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Javier Martínez-Casanova, Nuria Carballo, Sonia Luque, Luisa Sorli, Santiago Grau
Azole antifungals have frequently been linked to the presence of hepatotoxicity, but there is scarce information on cross-toxicity between these drugs or on the possibility of using some of them when this type of toxicity occurs. We report the case of a 64-year-old man with invasive aspergillosis (IA) leading to spondylodiscitis with neurological involvement. Early management included intravenous (iv) voriconazole, which had to be interrupted after 1 week due to liver damage. Therapeutic drug monitoring (TDM) of voriconazole showed that the plasma concentration was within the therapeutic range...
2018: Infection and Drug Resistance
Ghazwan Abdulla Hasan, Saif Mohammed Kani, Ahmed Alqatub
INTRODUCTION: Spinal Epidural abscess (SEA) is an uncommon pathology that needs an urgent intervention to decompress the pressure on the spinal epidural sac, cord, and roots. The authors report a rare case of a young adult with lumbar spinal epidural tuberculous abscess occupying the spinal canal from L2-L5 vertebrae with extesion to the posterior paraspinal muscles and presenting with bilateral progressive lower limb weakness.   Case report: A 42 years old male teacher presented with a 15-day history of progressive difficulty to walking and bilateral lower limb weakness associated with fever, malaise and later on urinary incontinence...
2018: SICOT-J
Man-Kyu Park, Dae-Chul Cho, Woo-Seok Bang, Kyoung-Tae Kim, Joo-Kyung Sung
PURPOSE: Delayed esophageal perforation after anterior cervical discectomy and fusion (ACDF) is an extremely rare cause of infection such as spondylodiscitis. We present a rare case in which a patient had two delayed esophageal perforations occurring 20 and 25 years after ACDF. By sharing our experience of this rare case, we hope to provide new information related to delayed esophageal perforation. METHODS: We present the case of a 72-year-old patient who underwent ACDF due to cervical spondylosis 25 years ago...
March 2, 2018: European Spine Journal
Elodie Degroote, Halil Yildiz, Frederic Lecouvet, Alexia Verroken, Leila Belkhir
OBJECTIVE AND IMPORTANCE: New methods of microbiology identification as MALDI-TOF MS increased the rate of Aerococci detection in microbiological samples making this germ an emerging pathogen. The purpose of this case report and literature review is to highlight the role of A. urinae in spine infection and discuss the management of this type of infection. CLINICAL PRESENTATION AND INTERVENTION: A 32-year-old man, with a medical history of paraplegia secondary to a relapsing form of multiple sclerosis, was admitted because of lower back-pain following complaints suggestive of urinary tract infection...
March 2, 2018: Acta Clinica Belgica
Paolo di Russo, Carlo Tascini, Maria Elena Benini, Carlotta Martini, Paolo Lepori
Background: Propionibacterium acnes ( P. acnes ) is a microaerophilic anaerobic Gram-positive rod responsible for acne vulgaris. Although it is often considered to be a skin contaminant, it may act as a virulent agent in implant-associated infections. Conversely, spontaneous infectious processes have been rarely described. Case Description: Here, we describe a 43-year-old female with C1-C2 spondylodiscitis attributed to P. acnes infection. Despite long-term antibiotic treatment, computed tomography demonstrated erosion of the C1 and C2 vertebral complex that later warranted a fusion...
2018: Surgical Neurology International
Tsunemasa Matsubara, Kei Yamada, Kimiaki Sato, Masafumi Gotoh, Kensei Nagata, Naoto Shiba
BACKGROUND CONTEXT: Patients with infective spondylodiscitis who failed conservative treatment are generally indicated for open surgery. However, some patients are poor candidates for standard surgery, hence the need to evaluate less invasive approaches. Good outcomes were previously reported for percutaneous suction aspiration and drainage (PSAD) in the treatment of infective spondylodiscitis resistant to conservative therapy. We recently extended the surgical approach of PSAD to allow drainage of paravertebral or epidural abscesses in patients with progressive infective spondylodiscitis...
