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https://www.readbyqxmd.com/read/28437330/pedicle-screw-fluid-sign-an-indication-on-magnetic-resonance-imaging-of-a-deep-infection-after-posterior-spinal-instrumentation
#1
Hiroaki Kimura, Jitsuhiko Shikata, Seiichi Odate, Tsunemitsu Soeda
STUDY DESIGN: A single-center case-referent study. OBJECTIVE: To assess whether the "pedicle screw (PS) fluid sign" on magnetic resonance imaging (MRI) can be used to diagnose deep surgical site infection (SSI) after posterior spinal instrumentation (PSI). SUMMARY OF BACKGROUND DATA: MRI is a useful tool for the early diagnosis of a deep SSI. However, the diagnosis is frequently difficult with feverish patients with clear wounds after PSI because of artifacts from the metallic implants...
May 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28435744/diagnosis-of-spinal-epidural-abscess-a-case-report-and-literature-review
#2
Chidinma Chima-Melton, Michelle Pearl, Marni Scheiner
INTRODUCTION: Spinal epidural abscess (SEA) is a rare but serious cause of back pain in the critical care setting. It occurs most commonly in adults in their fifth and sixth decades of life. Risk factors include diabetes mellitus, alcoholism, AIDS or other immunocompromised states, cancer, intravenous drug use, trauma and spinal surgery. The clinical presentation can be non-specific but the classical triad includes back pain, fever and neurological deficits. Magnetic resonance imaging (MRI) with gadolinium is the diagnostic imaging modality of choice...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28430048/a-spinal-epidural-abscess-due-to-streptobacillus-moniliformis-infection-following-a-rat-bite-case-report
#3
Alexander Hammer, Dorit Wolff, Walter Geißdörfer, Michael Schrey, Renate Ziegler, Hans-Herbert Steiner, Christian Bogdan
The authors describe the case of a 40-year-old man suffering from an epidural abscess in the thoracic spine due to a rarely isolated pathogen, Streptobacillus moniliformis, the causative agent of rat bite fever. Besides diffuse abdominal pain, ataxia, paresthesia, hypesthesia, and enhanced reflexes of the lower extremities, the patient suffered from a decreased sensation of bladder filling. His history was also positive for a rat bite 6 weeks earlier. Magnetic resonance imaging showed an epidural, space-occupying lesion compressing the spinal cord at the vertebral levels of T6-8...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28427732/endogenous-bacterial-endophthalmitis-a-report-of-2cases
#4
M Cubillas, A Sampedro, B Domínguez, I Carrio, V Bango, J J Barbón
CLINICAL CASES: The cases are presented on 2patients with bacterial endogenous endophthalmitis. The first one was caused by Streptococcus bovis, developed after colonoscopy, which had a poor outcome and resulted in evisceration. The second case was caused by a methicillin resistant Staphylococcus aureus from an arthrodesis complicated with a para-spinal abscess. It had an excellent visual outcome. DISCUSSION: Bacterial endogenous endophthalmitis is a rare, but serious ocular disease that occurs when bacteria reach the eye via the bloodstream...
April 17, 2017: Archivos de la Sociedad Española de Oftalmología
https://www.readbyqxmd.com/read/28417614/spinal-epidural-abscess-caused-by-brucella-species-a-review-of-17-cases
#5
Qin Zhang, Xiaohui Yang, Honglin Yu, Benrang Jia, Bin Meng
BACKGROUND: Spinal epidural abscess (SEA) is a rarely encountered clinical entity during the course of Brucella infection. METHODS: We reported 17 patients diagnosed with Brucellar SEA for a mean follow-up of 15 months. Spinal epidural abscess was detected by magnetic resonance imaging in all cases. Brucella diagnosis was established by serological tests. Patients were administered antibiotics for duration of 6 to 16 weeks. RESULTS: SEA was localized in lumbar region in 9 patients, thoracic in 4 patients, cervical in 3 patients, both thoracic and lumbar in 1 patient...
June 2017: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/28416829/-clinical-characteristics-and-prognosis-of-cultured-negative-pyogenic-spondylitis
#6
Y P Cui, C Mi, X D Shi, B Wang, Y X Pan, Y F Lin
OBJECTIVE: There are limited data describing the clinical characteristics and prognosis of culture negative pyogenic spondylitis. The aim of this study was to investigate the treatment, prognosis and clinical characteristics of culture negative pyogenic spondylitis. METHODS: A retrospective study reviewed 74 patients who were diagnosed with spondylitis in Peking University First Hospital from January 2010 to December 2015. A total of 27 patients suffered from pyogenic spondylitis...
