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Bhavanam Hanuma Srinivas, Megha Shantveer Uppin, Sateesh Killi, Malladi Venkata Surya Subbalaxmi, Madhusudan Patil, Alugolu Rajesh
Tuberculous osteomyelitis of skull is very rare, even in areas where tuberculosis is endemic. We herein describe an elderly woman who was apparently immunocompetent and presented with left frontal scalp swelling and right cervical lymphadenopathy. CT scan showed irregular bony destruction of the frontal bone. MRI revealed a large extradural, multiseptate, solid-cystic lesion with peripheral enhancement. FNAC from the lesion showed granulomas with caseation suggestive of tuberculosis. The lesion was debrided and she was started on anti-tubercular therapy...
October 2016: Asian Journal of Neurosurgery
Jessica Amber Jennings, Karen E Beenken, Robert A Skinner, Daniel G Meeker, Mark S Smeltzer, Warren O Haggard, Karen S Troxel
AIM: To test antibiotic-loaded coating for efficacy in reducing bacterial biofilm and development of osteomyelitis in an orthopaedic model of implant infection. METHODS: Phosphatidylcholine coatings loaded with 25% vancomycin were applied to washed and sterilized titanium wires 20 mm in length. A 10 mm segment was removed from rabbit radius (total = 9; 5 coated, 4 uncoated), and the segment was injected with 1 × 10(6) colony forming units (CFUs) of Staphylococcus aureus (UAMS-1 strain)...
August 18, 2016: World Journal of Orthopedics
Mahir Aliyev, Andaç Aykan, Muhitdin Eski, Nuri Arslan, Bülent Kurt, Mustafa Şengezer
BACKGROUND: Based on the angiogenetic and stimulating effects of bone healing and formation of vascular endothelial growth factor (VEGF), the present study was designed to assess the efficacy of VEGF gene application in the management of experimentally induced osteomyelitis. METHODS: Thirty-two male Sprague Dawley rats were divided into 4 groups, and osteomyelitis was induced in the left tibial bones. Group 1 (n=8) was designated as a control group, and, after the induction of osteomyelitis, no treatment was applied for a period of 4 weeks...
May 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Gaetano Caruso, Emanuele Gerace, Vincenzo Lorusso, Rosario Cultrera, Loredana Moretti, Leo Massari
BACKGROUND: Chronic osteomyelitis is a challenging problem, and malignant transformation is a rare occurrence. We report a case of a patient with squamous cell carcinoma arising from an osteomyelitic hotbed and discuss through a literature review the etiopathogenesis, diagnosis, and treatment of this lesion. CASE PRESENTATION: A 69-year-old Italian man had sustained an exposed tibial fracture 40 years ago during a road accident, for which he had undergone various surgical osteosynthesis treatments with multiple antibiotic therapies...
2016: Journal of Medical Case Reports
O Robineau, S Nguyen, E Senneville
INTRODUCTION: Infection is the commonest foot complication that arises in people with diabetes and may lead to amputation and even death. The emergence of multidrug resistant bacteria, especially in Gram negative rods, may have a negative impact on the chances of cure in these patients. AREAS COVERED: We searched the Medline and Pubmed databases for studies using the keywords 'diabetic foot infection' and 'diabetic foot osteomyelits' from 1980 to 2016. Expert commentary: Much has been done in the field of diabetic foot infection regarding pathophysiology, diagnosis and treatment...
September 2016: Expert Review of Anti-infective Therapy
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
Prajwal Gurung, Amanda Burton, Thirumala-Devi Kanneganti
Missense mutation in the proline-serine-threonine phosphatase-interacting protein 2 (Pstpip2) gene results in the development of spontaneous chronic bone disease characterized by bone deformity and inflammation that is reminiscent of patients with chronic multifocal osteomyelitis (cmo). Interestingly, this disease is specifically mediated by IL-1β but not IL-1α. The precise molecular pathways that promote pathogenic IL-1β production inPstpip2(cmo)mice remain unidentified. Furthermore, how IL-1β provokes inflammatory bone disease inPstpip2(cmo)mice is not known...