February 26, 2018: Spine Journal: Official Journal of the North American Spine Society
George Kuo, Wei-Chiao Sun, Yueh-An Lu, Chao-Yu Chen, Huang-Kai Kao, Yu Lin, Yung-Chang Chen, Cheng-Chieh Hung, Ya-Chung Tian, Hsiang-Hao Hsu
Purpose: Infectious spondylodiscitis is a serious disease that can lead to permanent neurological deficit. Because there were only a few case reports or series featuring infectious spondylodiscitis in chronic dialysis patients, we investigated the epidemiology and outcome in the chronic dialysis patients versus general population. Materials and methods: We retrospectively identified chronic dialysis patients admitted for infectious spondylodiscitis between January 2002 and December 2015...
2018: Therapeutics and Clinical Risk Management
Nicola Di Meo, Sara Trevisini, Cecilia Noal, Katiuscia Nan, Giusto Trevisan
We report the occurrence of Staphylococcus lugdunensis cutaneous infection with sporotrichoid distribution of the left lower limb of a 60-year-old man. Recent studies have confirmed that Staphylococcus lugdunensis is a significant pathogen in causing skin and soft tissue infections that usually manifest in abscesses, surgical wound infections, and cellulitis. It used to be considered a skin commensal bacteria, but if unrecognized it can lead to  fulminant endocarditis, meningitis, skin abscesses, peritonitis, and spondylodiscitis...
August 15, 2017: Dermatology Online Journal
Estelle Rougier, Antoine Braud, Xavier Argemi, Nicolas Lefebvre, Daniel Christmann, Yves Hansmann, Nawal Douiri
INTRODUCTION: Aerococccus urinae (AU) is a pathogen mainly identified in male urinary tract infections and responsible for bacteremia and endocarditis. To the best of our knowledge, there are only five patients with osteomyelitis due to AU described in the literature. All of them had urinary tract disease or systemic conditions such as diabetes, and two were associated with an endocarditis. CASE REPORT: We described the first case of isolated spondylodiscitis without general or local predisposing condition, excepted age > 65 years...
February 16, 2018: Infection
Mougnyan Cox, Brian Curtis, Manisha Patel, Victor Babatunde, Adam E Flanders
OBJECTIVE: Multi-sequence sagittal magnetic resonance imaging (MRI) of the entire spine is performed in patients with known single level spondylodiscitis. Our objective is to determine the frequency of multifocal infection. METHODS: After IRB approval, a retrospective five-year review of all patients with spondylodiscitis was performed. RESULTS: MRI identified 82 patients with single-level infection. All 82 had entire spine imaging performed within 72 h of admission, showing additional non-continuous sites of infection in 19 patients (23%)...
February 13, 2018: Clinical Imaging
Mike M Sathekge, Alfred O Ankrah, Ismaheel Lawal, Mariza Vorster
Monitoring response to treatment is a key element in the management of infectious diseases, yet controversies still persist on reliable biomarkers for noninvasive response evaluation. Considering the limitations of invasiveness of most diagnostic procedures and the issue of expression heterogeneity of pathology, molecular imaging is better able to assay in vivo biologic processes noninvasively and quantitatively. The usefulness of18 F-FDG-PET/CT in assessing treatment response in infectious diseases is more promising than for conventional imaging...
March 2018: Seminars in Nuclear Medicine
Meera Raghavan, Elena Lazzeri, Christopher J Palestro
Spondylodiscitis is an infection of the vertebral body or disc and may also involve the epidural space, posterior elements, and paraspinal soft tissues. It is a cause of morbidity and mortality, and warrants early diagnosis and prompt treatment. Diagnosis can be difficult because of nonspecific signs and symptoms. Magnetic resonance imaging is sensitive and specific and is the imaging modality of choice for spondylodiscitis. Gadolinium contrast can show the extent of soft tissue and bone phlegmon and abscess...
March 2018: Seminars in Nuclear Medicine
K Farah, T Graillon, H Dufour, S Fuentes
INTRODUCTION: Adjacent level spondylodiscitis (ALS) after primary surgery for thoracic spondylodiscitis is a very rare condition. CASE REPORT: We report the case of a 76-year-old man with this pathology. A first posterior minimally invasive approach combined with anterior approach to the thoracic spine was safely performed for thoracic spondylodiscitis. More than a year later, exploration of recurrent symptoms with 18 FDG PET scan helped to diagnose ALS. Further surgery was performed...
