Cases reported "Osteomyelitis"

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1/33. Disseminated mycobacterium avium complex infection presenting as osteomyelitis in a normal host.

    Disseminated mycobacterium avium complex (MAC) infection presenting as a painful lytic femur lesion with associated fever, night sweats and weight loss occurred in a 45-y-old woman with apparent normal immune function. Surgical drainage and 24 months of medical therapy resulted in a cure.
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ranking = 1
keywords = mycobacterium avium, mycobacterium, avium
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2/33. Postoperative Mycobacterium avium osteomyelitis confirmed by polymerase chain reaction.

    An 18-year-old male with Escobar syndrome developed Mycobacterium avium osteomyelitis after corrective osteotomy. After three surgical interventions the infection reappeared a fourth time. Repeated attempts at microbiological diagnosis of the granulomatous lesions by microscopy and culture for conventional bacteria and Mycobacteria did not reveal any organism. The diagnosis of Mycobacterium avium finally was achieved by polymerase chain reaction. Extensive immunological work-up did not reveal signs of immunodeficiency. The patient was treated successfully by a combined surgical and chemotherapeutic approach consisting of clarithromycin, ethambutol and ciprofloxacin. CONCLUSION: polymerase chain reaction may be especially useful for clinical situations with a low bacterial load, especially for fastidious and slow growing pathogens like Mycobacteria. In our patient a combination of surgical therapy with a triple regimen containing clarithromycin proved successful for treatment of a localised infection with M. avium in a supposedly immunocompetent host.
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ranking = 0.064267292158232
keywords = avium
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3/33. Sternal osteomyelitis caused by mycobacterium tuberculosis: case report and review of the literature.

    Sternal osteomyelitis caused by mycobacterium tuberculosis is rare; since the advent of modern antituberculous therapy, a limited number of detailed cases have been reported. Most patients were relatively young, free of underlying disease, and lived in a country in which tuberculosis is endemic. The disease presented indolently with sternal pain and swelling. Extrasternal disease is detectable in less than half. diagnosis was based on histologic examination of infected tissues and mycobacterial cultures. Most patients recovered after surgical debridement and combination drug therapy. Tuberculous sternal osteomyelitis should be considered in patients with sternal pain and swelling.
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ranking = 0.19887358506055
keywords = mycobacterium
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4/33. Successful treatment of mycobacterium avium osteomyelitis and arthritis in a non-immunocompromised child.

    In non-immunocompromised children, infections with mycobacterium avium complex (MAC) are rare, except for cervical lymphadenitis. We report here a 34-month-old boy who developed osteomyelitis and septic arthritis due to MAC. No findings could be revealed for immunodeficiency. He was treated successfully for 12 months with combined therapy consisting of clarithromycin, rifabutin and protionamid.
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ranking = 1.2385236978289
keywords = mycobacterium avium, mycobacterium, avium
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5/33. A case of mycobacterium scrofulaceum osteomyelitis of the right wrist.

    INTRODUCTION: The objective of the case report is to highlight the possibility of osteomyelitis caused by atypical mycobacteria. Such an infection may simulate tuberculous bone infection and yet fail to respond to standard anti-tuberculous drug therapy. CLINICAL PICTURE: A 66-year-old man who suffered from diabetes mellitus presented with osteomyelitis of the right wrist, with extensive synovial swellings of the flexor tendon sheaths. The clinical features, radiological appearances and histology suggested a tuberculous infection, but subsequent culture grew an atypical mycobacterium, mycobacterium scrofulaceum. TREATMENT AND OUTCOME: There was good clinical improvement and control of the infection with a regime of kanamycin, ethambutol and ethionamide to which the organism was sensitive. CONCLUSION: This case illustrates the need to be aware of the possibility of infection with atypical mycobacteria in cases of suspected tuberculosis of the skeletal system which fail to respond to standard treatment.
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ranking = 0.049718396265137
keywords = mycobacterium
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6/33. rifabutin-associated hypopyon uveitis in human immunodeficiency virus-negative immunocompetent individuals.

