ghebremedhin, Andreas C Jenke
In the course of a hospital management takeover, a microbial outbreak took place in a tertiary neonatal intensive care unit (NICU). Here, we characterize the outbreak and its management. About 4 months prior to takeover, there was a sharp increase in positive isolates for MSSA and multidrug-resistant organisms (MDROs). Simultaneously, the nursing staff sick leave rate increased dramatically which directly correlated with the number of infection/colonization per week (r(2) = 0.95, p = 0.02). During the following months we observed several peaks in positive isolates of methicillin-sensitive staphylococcus aureus (MSSA), MDROs and subsequently a vancomycin-resistant enterococcus (VRE) outbreak...
March 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28320836/adaptive-upregulation-of-clumping-factor-a-clfa-by-s-aureus-in-the-obese-type-2-diabetic-host-mediates-increased-virulence
#20
Christopher W Farnsworth, Eric M Schott, Sarah E Jensen, Jacob Zukoski, Abigail M Benvie, Majed A Refaai, Stephen L Kates, Edward M Schwarz, Michael J Zuscik, Steven R Gill, Robert A Mooney
Obesity and associated type 2 diabetes (T2D) are important risk factors for infection following orthopaedic implant surgery. Staphylococcus aureus, the most common pathogen in bone infections, adapts to multiple environments to survive and evade host immune responses. Whether adaptation of S. aureus to the unique environment of the obese/T2D host accounts for its increased virulence and persistence in this population is unknown. Thus, we assessed implant-associated osteomyelitis in normal versus high fat-diet obese/T2D mice and found that S...
March 20, 2017: Infection and Immunity
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