February 12, 2018: Neuro-Chirurgie
Rahul Garg, Tushar Shaw, Shyamasunder N Bhat, Chiranjay Mukhopadhyay
Melioidosis, a syndrome with protean clinical manifestations, is caused by Gram-negative soil saprophyte Burkholderiapseudomallei Among its diverse clinical presentations, the involvement of spine is a rare phenomenon and can mimic tuberculosis on presentation. A 65-year-old female with a known case of diabetes presented with fever with lower back pain. Blood culture grew Staphylococcus aureus , and as per sensitivity report, clindamycin and cefazolin were started. X-ray and MRI lumbosacral spine showed spondylodiscitis (likely Koch's)...
February 8, 2018: BMJ Case Reports
M Geerdes, S P Smook, T A von Schükkmann
A 42-year-old woman presented with neck pain without previous trauma. On suspicion of spondylodiscitis, an MRI of the cervical spine was made. This MRI and an additional CT showed calcific tendinitis of the longus colli muscle, a self-limiting disorder.
2018: Nederlands Tijdschrift Voor Geneeskunde
Myung Soo Youn, Jong Ki Shin, Tae Sik Goh, Jung Sub Lee
INTRODUCTION: Acute pyogenic spondylodiscitis caused by percutaneous vertebroplasty is a rare complication. We present the first report of minimally invasive endoscopic treatment for acute spondylodiscitis caused by vertebroplasty. CASE PRESENTATION: A 60-year-old female was transferred with the symptom of right hip flexion weakness for 1 day. The patient underwent a vertebroplasty procedure because of L3 osteoporotic compression fracture at other hospital 6 weeks ago...
January 22, 2018: European Spine Journal
Om Biju Panta, Yagya Raj Pathak, Dan Bahadur Karki
BACKGROUND: Magnetic Resonance Imaging is the imaging modality of choice for imaging spinal infection due to its high sensitivity and specificity. This study aims to study the magnetic resonance imaging changes in patients with spondylodiscitis. METHODS: The study was a retrospective study carried in a multimodality imaging centre in Kathmandu. Magnetic resonance imaging records and clinical record of 3 years duration were reviewed and patients with clinical and radiological diagnosis of spondylodiscitis were included in the study...
January 1, 2018: Journal of Nepal Health Research Council
Manfredi Gagliano, Costanza Marchiani, Giulia Bandini, Paolo Bernardi, Nicolas Palagano, Elisa Cioni, Martina Finocchi, Silvia Bellando Randone, Alberto Moggi Pignone
BACKGROUND: Spondylodiscitis are vertebral column infections whose incidence is rising due to an increase of the susceptible population and improved ascertainment. They have been associated with a wide range of microorganisms. Fungal spondylodiscitis is uncommon (0.5%-1.6%) and strongly associated with immunodepression and diabetes (Gouliouris et al., 2010). We present a rare case of Candida glabrata spondylodiscitis in a non neutropenic diabetic patient with the review of the literature...
January 12, 2018: International Journal of Infectious Diseases: IJID
Jeroen D Langereis, Stefanie S Henriet, Saskia Kuipers, Corry M R Weemaes, Mirjam van der Burg, Marien I de Jonge, Michiel van der Flier
Antibody replacement therapy for patients with antibody deficiencies contains only IgG. As a result, concurrent IgM and IgA deficiency present in a large proportion of antibody deficient patients persists. Especially patients with IgM deficiency remain at risk for recurrent infections of the gastrointestinal and respiratory tract. The lack of IgM in the current IgG replacement therapy is likely to contribute to the persistence of these mucosal infections because this antibody class is especially important for complement activation on the mucosal surface...
January 15, 2018: Journal of Clinical Immunology
S W Lim, H Y Lim, T Kannaiah, Z Zuki
Streptococcus constellatus is an extremely rare cause of pyogenic spondylodiscitis. Literature search yielded only one case report in an elderly 72 years old man with spontaneous T10-T11 S. constellatus spondylodiscitis. It is virtually unheard of in young teenage. We report the case of a 14 years old male teenager who presented with worsening low back pain for one year with no neurological deficit. Imaging studies were consistent with features of L4-L5 spondylodiscitis. CT guided biopsy grew a pure culture of streptococcus constellatus sensitive to penicillin and erythromycin...
November 2017: Malaysian Orthopaedic Journal
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