April 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28407707/destruction-of-the-c2-body-due-to-cervical-actinomycosis-connection-between-spinal-epidural-abscess-and-retropharyngeal-abscess
#7
Dong Min Kim, Seok Won Kim
Human actinomycosis with involvement of the spine is a rare condition, with only a limited number of case reports published. To the best of our knowledge, no cases have been reported of epidural abscess causing destruction of the C2 body, bringing about a direct connection between spinal epidural and retropharyngeal abscesses. Here, we present such a case that occurred after acupuncture, and we review the relevant literature.
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28407706/gas-containing-cervical-epidural-abscess-accompanying-bacterial-meningitis-in-an-adult
#8
Dong Min Kim, Seok Won Kim
Gas-containing spinal epidural abscesses are uncommon. Moreover, acute spinal epidural abscesses rarely complicate bacterial meningitis in adults. Here, we report a rare case of a gas-containing cervical epidural abscess accompanying bacterial meningitis. In spite of aggressive fluid and continuous antibiotic therapy after the isolation of Streptococcus anginosus and Streptococcus constellatus in the cerebrospinal fluid cultures, the patient showed remaining motor dysfunction and bladder involvement. Our experience suggests that the effort to prevent neurologic deterioration by emergent surgical decompression and drainage of pus is mandatory to avoid additional spinal cord dysfunction in patients with spinal epidural abscesses accompanying bacterial meningitis...
March 2017: Korean Journal of Spine
https://www.readbyqxmd.com/read/28399057/staphylococcus-aureus-central-nervous-system-infections-in-children
#9
Jesus G Vallejo, Alexandra N Cain, Edward O Mason, Sheldon L Kaplan, Kristina G Hultén
BACKGROUND: Central nervous system (CNS) infections due to Staphylococcus aureus are uncommon in pediatric patients. We review the epidemiology, clinical features, and treatment in 68 patients with a S. aureus CNS infection evaluated at Texas Children's Hospital (TCH). METHODS: Cases of CNS infection in children with positive cerebrospinal fluid cultures or spinal epidural abscess for S. aureus at TCH from 2001-2013 were reviewed. RESULTS: 70 cases of S...
April 10, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28383432/atypical-spinal-tuberculosis-involved-noncontiguous-multiple-segments-case-series-report-with-literature-review
#10
Lin-Nan Wang, Lei Wang, Li-Min Liu, Yue-Ming Song, Yue Li, Hao Liu
In its typical form, spinal tuberculosis (TB) presents as destroyed contiguous vertebral bodies with involvement of intervertebral discs and paravertebral or psoas abscesses. Atypical forms are uncommonly reported. Here, we describe 8 patients with noncontiguous multisegmental spinal TB with no intervertebral disc involvement. From 2013 to 2014, we surgically treated 384 patients with spinal TB to relieve spinal cord compression, re-establish spinal stability, confirm the diagnosis, and debride the TB foci...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28379730/paraspinal-edema-is-the-most-sensitive-feature-of-lumbar-spinal-epidural-abscess-on-unenhanced-mri
#11
Anna Shifrin, Qin Lu, Michael H Lev, Timothy M Meehan, Ranliang Hu
OBJECTIVE: Spinal epidural abscess (SEA) is a serious infection requiring prompt treatment and potential neurosurgical intervention. Although contrast-enhanced spine MRI is the mainstay for diagnosis of SEA, unenhanced MRI is typically performed for patients with nonspecific symptoms or insufficient clinical information. We evaluated the sensitivity and specificity of imaging features suggestive of SEA at unenhanced spine MRI. MATERIALS AND METHODS: We searched our database for contrast-enhanced lumbar spine MRI examinations from January 1, 2000, through August 1, 2014, with "epidural abscess" in the report...
April 5, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28377250/acute-spinal-epidural-hematoma-after-acupuncture-personal-case-and-literature-review
#12
Maurizio Domenicucci, Daniele Marruzzo, Alessandro Pesce, Antonino Raco, Paolo Missori
BACKGROUND: Spinal acupuncture is a relatively safe and common analgesic treatment, but it may be complicated by serious adverse effects such as direct spinal cord and nerve root injury, subdural empyema and epidural abscesses. In this report we are comparing our case of an extremely uncommon spinal epidural hematoma which appeared following treatment by acupuncture with other similar documented cases. CASE DESCRIPTION: This is the case of a 64-year-old man who presented a left hemiparesis associated with paraesthesias...
April 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28366427/errors-in-diagnosis-of-spinal-epidural-abscesses-in-the-era-of-electronic-health-records
#13
Viraj Bhise, Ashley N D Meyer, Hardeep Singh, Li Wei, Elise Russo, Aymer Al-Mutairi, Daniel R Murphy
PURPOSE: To identify missed opportunities in diagnosis of spinal epidural abscesses to outline areas for process improvement. METHODS: Using a large national clinical data repository, we identified all patients with a new diagnosis of spinal epidural abscess in the Department of Veterans Affairs (VA) during 2013. Two physicians independently conducted retrospective chart reviews on 250 randomly selected patients and evaluated their records for red flags (e.g., unexplained weight loss, neurological deficits, and fever) 90 days prior to diagnosis...