April 19, 2016: Proceedings of the National Academy of Sciences of the United States of America
Luca Dalla Paola, Anna Carone, Marco Baglioni, Giulio Boscarino, Lucian Vasilache
AIMS: Charcot neuropathic osteoarthropathy (CN) represents a complication for diabetic patients which involves a progressive alteration of the osteoarticular apparatus with high risk of amputation. The aim of the study was to assess whether the localization of CN and the extent or grading of the osteomyelitis have an influence on the rate of limb salvage and the time to recovery. METHODS: We treated a diabetic population affected by CN complicated by ulceration and widespread osteomyelitic involvement...
May 2016: Journal of Diabetes and its Complications
A Kulyapina, J Verdaguer Martin, C Navarro Cuellar, C Navarro Vila
Osteopetrosis (OP) is a rare metabolic bone disease characterized by a generalized increase in skeletal mass. The disease is characterized by increased susceptibility to develop osteomyelitis of the jaws. We report a case of clinical and radiological progression of bimaxillary osteomyelitis in a patient with autosomal dominant OP. The patient presented non simultaneous osteomyelitis in both upper and lower jaws with time interval of 10 years. The osteomyelitis of maxilla resulted in oroantral fistula formation and required surgical closure with Bichat fat pad flap...
March 2016: Journal of Maxillofacial and Oral Surgery
Johannes Maximilian Wagner, Hannah Zöllner, Christoph Wallner, Britta Ismer, Jessica Schira, Stephanie Abraham, Kamran Harati, Marcus Lehnhardt, Björn Behr
INTRODUCTION: Bone infections after trauma, i.e. posttraumatic osteomyelitis, pose one of the biggest problems of orthopedic surgery. Even after sufficient clinical therapy including vast debridement of infected bone and antibiotic treatment, regeneration of postinfectious bone seems to be restricted. One explanation includes the large sized defects resulting from sufficient debridement. Furthermore, it remains unclear if inflammatory processes after bone infection do affect bone regeneration...
2016: PloS One
Joseph Lopez, Shuting Susan Zhong, Eric W Sankey, Edward W Swanson, Harlyn Susarla, Ignacio Jusue-Torres, Judy Huang, Henry Brem, Paul G Auwaerter, Chad R Gordon
BACKGROUND: Reinfections following implant-based cranioplasty, in the setting of previous bone flap osteomyelitis, are common and associated with significant morbidity. The timing of reconstruction following initial osteomyelitic bone flap removal remains controversial; most advocate for prolonged time intervals of approximately 6 to 12 months. Thus, the authors investigated their delayed cranioplasty outcomes following both early (between 90 and 179 days) and late (≥ 180 days) time intervals with custom craniofacial implants to determine whether timing affected outcomes and rates of reinfection...
February 2016: Plastic and Reconstructive Surgery
Gaurav Bakutra, Balaji Manohar, Lalit Mathur
Tuberculous lesions affecting periodontium are rare and seen as secondary infections localized to the soft tissues. With the advent of effective drug therapy, tuberculous lesions of the oral cavity have become rare. Involvement of the periodontium has seldomly been reported in the recent literature. We report a case of tuberculous osteomyelitis of mandible affecting periodontium leading to gingival recession and bone exposure in the mandibular premolar region in a 42-year-old female patient. The diagnosis was based on patient's medical and dental history, bacterial culture, clinical and radiographic examination, blood investigation, immunologic tests, histopathologic examination of the tissue specimen...
September 2015: Journal of Indian Society of Periodontology
Tejasvini Vaid, Karthik Rao, Handattu Manjunath Hande
A 56-year-old woman presented with fever, pain and restriction of movement of the right temporomandibular joint. She was premorbidly diagnosed to have type 2 diabetes mellitus and rheumatoid arthritis. Local examination revealed a poorly demarcated severely tender, erythematous swelling in the right preauricular region. All haematological and biochemical investigations were within normal limits. MRI of the neck revealed the presence of a masticator space infection with intramuscular abscess involving the masseter and the temporalis muscles along with intracranial extension...
2015: BMJ Case Reports
Hugo F G Martins, Alexandra Raposo, Isabel Baptista, Julio Almeida
We report a case of a 46-year-old man with fever, hypotension and arthralgias of the ankles and knees after brain surgery for a pituitary tumour causing Cushing's disease. Blood and urine cultures isolated Serratia marcescens; antibiotic susceptibility testing showed sensitivity to piperacillin-tazobactan and ciprofloxacin. Articular MRI showed inflammation and necrosis of both knees and ankles, and left hip and right elbow (compatible with osteomyelitis). Culture of an ankle abscess on the ankle joint was positive for Serratia marcescens...