    OBJECTIVE: To report the occurrence of rifabutin-associated hypopyon uveitis in human immunodeficiency virus (hiv)-negative immunocompetent individuals. DESIGN: Retrospective case series. PARTICIPANTS: Three hiv-negative subjects on rifabutin and clarithromycin for mycobacterium avium complex infections with hypopyon uveitis are described. One subject was iatrogenically immunosuppressed because of a prior lung transplant. Two subjects had no known immunosuppressive conditions. INTERVENTION: Topical and regional steroid therapy. Discontinuation of rifabutin was required in two subjects. MAIN OUTCOME MEASURES: visual acuity, resolution of hypopyon, anterior uveitis, and vitreitis. RESULTS: All subjects had resolution of hypopyon after therapy, two within 24 hours of beginning topical steroids. Vitreitis resolved with the discontinuation of rifabutin in two subjects. Chronic low-grade anterior uveitis and vitreitis were observed in the remaining subject, whose rifabutin dose was lowered but not discontinued because of active mycobacterium avium complex osteomyelitis. CONCLUSIONS: rifabutin-associated uveitis is well described in hiv-positive individuals, but it has been reported only once in an hiv-negative individual. We report two cases of hypopyon uveitis in immunocompetent individuals and one case in an immunosuppressed hiv-negative individual. All three subjects were receiving concurrent rifabutin and clarithromycin. awareness that this entity can occur in hiv negative and nonimmunosuppressed individuals and that it can mimic infectious endophthalmitis may spare the subject from an invasive workup of systemic infection.
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ranking = 0.018362083473781
keywords = avium
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7/33. Recurrent Mycobacterium avium osteomyelitis associated with a novel dominant interferon gamma receptor mutation.

    Mycobacterium avium causes infections in immunocompromised individuals. Recurrent infection with this organism has been associated with a deletion at the 818 residue of the interferon-gamma receptor (IFN-gammaR). This mutation produces a truncated receptor without an intracytoplasmic tail, resulting in diminished signaling. We describe a substitution at the 832 residue of the IFN-gammaR causing a similar truncated receptor in a 7-year-old girl with recurrent M avium osteomyelitis.
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ranking = 0.055086250421342
keywords = avium
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8/33. Cutaneous botryomycosis of the cervicofacial region.

    BACKGROUND: Botryomycosis is a rare, chronic, bacterial infection of insidious onset involving the integument or viscera that often mimics actinomycosis or a deep fungal infection. The pathogenesis is thought to be a symbiotic relationship between the host and the infecting organism. methods: Case report of a patient with a chronic infection involving the cervicofacial region diagnosed as cutaneous botryomycosis arising from a chronic osteomyelitis of the mandible. The diagnosis was based on the chronicity of the infection along with the identification of botryomycotic (bacteria-containing) granules on histopathologic examination. Special stains excluded fungi and mycobacterium. Cultures identified the offending bacteria, and antibiotic therapy was initiated on the basis of the sensitivities, resulting in resolution of this chronic infectious process. A review of the English language literature revealed that this is the first case of cutaneous botryomycosis arising from a chronic osteomyelitis of the mandible. RESULTS: Medical therapy proved curative at 14 months follow-up. Surgery was performed for diagnostic purposes only. CONCLUSIONS: Botryomycosis is exceedingly rare in the head and neck, and consideration of this entity in the differential diagnosis is critical to the diagnosis. The mainstay of therapy is medical with surgery reserved for biopsy and/or excision of persistent disease. Published 2001 John Wiley & Sons, Inc.
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ranking = 0.049718396265137
keywords = mycobacterium
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9/33. Multifocal osteomyelitis caused by nontuberculous mycobacteria in patients with a genetic defect of the interferon-gamma receptor.

    We describe three patients with multifocal osteomyelitis caused by Mycobacterium avium and a family history of one or more first degree family members diagnosed with various clinical presentations of infections with nontuberculous mycobacteria. There was a significant delay in the diagnosis and they had a protracted course of their illness, which responded only slowly to prolonged multi-drug treatment. In one patient, additional treatment with interferon-gamma (IFN-gamma) was necessary. macrophages of these patients had decreased in vitro responsiveness to IFN-gamma. Genomic sequencing revealed that these patients and their affected family members were heterozygous for a previously described dominant negative mutation in the gene encoding the IFN-gamma binding receptor-1 chain. The clinical presentations of the infections with nontuberculous mycobacteria in these families, with spread limited to skin, bone and lymph nodes, is discussed in the light of the immune mechanisms that are responsible for the clearance of otherwise poorly pathogenic environmental mycobacteria.
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ranking = 0.0091810417368904
keywords = avium
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10/33. Bone scintigraphy in mycobacterium avium osteomyelitis: a case report.

    A 30-year-old woman who had a destructive mycobacterium avium complex infection in the left inguinal fossa affecting the pubic bone underwent three-phase bone scanning to identify other possibly affected sites. Multiple skeletal lesions were seen scattered throughout the vertebral column, sternum, and pelvis. This case is presented to describe a rare extensive metastatic M. avium complex infection in an immunocompromised patient.
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ranking = 1.0091810417369
keywords = mycobacterium avium, mycobacterium, avium
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