1/21. Anaerobic osteomyelitis of femoral head with intraosseous, intra-articular, bursal and muscle pneumatosis.A case is presented of anaerobic osteomyelitis with intraosseous pneumatosis resulting in extension of gas in soft tissue structures and femur in a patient with mitral valve vegetation and bacteremia. The finding of intraosseous pneumatosis and its extension into the hip joint, iliopsoas bursa and subgluteus medius bursa is depicted. Intraosseous pneumatosis is a rare but concerning finding for osteomyelitis in the absence of a penetrating wound, recent surgery, biopsy or fracture.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
2/21. bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin iii and protein c deficiency: a case report.Hypercoagulability is one of the causes of portal vein and superior mesentery vein thrombosis. We report a case of bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin iii and protein c deficiency. The patient presented with high fever for more than 3 weeks. Abdominal sonography revealed a liver cyst of 1.7 cm in diameter over segment 4 and a renal stone of 0.7 cm in size over the lower portion of the right kidney but no evidence of hydronephrosis. Elevation of liver enzymes was also noted. Intermittent fever was noted despite treatment with ceftriaxone and doxycycline. On Day 15 of hospitalization, blood culture revealed B. fragilis, which prompted further investigation of the source of intraabdominal and pelvic infection. Abdominal computed tomography revealed portal vein and superior mesentery vein thrombosis. Endoscopic studies of the gastrointestinal tract showed no tumor or diverticulum. Study of coagulation factors disclosed deficiency of antithrombin iii and protein C. Clinicians should remain aware of the need to promptly search for a portal or mesentery vein thrombosis in cases of Bacteroides bacteremia of unknown origin.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
3/21. Retroperitoneal air dissection associated with mechanical ventilation.The radiologic patterns, etiology, and possible consequences of gas dissection into the retroperitoneal space from pulmonary sources are reviewed in three patients requiring mechanical ventilation. Airway disruption appears to be related to peak airway pressures, underlying pulmonary disease, and the patient's hemodynamic condition and may cause different forms of interstitial emphysema and air embolization, which may lead to severe respiratory or circulatory dysfunction. Gas migration to the retroperitoneum and, secondarily, into the peritoneal cavity should be considered in the differential diagnosis of free intra-abdominal gas.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
4/21. Polymicrobial septicemia with clostridium difficile in acute diverticulitis.A case is reported of a patient without previous gastrointestinal symptoms, who presented with polymicrobial septicemia caused by escherichia coli, enterococcus faecalis, clostridium difficile and Bacteroides vulgatus. Septicemia occurred during acute diverticulitis. A strain of clostridium difficile, which was of the same serogroup C as the blood culture isolate and also produced toxin, was recovered from the stools, but the pathogenic role of this organism in the gastrointestinal symptomatology was not clearly established. Other reported cases of clostridium difficile septicemia are also reviewed.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
5/21. eikenella corrodens: an unusual cause of endocarditis in a patient with silent mitral valve prolapse.A 69-year old man with clinically silent mitral valve prolapse developed infective endocarditis secondary to eikenella corrodens after dental work. The patient required surgical removal of abscessed teeth and long-term antibiotic therapy. E. corrodens is a gram-negative coccobacillus which normally inhabits the oropharynx, gastrointestinal tract, and upper respiratory tract. The organism can cause cutaneous and abdominal abscesses, meningitis, osteomyelitis, and endocarditis. patients with mitral valve prolapse and a pre-existent systolic murmur or Doppler echocardiographic evidence of mitral regurgitation should receive prophylactic antibiotics for any procedure associated with a bacteremia. An infection caused by E. corrodens should be considered in patients with fever after dental manipulation or in patients with "culture-negative" endocarditis.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
6/21. CT detection of sacral osteomyelitis associated with pelvic abscesses.In three patients the diagnosis of sacral osteomyelitis was made when CT demonstrated intraosseous (two) and intraforaminal (one) gas. Two of the three patients also had radionuclide bone scans, one of which was unremarkable. In the other case, radionuclide scintigraphy greatly underestimated the extent of the disease process when compared with CT. All three patients had contiguous pelvic abscesses as a cause of the osteomyelitis. Although there was a high clinical suspicion for an intraabdominal process, the diagnosis of superimposed osteomyelitis of the sacrum was unsuspected. The detection of intraosseous gas is a pathognomonic, albeit uncommon, manifestation of osteomyelitis. Although the radionuclide bone scan is the method of choice for detecting osteomyelitis, CT should be used as a complementary study in certain patients.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
7/21. Unusual infections associated with colorectal cancer.Unusual infections associated with colorectal tumors may, in some instances, be the sole clue to the presence of a malignancy. The infections are either related to invasion of tissues or organs in close proximity to the tumor or secondary to distant seeding by transient bacteremia arising from necrotic tumors. Seven patients seen at one hospital over a 5-year period illustrate the clinical presentations of such infections. The infections identified in these seven patients include endocarditis, meningitis, nontraumatic gas gangrene, empyema, hepatic abscesses, retroperitoneal abscess, clostridial sepsis, and colovesical fistulae with urosepsis. A computer-assisted search of the English-language literature and cross-checks from other review articles identified other infections associated with colon cancer, which include nontraumatic crepitant cellulitis, suppurative thyroiditis, pericarditis, appendicitis, pulmonary microabscesses, septic arthritis, and fever of unknown origin. The clinical importance of these infections and their correlation with colorectal malignancies are reviewed.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
8/21. Anaerobic bacterial meningitis.We report a case of anaerobic bacterial meningitis in which a rapid diagnosis was achieved by direct gas-liquid chromatography of cerebrospinal fluid.- - - - - - - - - - ranking = 1keywords = gas (Clic here for more details about this article) |
9/21. air in painful total hip arthroplasty: diagnosis and treatment.A 78-year-old woman presented with a painful total hip arthroplasty five years postoperation. Plain radiographs revealed air in the hip joint. Aspiration of the hip indicated hip sepsis, and arthrogram showed communication of the hip joint with the sigmoid colon. Cultures grew bacteroides fragilis. Abdominal exploration showed a ruptured diverticulum that decompressed through the sciatic notch into the total hip arthroplasty. A colostomy was performed, and the hip joint was drained and debrided laterally at the same operation. The prosthesis was later removed with all cement, and the hip was converted to a Girdlestone resection. The authors conclude that air or gas shadows in a painful total hip arthroplasty are an ominous finding and mean either joint sepsis with a gas-forming bacteria or communication of the joint with a hollow viscus and sepsis.- - - - - - - - - - ranking = 2keywords = gas (Clic here for more details about this article) |
10/21. Non-clostridial gas gangrene in the diabetic lower limb.Three cases of non-clostridial gas gangrene in diabetic lower limbs are reported. This rare condition occurs only in diabetes with peripheral neuropathy and is invariably fatal unless treated surgically. The clinical picture is deceptive with a slow, but insidiously progressive course, and the late appearance of skin necrosis. Antibacterial therapy is ineffective in preventing death. A serious delay may be fostered by inconclusive bacteriological investigations. Urgent radical amputation is required to save the patient's life.- - - - - - - - - - ranking = 5keywords = gas (Clic here for more details about this article) |
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