1/12. osteomyelitis associated with peripheral vascular disease secondary to diabetes mellitus.diabetes mellitus and arteriosclerotic vascular disease have been found to be the predisposing factors of osteomyelitis associated with peripheral vascular disease (10). A diabetic person is more susceptible to osteomyelitis because of the microangiopathy, peripheral neuropathy and decreased resistance to infection. In diabetes mellitus there can be microangiopathy which results from the proliferation of the endothelium of the intima and thickening of the basement membrane. This further contributes to a sluggish blood flow. In the patient with arteriosclerotic vascular disease, the lumens of the arterioles and arterioles are compromised by the atheromatous plaques. The anatomic structure of the blood supply to bone along with the pathologic membrane thickening, allows for slowing of blood. This slowing of blood flow causes micro-thrombi and enhances bacterial growth. In diabetes mellitus it has been shown that there is a decreased immunologic response which, along with the above, contributes to the sheltering and proliferation of bacteria in the small bones of the foot.- - - - - - - - - - ranking = 1keywords = vascular disease (Clic here for more details about this article) |
2/12. osteomyelitis of the skull base with atypical onset and evolution.skull base osteomyelitis arises as a complication of malignant external otitis, but it can be also due to middle ear and/or mastoid infection. Other causes can be infections of the paranasal sinuses or of the mandible or maxilla due to odontic caries. Generally, osteomyelitis involves elderly patients affected by diabetic immunodeficiency or microvascular disease. In this paper, we present 3 new cases of skull base osteomyelitis with atypical onset and evolution. The difficulties of diagnosis and details of the management are discussed.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
3/12. Microvascular anastomosis through the tibial tunnel: a new technique in free-tissue transfer to the leg.Free-tissue transfer to a severely traumatized leg has a high rate of vascular complications. We present three successful cases using a new technique of microvascular anastomosis through the tibial tunnel. Because of the unavailability of anterior tibial artery due to posttraumatic vascular disease, donor vascular pedicles were passed posterior to the tibia through the tibial tunnel and anastomosed to the posterior tibial artery or its branch in an end-to-end fashion. The flaps survived perfectly, without any vascular complication. This technique represents a safe route, and the shortest route, to an expected anastomosis point. Our technique is indicated especially in cases with a single-vessel leg.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
4/12. fusarium osteomyelitis: case report and review of the literature.We present a case of fusarium osteomyelitis attributed to innocuous trauma in a patient with significant peripheral vascular disease and diabetes mellitus type 2. fusarium species have been reported to cause an increasing number of infections, particularly in severely immunocompromized patients. Colonization of normal skin has also been reported. To the best of the author's knowledge, there are 5 cases of fusarium osteomyelitis described in English-language literature. There is also a report with little detail of fusarium infection involving bone in 3 patients with hematologic malignancy. We tabulated the pertinent facts of the 5 detailed cases and compared them to ours. early diagnosis requires some suspicion of invasive fungal infection. Tissue culture and pathologic examination are necessary for definitive diagnosis and to distinguish infection from colonization. Therapy includes antifungal drugs and aggressive surgical debridement, and even when these modalities are readily implemented the outcome may not be optimal because of the angioinvasive character of the organism.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
5/12. Diabetic osteomyelitis: long-term attempts at salvage with eventual mortality.Long-term complications of diabetes mellitus with respect to the lower extremities are well known to the podiatric profession. The author presents a case of a diabetic with multisystem pathology who underwent several salvage procedures for osteomyelitis and later expired from cardiovascular disease. The multi-system nature of diabetes necessitates a team approach in management of the acutely ill diabetic patient.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
6/12. Decubitus ulcers: when to suspect osteomyelitis.Six nursing home patients developed pressure sores of the foot and ankle, complicated by osteomyelitis of the underlying bone. All patients had advanced multi-infarct dementia with multiple contractures, and were bedridden, debilitated, and nutritionally deficient. All had arteriosclerotic heart and peripheral vascular disease, and other chronic illnesses. The pressure sores progressed rapidly and did not respond to medical and surgical therapy. Cultures yielded organisms usually associated with pressure sores. Diagnosis of osteomyelitis was initially made by radiography and eventually confirmed surgically. patients with osteomyelitis of the metatarsal bones responded well to intravenous antibiotics and local amputation; all survived. The two patients with osteomyelitis of the calcaneal bone died after a short course. The diagnosis of osteomyelitis of the foot associated with pressure ulcers requires a high index of suspicion when a pressure sore does not respond to medical and surgical therapy in the appropriate clinical setting.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
7/12. Intravenous digital subtraction angiography and its use in amputation level consideration in the ischemic forefoot.This case report utilizes a recently popularized method of radiologic examination for peripheral vascular disease. In a diabetic foot with osteomyelitis, ischemia, and gangrene we have assessed patent arterial supply in the distal arterial tree. This examination has allowed the authors to accurately predict wound healing potential preoperatively at a specific anatomic level.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
8/12. Clostridial myonecrosis in a patient undergoing oxacillin therapy for exacerbation of chronic foot ulcers and osteomyelitis. A case report.gas gangrene developed from a chronic foot ulcer in the absence of periferal vascular disease or diabetes mellitus in a hospitalized patient undergoing parenteral antibiotic therapy. Within a 6 hour period the patient developed profound toxemia necessitating emergency and life saving leg amputation. Classically clostridial myonecrosis is diagnosed by the clinical course and the gram stain. In this case, 2 preoperative gram stains failed to show gram-positive rods. At the time of surgery, frank fasical and muscle necrosis in the peroneal compartment dictated extending the below knee amputation to above the knee. In retrospect demonstration of clostridial species and myonecrosis in the pathological specimen confirmed the clinical impression. The identified organism, clostridium sporogenes has rarely been implicated as a cause of gas gangrene.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
9/12. Hematogenous group B streptococcal osteomyelitis in an adult.We have reported a case of group B streptococcal vertebral osteomyelitis in a 55-year-old alcoholic man. This may be the first reported case of group B streptococcal osteomyelitis in an adult that was not secondary to surgery, ischemic peripheral vascular disease, or a contiguous infection.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
10/12. Group B streptococcal vertebral osteomyelitis with bacteremia.Group B streptococcal vertebral osteomyelitis is rare in adults. osteomyelitis due to this organism is in general related to contiguous infections, recent surgery, or peripheral vascular disease. All reported cases of group B streptococcal vertebral osteomyelitis, however, have had no association with these predisposing factors and have usually been presumed to be of hematogenous origin, though bacteremia has never been demonstrated. Here we describe a 45-year-old intravenous drug abuser who had vertebral osteomyelitis and bacteremia. We conclude that the vertebral osteomyelitis in this patient was hematogenous, as shown by bacteremia, and most likely resulted from intravenous needle use.- - - - - - - - - - ranking = 0.14285714285714keywords = vascular disease (Clic here for more details about this article) |
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