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Chronic osteomyelitis

H W Guo, W S Kong, Y Q Lai, F Kuang, J W Zhuang, Z G Shan
Objective: To explore the diagnosis, therapy and prevention method of chronic sternal osteomyelitis with sinus tract after cardiovascular surgery. Methods: A total of 53 patients with chronic sternal sinus tract after cardiovascular surgery between January 2000 and January 2016. After definite diagnosis by contrast fistulography and CT scanning, all the patients received combined modality therapy including debridement, musculocutaneous flap transplantation and intermediate thickness free skin graft transplantation if necessary...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Victoria Rizzo, Yousuf Salmasi, Michael Hunter, Pushpinder Sidhu
Sternal osteomyelitis secondary to mycobacterium tuberculosis (TB) is rare, with <1% of musculoskeletal TB cases reported. The recurrent scenario is unresolving infection and delayed diagnosis. A 75-year-old woman presented with a persistently discharging sternal wound 10 months after coronary artery bypass grafting. Multiple antibiotics, wound debridement and removal of sternal wires was attempted; however, progression to local osteomyelitis and sternoclavicular joint destruction occurred. Tissue biopsies were finally sent for mycobacterial culture testing positive for Mycobacterium tuberculosis High index of suspicion is necessary for diagnosis of sternal tuberculosis, confirmed through timely microbiological investigations...
March 5, 2018: BMJ Case Reports
Yunes Nadim Hammad, Abigail Johnson, Alan Norrish
Medial tibial stress syndrome and chronic osteomyelitis are conditions that are traditionally thought to affect very different patient groups. We present a case of shin splints in a recreational long-distance runner, complicated by chronic osteomyelitis of the tibia. This is a unique case in which the microtrauma resulting from shin splints was implicated as an entry point for bacterial infection into the bone. Clinical evaluation and bone biopsy culture results indicated haematogenous spread of bacteria originating from the oral cavity...
March 1, 2018: BMJ Case Reports
Abhishek Jairam, Ping Song, Nirav B Patel, Michael S Wong
BACKGROUND: The National Pressure Ulcer Advisory Panel estimates pressure sore care to approach $11 billion annually. It is not uncommon for these patients to present to the emergency department (ED) with a chief concern of a pressure sore, while concurrently carrying an undiagnosed infectious process that is the culprit for the acute presentation, rather than the chronic pressure injury. We aim to identify patients who met systemic inflammatory response syndrome (SIRS) criteria at ED presentation who were referred to plastic and reconstructive surgery for pressure sore debridement prior to a complete medical workup...
February 27, 2018: Annals of Plastic Surgery
José Palma, Eduardo Díaz, Sergio Islas, Julio Silva, Sergio Mella
Monoarticular tuberculosis of the wrist is a rare presentation of primary tuberculosis, being more common skeletal forms involving the spine. Extraspinal tuberculous osteomyelitis is rare and comprises only 2 to 3% of all cases of osteoarticular Mycobacterium tuberculosis infections. We present a case of a 49 years old female patient, who worked as an hospital cleaning employed without other comorbidity. After a low energy injury of the wrist she suffered pain syndrome diagnosticated as a flexor tendinopathy, managed with nonsteroidal antiinflammatory drugs and physical therapy...
October 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Joon Pio Hong, Terence L H Goh, Dong Hoon Choi, Jung Jae Kim, Peter Hyunsuk Suh
No abstract text is available yet for this article.
March 2018: Plastic and Reconstructive Surgery
Nathalie Kerfant, Nicolas Bertheuil, Baptiste Bertrand, Weiguo Hu, Christian Herlin, Benoit Chaput
No abstract text is available yet for this article.
March 2018: Plastic and Reconstructive Surgery
Sabine A Egeler, Tim de Jong, Antonius J M Luijsterburg, Marc A M Mureau
BACKGROUND: Reconstruction of severe lower extremity injuries using free flaps has become a reliable approach. Knowledge of long-term surgical outcomes, limb function, and quality of life is limited. METHODS: Two hundred thirty-nine patients undergoing a free flap reconstruction of an open lower extremity fracture between 1993 and 2014 were divided into three groups and studied, as follows: group 1, early free flap reconstruction within 6 weeks; group 2, delayed reconstruction after 6 weeks; and group 3, delayed reconstruction with osteomyelitis...
