1/420. vancomycin-induced neutropenia associated with fever: similarities between two immune-mediated drug reactions.A 39-year-old woman being treated for osteomyelitis with vancomycin developed severe neutropenia and drug fever. After she discontinued therapy, both disorders quickly resolved. These adverse reactions have rarely been reported with vancomycin, and share many similarities with regard to clinical features and postulated mechanisms of induction. To our knowledge this is the first case documenting drug fever as a principal component of vancomycin-induced neutropenia, and provides further evidence in support of an immune-mediated mechanism.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
2/420. Vertebral osteomyelitis in insulin-dependent diabetics.Vertebral osteomyelitis continues to be a diagnostically and therapeutically challenging disease with a relatively high incidence in diabetics. The clinical features, investigations and treatment of 7 insulin-dependent diabetics with vertebral osteomyelitis are presented and possible aetiological factors in this group are discussed.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
3/420. Purulent osteomyelitis of the cervical spine with epidural abscess. Operative treatment by means of dorsal and ventral approach.The present case concerns an acute purulent osteomyelitis with an epidural abscess, located particularly in the intervertebral foramen between C5 and C6, which led to infection by staphylococci of the adjacent vertebral arches and vertebral bodies. An obstruction of the CSF passage was discovered by myelography at the level between C5 and C6. The bony tissue changed by inflammation was removed as far as possible by laminectomy. After irrigation of the epidural space with antibiotics and after control of the severe inflammation, the vertebral bodies C6 and C7 which were destroyed by the spreading inflammatory granulations, could be removed by a ventral approach 4 weeks later. The defect was filled with spongiosa chips. After immobilisation in a plaster shell and Crutchfield extension for 8 weeks the patient was slowly mobilized. A fusion of the vertebral bodies C5 and C6, C6/C7 and C7/C1 was achieved. A dislocation of the cervical spine did not occur and the patient recovered completely except for a paresis of the right hand. Treatment of this very rare and severe case was only possible by a combined dorsal and ventral procedure on the cervical spine.- - - - - - - - - - ranking = 217.32015475695keywords = intervertebral, disc (Clic here for more details about this article) |
4/420. Presentation and management of chronic osteomyelitis in an African patient with pycnodysostosis.A case is reported of pycnodysostosis (PCD) with chronic osteomyelitis in the mandible. The clinical and radiological features and the problems of management and follow-up are discussed.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
5/420. Primary sternal osteomyelitis in infants: a report of two cases.Primary sternal osteomyelitis in infants, older children, and adults is rare. Secondary sternal osteomyelitis, however, is more common because of the increased frequency of cardiothoracic surgery and intravenous drug abuse. Primary sternal osteomyelitis is reviewed, two infants with further cases of primary sternal osteomyelitis are presented, and diagnosis and management are discussed.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
6/420. Fungal spinal osteomyelitis in the immunocompromised patient: MR findings in three cases.The MR imaging findings of fungal spinal osteomyelitis in three recipients of organ transplants showed hypointensity of the vertebral bodies on T1-weighted sequences in all cases. Signal changes and enhancement extended into the posterior elements in two cases. Multiple-level disease was present in two cases (with a total of five intervertebral disks involved in three cases). All cases lacked hyperintensity within the disks on T2-weighted images. In addition, the intranuclear cleft was preserved in four of five affected disks at initial MR imaging. MR features in candida and aspergillus spondylitis that are distinct from pyogenic osteomyelitis include absence of disk hyperintensity and preservation of the intranuclear cleft on T2-weighted images. Prompt recognition of these findings may avoid delay in establishing a diagnosis and instituting treatment of opportunistic osteomyelitis in the immunocompromised patient.- - - - - - - - - - ranking = 221.28185822273keywords = intervertebral, disk (Clic here for more details about this article) |
7/420. Progressive unilateral mandibular swelling in adolescence: a diagnostic dilemma.Asymmetrical swelling of the mandible in adolescence may pose a significant diagnostic dilemma. The differential diagnosis ranges from traumatic, infectious, and metabolic processes to benign and malignant tumors. Among them, fibrous dysplasia, osteomyelitis, and malignancy may present with similar clinical and radiological features, making an accurate diagnosis quite difficult. This is an illustrative case involving a 14-year-old girl who initially presented with diffuse fibrous dysplasia of the mandible and in whom a superimposed osteomyelitis of the left side subsequently developed. Multiple investigations and several biopsies were required to arrive at a diagnosis. Similarities in clinical and radiographic findings of fibrous dysplasia, osteomyelitis, and malignancy are presented, and implications for treatment are discussed.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
8/420. sinusitis with contiguous abscess involvement of the clivus and petrous apices. Case report.A wide spectrum of diseases may involve the clivus, such as primary neoplasms, metastatic disease, and inflammatory, vascular, hematopoietic, and infectious processes. Of these, osteomyelitis of the skull base and/or clival-petrous abscess are unusual, but may occur as a result of contiguous spread from the paranasal sinuses, namely, the posterior ethmoid and sphenoid, as was demonstrated by this patient. In this case report we discuss the pertinent anatomy, imaging studies, pathogenesis, and medical and surgical management of this case.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
9/420. SAPHO syndrome or psoriatic arthritis? A familial case study.OBJECTIVE: To discuss the relationships between SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome and the group of spondylarthropathies. methods: Few reports of familial SAPHO have been published. We describe three children, two sisters and one brother, whose clinical and radiological presentation was in accordance with SAPHO syndrome. RESULTS: Two children developed psoriasis, and one child palmoplantar pustulosis. Both sacroiliac and sternoclavicular joints were involved in these three cases. Some features in our observations are also common to psoriatic arthritis. No association was found with hla antigens, but a history of trauma preceding the onset of symptoms was present in all three children. CONCLUSIONS: We can consider that SAPHO is nosologically related to spondylarthropathies. Psoriatic arthritis could be the missing link between SAPHO and spondylarthropathies. It is likely that both genetic and environmental factors are involved.- - - - - - - - - - ranking = 1keywords = disc (Clic here for more details about this article) |
10/420. Vertebral aspergillus osteomyelitis and acute diskitis in patients with chronic obstructive pulmonary disease.aspergillus osteomyelitis of the spine with acute diskitis has been well documented in immunocompromised hosts but is rare in immunocompetent patients. Predisposing factors to infection are prolonged neutropenia, hematologic malignancies, chemotherapy, history of prior spinal trauma or surgery, allograft transplantation, or any condition requiring the use of long-term immunosuppressive agents or systemic corticosteroids. patients with chronic obstructive pulmonary disease (COPD) treated with systemic corticosteroids for either long-term management or frequent exacerbations are at potential risk for such infections. patients with severe COPD treated primarily with inhaled corticosteroids are considered immunocompetent. This report describes 2 cases of aspergillus osteomyelitis with acute diskitis in apparently immunocompetent patients with COPD who, aside from brief courses of systemic corticosteroids, were using inhaled corticosteroid therapy. One patient was treated with intravenous amphotericin b alone, whereas the other received amphotericin b and underwent surgical debridement. Both have done well and were symptom free at 6-month follow-up.- - - - - - - - - - ranking = 7.4425551986703keywords = disk (Clic here for more details about this article) |
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