March 30, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28366222/infections-of-the-spine
#14
REVIEW
Maja Babic, Claus S Simpfendorfer
Pyogenic infections of the bony spinal column and the intervertebral discs are on a steady rise in an aging western population. Despite advanced medical imaging, this clinical entity of devastating consequences if missed, still presents a diagnostic conundrum and is plagued by an unacceptably long diagnostic delay. The aim of this article is to raise awareness of the heterogeneity of spinal infections paralleling the complex structure of the spinal column and neighboring soft tissues. Emphasis is placed on the clinical presentation and management of septic facet joints and psoas muscle abscesses associated with lumbar spondylodiscitis...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28337426/pathogen-identification-in-suspected-cases-of-pyogenic-spondylodiscitis
#15
Ahmad Farajzadeh Sheikh, Azar D Khosravi, Hamed Goodarzi, Roohangiz Nashibi, Alireaza Teimouri, Azim Motamedfar, Reza Ranjbar, Sara Afzalzadeh, Mehrandokht Cyrus, Mohammad Hashemzadeh
Pyogenic spinal infection continues to represent a worldwide problem. In approximately one-third of patients with pyogenic spondylodiscitis, the infectious agent is never identified. Of the cases that lead to organismal identification, bacteria are more commonly isolated from the spine rather than fungi and parasites. This study applied universal prokaryotic 16S rRNA PCR as a rapid diagnostic tool for the detection of bacterial agents in specimens from patients suspected of pyogenic spondylodiscitis. Gram and Ziehl-Neelsen staining were used as a preliminary screening measure for microbiologic evaluation of patient samples...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28319551/a-contemporary-medicolegal-analysis-of-implanted-devices-for-chronic-pain-management
#16
Christopher R Abrecht, Penny Greenberg, Ellen Song, Richard D Urman, James P Rathmell
BACKGROUND: Analysis of closed malpractice claims allows the study of rare but serious complications and likely results in improved patient safety by raising awareness of such complications. Clinical studies and closed claims analyses have previously reported on the common complications associated with intrathecal drug delivery systems (IDDS) and spinal cord stimulators (SCS). This study provides a contemporary analysis of claims from within the past 10 years. METHODS: We performed a closed claims analysis for a period January 1, 2009 to December 31, 2013 for cases with pain medicine as the primary service...
April 2017: Anesthesia and Analgesia
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
#17
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/28274020/role-of-cross-sectional-imaging-in-isolated-chest-wall-tuberculosis
#18
Deb Kumar Boruah, Shantiranjan Sanyal, Barun K Sharma, Arjun Prakash, Dhabal D Dhingani, Karobi Bora
INTRODUCTION: Isolated chest wall tuberculosis though a rare entity, the incidence of it has been on rise among immunocompromised population making it an important challenging diagnosis for the physicians. Its clinical presentation may resemble pyogenic chest wall abscess or chest wall soft tissue tumour. Sometimes it is difficult to detect clinically or on plain radiograph. AIM: The present study was conducted with an aim to evaluate the common sites and varying appearances of isolated chest wall tuberculosis...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28253945/-pyogenic-spinal-infections-in-adults-a-5-year-experience-from-a-tertiary-care-centre
#19
O Džupová, R Cihlářová
PURPOSE OF THE STUDY To describe epidemiological and clinical features of pyogenic spinal infections in patients treated at the Department of Infectious, Parasitic and Tropical Diseases of the Hospital Na Bulovce in 2010-2014, and to analyse a predictive significance of selected variables. MATERIAL AND METHODS A single-centre retrospective cohort study carried out from 1.1.2010 to 31.12.2014 enrolled adult patients with septic spondylitis, discitis and facet joint infections. Recorded parameters included: demographics, chronic comorbidities, time to diagnosis, radiological work-up, anatomical level of spinal infection, source of infection, etiological agent, complications, treatment and outcomes...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28251880/choosing-wisely-canada%C3%A2-five-tests-procedures-and-treatments-to-question-in-emergency-medicine
#20
Amy H Y Cheng, Sam Campbell, Lucas B Chartier, Tom Goddard, Kirk Magee, Jill McEwen, Atul K Kapur, Brian R Holroyd, Suneel Upadhye, Stephanie Couperthwaite, Brian H Rowe
OBJECTIVES: Choosing Wisely Canada (CWC) is an initiative to encourage patient-physician discussions about the appropriate, evidence based use of medical tests, procedures and treatments. We present the Canadian Association of Emergency Physicians' (CAEP) top five list of recommendations, and the process undertaken to generate them. METHODS: The CAEP Expert Working Group (EWG) generated a candidate list of 52 tests, procedures, and treatments in emergency medicine whose value to care was questioned...
March 2, 2017: CJEM
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