March 2018: Plastic and Reconstructive Surgery
Inés Poveda-Montoyo, Eduardo Vergara-de Caso, David Romero-Pérez, Isabel Betlloch-Mas
Retronychia is a clinical condition resulting from embedding of the nail plate into the proximal nail fold. We report two adolescent girls, 14 and 16 years of age, with a history of chronic proximal paronychia of the great toe, one of them developing osteomyelitis. After failure of treatment with several systemic antibiotics, nail avulsion was performed, leading us to the diagnosis of retronychia and with rapid and complete resolution of symptoms in both cases. Delay in diagnosis of retronychia can lead to local complications and prolonged discomfort...
February 26, 2018: Pediatric Dermatology
Nese Saltoglu, Onder Ergonul, Necla Tulek, Mucahit Yemisen, Ayten Kadanali, Gul Karagoz, Ayse Batirel, Oznur Ak, Cagla Sonmezer, Haluk Eraksoy, Atahan Cagatay, Serkan Surme, Salih A Nemli, Tuna Demirdal, Omer Coskun, Derya Ozturk, Nurgul Ceran, Filiz Pehlivanoglu, Gonul Sengoz, Turan Aslan, Yasemin Akkoyunlu, Oral Oncul, Hakan Ay, Lutfiye Mulazımoglu, Buket Erturk, Fatma Yilmaz, Gulsen Yoruk, Nuray Uzun, Funda Simsek, Taner Yildirmak, Kadriye Kart Yaşar, Meral Sonmezoglu, Yasar Küçükardali, Nazan Tuna, Oguz Karabay, Nail Ozgunes, Fatma Sargın
OBJECTIVES: We described the clinical outcome of the diabetic patients who had foot infections with multidrug resistant organisms. METHODS: We included the patients with diabetic foot infections (DFI) from 19 centers, between May 2011 and December 2015. Infection was defined according to IDSA DFI guidelines. Patients with severe infection, complicated moderate infection were hospitalized. The patients were followed-up for 6 months after discharge. RESULTS: In total, 791 patients with DFI were included, 531(67%) was male, median age was 62 (19-90)...
February 21, 2018: International Journal of Infectious Diseases: IJID
Qiang Li, Shi-Feng Song, Wei Zhang, Guo-Zhi Wu, Li-Zhu Liu
OBJECTIVE: To study the clinical effects of negative pressure closed drainage combined with vancomycin loaded calcium sulfate and autogenous bone in the treatment of chronic osteomyelitis. METHODS: From June 2013 to December 2016, there were 35 cases of chronic osteomyelitis patients in our department, including 23 males and 12 females, ranging in age from 11 to 65 years old, with an average of 34 years old. The course of disease ranged from 8 to 46 months, with an average of 26 months...
November 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Carlos M Suligoy, Santiago M Lattar, Mariángeles Noto Llana, Cintia D González, Lucía P Alvarez, D Ashley Robinson, Marisa I Gómez, Fernanda R Buzzola, Daniel O Sordelli
Selection pressures exerted on Staphylococcus aureus by host factors may lead to the emergence of mutants better adapted to the evolving conditions at the infection site. This study was aimed at identifying the changes that occur in S. aureus exposed to the host defense mechanisms during chronic osteomyelitis and evaluating whether these changes affect the virulence of the organism. Genome assessment of two S. aureus isolates collected 13 months apart (HU-85a and HU-85c) from a host with chronic osteomyelitis was made by whole genome sequencing...
2018: Frontiers in Cellular and Infection Microbiology
Maria Francesca Gicchino, Mario Diplomatico, Carmela Granato, Daniela Capalbo, Pierluigi Marzuillo, Alma Nunzia Olivieri, Emanuele Miraglia Del Giudice
BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic nonbacterial osteomyelitis, is a rare, noninfectious inflammatory disorder that causes multifocal bone lesions with swelling and pain. Lytic and sclerotic bone lesions could be found on X-ray. Short tau inversion recovery magnetic resonance imaging (STIR MRI) shows bone marrow oedema, bone expansion, lytic areas and periosteal reaction. CRMO is characterized by periodic exacerbations and remissions of unclear/unknown pathogenesis...