2015: BMJ Case Reports
Urszula Posadowska, Monika Brzychczy-Wloch, Elzbieta Pamula
Infection spreading in the skeletal system leading to osteomyelitis can be prevented by the prolonged administration of antibiotics in high doses. However systemic antibiotherapy, besides its inconvenience and often low efficacy, provokes numerous side effects. Thus, we formulated a new injectable nanoparticle-loaded system for the local delivery of vancomycin (Vanc) applied in a minimally-invasive way. Vanc was encapsulated in poly(L-lactide-co-glycolide) nanoparticles (NPs) by double-emulsification. The size (258 ± 11 nm), polydispersity index (0...
January 2016: Journal of Materials Science. Materials in Medicine
Roberto J Aranibar, Diana Cardenas Del Monaco, Phoebe Gonzales
Osteomyelitis of the spine is a fairly uncommon event following an orthopedic surgical procedure. However, a solitary osteomyelitic abscess of the upper cervical spine is very rare. Surgical intervention is often the only life-saving treatment method. A 70-year-old female patient with diabetes was received from a rural community with symptoms of progressive quadraparesis and progressive respiratory failure. A CT scan of the cervical spine showed a destruction of the C1 and C2 complex, as well as the left occipital condyle, and clear evidence of craniocervical instability...
2015: International Journal of Spine Surgery
C Lamm, M Dockner, B Pospischek, E Winter, B Patzak, M Pretterklieber, G W Weber, P Pietschmann
OBJECTIVE: Osteomyelitis is an inflammation of the bone marrow mainly caused by bacteria such as Staphylococcus aureus. It typically affects long bones, e.g. femora, tibiae and humeri. Recently micro-computed tomography (μCT) techniques offer the opportunity to investigate bone micro-architecture in great detail. Since there is no information on long bone microstructure in osteomyelitis, we studied historic bone samples with osteomyelitis by μCT. MATERIALS AND METHODS: We investigated 23 femora of 22 individuals suffering from osteomyelitis provided by the Collection of Anatomical Pathology, Museum of Natural History, Vienna (average age 44 ±19 years); 9 femora from body donors made available by the Department of Applied Anatomy, Medical University of Vienna (age range, 56-102 years) were studied as controls...
October 2015: Skeletal Radiology
K P Karumbaiah, M S Shruthi, V Ragavendran, T M Kariappa
Squamous cell carcinoma is a rare, but well documented complication of chronic osteomyelitis. Squamous cell carcinoma arising in a sinus tract following chronic osteomyelitis of the pelvic bone is a very rare occurrence. The patient presented with multiple draining sinuses and an ulcerative growth at the mouth of one of the sinuses in the peri-anal region. X-ray findings and sinogram showed de- struction of part of pubic bone. Biopsy from the growth confirmed a well differentiated squamous cell carcinoma. Therefore it is imperative that these lesions be biopsied for accurate diagnosis, adequate therapy and follow-up...
January 2014: Journal of the Indian Medical Association
D Dawson, G McLean, A Wilson
Here, we present a case report of a young male who had been travelling in Thailand. The patient sustained a relatively minor trauma to the soft tissue under his left third metatarsal head on a piece of coral reef. He subsequently developed an infected ulcer, which did not heal despite appropriate antibiotic therapy and surgical debridement. Unfortunately, the patient required amputation of the left third toe and metatarsal head due to osteomyelitic destruction. It later transpired that the ulcer was initially ischaemic in nature due to previously undiagnosed and asymptomatic popliteal artery stenosis...
2015: Journal of Surgical Case Reports
Amit G Krishnan, Lakshmi Jayaram, Raja Biswas, Manitha Nair
Surgical debridement of the dead bone and subsequent systemic antibiotic therapy is often ineffective in eliminating Staphylococcus aureus infections in osteomyelitic patients. The recurrence of S. aureus infection is mainly due to the intracellular growth of bacterial colonies within osteoblast cells that protect the organism from extracellular host defences and/or antibiotic therapy. In this study, porous gelatin-hydroxyapatite (HAP) scaffolds with various amounts of ciprofloxacin (1, 2, 5, and 10 wt%) were fabricated by freeze-drying technique and the release of the antibiotic was characterized, as was the efficacy of the released antibiotic against methicillin-sensitive and methicillin-resistant S...
April 2015: Tissue Engineering. Part A
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