Cases reported "Osteomyelitis"

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1/14. Vertebral osteomyelitis due to Pasteurella aerogenes.

    A case of C6-C7 vertebral osteomyelitis due to Pasteurella aerogenes in a previously healthy 62-y-old man in the absence of any history of animal exposure, debilitating disease or immunosuppression is reported. culture testing of biopsy samples of the vertebral body using the panels and database of the BBL Crystal enteric/non-fermenter system revealed that the infecting bacterium was P. aerogenes. Treatment with cloxacillin and gentamicin was followed by resolution of bone infection on serial follow-up magnetic resonance imaging scans. Pasteurellae are primarily animal pathogens but are capable of producing a variety of local and systemic diseases in humans.
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2/14. Vertebral osteomyelitis and prosthetic joint infection due to staphylococcus simulans.

    staphylococcus simulans, a coagulase-negative staphylococcus, is a common animal pathogen that is rarely encountered in human infections. We describe a 70-year-old man who developed multifocal vertebral osteomyelitis and late prosthetic joint infection caused by this pathogen. The patient was a farmer who had daily contact with cows and drank unpasteurized milk, although the portal of the pathogen's entry remains speculative. culture of the vertebral disk biopsy specimen and cultures during resection arthroplasty yielded S. simulans. A review of the literature suggests that S. simulans may be more virulent than other species of coagulase-negative staphylococci. Accurate identification of S. simulans isolates would facilitate studies to further define its pathogenic role in human infections.
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3/14. Pasteurella canis osteomyelitis and cutaneous abscess after a domestic dog bite.

    The genus Pasteurella is part of the normal oral flora of many animals, including domestic cats and dogs. In humans, Pasteurella may cause complications ranging from cellulitis to septicemia but rarely causes osteomyelitis or septic arthritis after bites and/or scratches by cats and dogs. Although pasteurella multocida is a common cause of infection, other Pasteurella species have also been cultured from wounds in humans. We describe here, a case of a cutaneous abscess and acute osteomyelitis associated with P canis after a domestic dog bite. To our knowledge, no previous case of P canis has been reported as the cause of acute osteomyelitis in humans.
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4/14. brucella osteomyelitis of the proximal tibia: a case report.

    brucellosis is a disease of domestic and wild animals that is transmittable to humans. Although endemic in some parts of the world, brucellosis is an uncommon human pathogen in the united states. The clinical presentation of brucellosis is nonspecific, and brucella osteomyelitis can produce lytic lesions on radiographs that resemble neoplasm. diagnosis can therefore be difficult unless a high index of suspicion is maintained. We present a case of brucella osteomyelitis of the proximal tibia that demonstrates these features.
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5/14. Severe osteomyelitis caused by Myceliophthora thermophila after a pitchfork injury.

    BACKGROUND: Traumatic injuries occurring in agricultural settings are often associated with infections caused by unusual organisms. Such agents may be difficult to isolate, identify, and treat effectively. CASE REPORT: A 4-year-old boy developed an extensive infection of his knee and distal femur following a barnyard pitchfork injury. Ultimately the primary infecting agent was determined to be Myceliophthora thermophila, a thermophilic melanized hyphomycete, rarely associated with human infection, found in animal excreta. Because of resistance to standard antifungal agents including amphotericin b and caspofungin, therapy was instituted with a prolonged course of terbinafine and voriconazole. Voriconazole blood levels demonstrated that the patient required a drug dosage (13.4 mg/kg) several fold greater than that recommended for adults in order to attain therapeutic blood levels. CONCLUSION: Unusual pathogens should be sought following traumatic farm injuries. Pharmacokinetic studies may be of critical importance when utilizing antifungal therapy with agents for which little information exists regarding drug metabolism in children.
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6/14. pasteurella multocida osteomyelitis of the cervical spine in a patient on chronic haemodialysis.

    osteomyelitis due to pasteurella multocida has been frequently documented but virtually all previous cases have resulted from direct inoculation of the organism or contiguous spread of local infection, following animal bites or scratches. Infections often occur in patients with serious underlying illnesses. Haematogenous osteomyelitis due to P multocida has very rarely been reported particularly in patients with chronic renal failure. We describe a patient on chronic haemodialysis who developed an acute febrile illness, two months following a monkey bite, caused by haematogenous cervical vertebral osteomyelitis due to P multocida.
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7/14. Septic arthritis and osteomyelitis from a cat bite.

    A 39-year-old man with no prior history of underlying arthritis developed osteomyelitis and septic arthritis in his hand following a cat bite. This case illustrates the virulence of pasteurella multocida infections associated with animal bites, particularly those of cats, whose teeth can inoculate bone directly. The onset of cellulitis caused by P. multocida infections is often rapid, and the drug of choice for such infections remains penicillin. Appropriate antibiotic therapy, however, does not always prevent complications such as those seen in this patient.
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8/14. Group C streptococcal osteomyelitis.

    A case of hematogenous osteomyelitis due to a group C streptococcus (streptococcus equisimilis) is presented because of the unusual nature of the infecting organism. Group C streptococci are common pathogens in animals but are infrequent causes of human infections. Of therapeutic concern is the observation that these isolates are frequently penicillin-tolerant. For this reason, it is important to speciate beta-hemolytic streptococcal isolates and to perform antimicrobial susceptibility studies.
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9/14. brucella osteomyelitis of a closed femur fracture.

    A 19-year-old man incurred a closed femoral fracture complicated by hematogenous dissemination of brucella osteomyelitis. Repeated limited incision and drainage were ineffective in eradicating infection. Wide debridement, delayed wound closure, and vigorous antimicrobial therapy with streptomycin and tetracycline, along with cephalosporin for secondary staphylococcal infection, were necessary measures before the infection was eradicated. A constant awareness of brucella musculoskeletal infection is advisable when caring for patients frequently exposed to all kinds of livestock, including domesticated and wild animals.
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10/14. Bacterial adherence and the glycocalyx and their role in musculoskeletal infection.

    bacteria produce a virulence-related polysaccharide exocellular slime (the glycocalyx), which preferentially adheres to the surfaces of biomaterials and compromised tissues. This biofilm resists antibiotic penetration and provides a degree of protection from antibodies and macrophages. Similar adhesive cell-to-substrate phenomena have been noted in natural environments and in bacterial-animal cell disease states. The adherent glycocalyx is one of the fundamental reasons for increased susceptibility to infection in the presence of biomaterials and compromised tissues and a significant factor in the persistence of such infection until the removal of the prosthetic device.
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