February 17, 2018: Italian Journal of Pediatrics
Karen L de Mesy Bentley, Ashlee MacDonald, Edward M Schwarz, Irvin Oh
CASE: A patient presenting with an infected diabetic foot ulcer and Staphylococcus aureus chronic osteomyelitis was studied to validate the clinical importance of bacterial colonization of osteocytic-canalicular networks, as we recently reported in a mouse model. We utilized transmission electron microscopy to describe the deformation of S. aureus, from round cocci to rod-shaped bacteria, in the submicron osteocytic-canalicular networks of amputated bone tissue. CONCLUSION: To our knowledge, this is the first evidence of S...
February 14, 2018: JBJS Case Connector
Ihsène Taihi, Loredana Radoi
Chronic non-suppurative osteomyelitis (CNSO) is a chronic bone disease and may be associated with a reparative periosteum entity called proliferative periostitis (PP). This condition rarely affects the maxillofacial region. Mandibular cases were already described for an infectious dental cause, often with an "onion skin" radiographic aspect, but some rare reported cases showed no obvious etiology. They represent a challenge for diagnosis because of possible misdiagnosis leading to unsuccessful or inappropriate treatment attempts...
February 12, 2018: Quintessence International
Andrea Ziegler, Monica Patadia, James Stankiewicz
PURPOSE OF REVIEW: Acute and chronic sinusitis can give rise to a wide array of intracranial and orbital complications. These complications include brain abscess, subdural empyema, epidural abscess, meningitis, venous sinus thrombosis, frontal bone osteomyelitis, and orbital cellulitis and abscess. Despite numerous medical advances, these complications carry a risk of mortality and significant morbidity. RECENT FINDINGS: Recent studies have shown improvement in both the mortality and the morbidity associated with the neurologic complications of acute and chronic sinusitis...
February 5, 2018: Current Neurology and Neuroscience Reports
Lakshmi Vemu, Sukanya Sudhaharan, Neeraja Mamidi, Padmasri Chavali
INTRODUCTION: Chronic osteomyelitis (COM) is a common infection, especially in developing countries. An adequate bone biopsy specimen processed with appropriate microbiology culture methods for isolation and identification of the causative organisms is considered as the gold standard for the diagnosis of osteomyelitis. MATERIALS AND METHODS: The present study is a retrospective microbiology analysis of the specimen from 219 clinically diagnosed cases of COM between January 2013 and April 2016...
January 2018: Journal of Laboratory Physicians
Ihsène Taihi, Loredana Radoi
Chronic non-suppurative osteomyelitis (CNSO) is a chronic bone disease and may be associated with a reparative periosteum entity called proliferative periostitis (PP). This condition rarely affects the maxillofacial region. Mandibular cases were already described for an infectious dental cause, often with an "onion skin" radiographic aspect, but some rare reported cases showed no obvious etiology. They represent a challenge for diagnosis because of possible misdiagnosis leading to unsuccessful or inappropriate treatment attempts...
2018: Quintessence International
Igor-Moreira Hazboun, Thiago-Pires Brito, Vanessa-Gonçalves Silva, Carlos-Eduardo-Monteiro Zappelini, Leopoldo-Nizam Pfeilsticker
Introduction: SAPHO syndrome is defined as the association of a group of rare sterile osteoarticular disorders and inflammatory skin diseases whose etiology, although not yet determined, probably involves genetic, immunological and infectious mechanisms. The recurrent multifocal osteomyelitis, an inflammatory disease, can be associated with this syndrome even as a single event. Case Report: A case of a young female patient, with a definite diagnosis of SAPHO and an inflammatory mandibular atypical disease for which therapeutic options with immunosuppressants were being used, is reported...
January 2018: Iranian Journal of Otorhinolaryngology
Cagri Neyisci, Yusuf Erdem, Ahmet Burak Bilekli, Bahtiyar Demiralp, Ozkan Kose, Dogan Bek, Feza Korkusuz, Berna Kankilic
INTRODUCTION: The purpose of this present study is to investigate the efficacy of vancomycin-loaded VK100 silicone cement drug delivery system in the treatment of implant-related methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis in rats. MATERIALS AND METHODS: Thirty-six adult (18-20 weeks old) female Sprague-Dawley rats were included in the study. All rats underwent experimental osteomyelitis surgery via injecting 100 µL bacterial suspension of MRSA into the medullary canal...
January 2018: Journal of Orthopaedic Surgery
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