Cases reported "Osteomyelitis"

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1/33. Pyogenic vertebral osteomyelitis.

    Pyogenic vertebral osteomyelitis is defined as a primary infection in the osseous elements of the spine by pyogenic organisms with secondary involvement of the intervertebral disc and adjacent soft tissue or epidural space. epidemiology and pathogenesis, clinical presentation, diagnosis, treatment and prognosis are briefly reviewed in this article.
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2/33. Epiphyseal separations after neonatal osteomyelitis and septic arthritis.

    Complete separation of an epiphysis is a rare complication of neonatal osteomyelitis and septic arthritis. We report two cases of pathologic epiphyseal separation after neonatal osteomyelitis, involving the distal and proximal femoral epiphyses with a follow-up of 2 and 7.5 years, respectively. Birth trauma, scurvy, and nonaccidental injury should be considered in the differential diagnosis of pathologic epiphyseal slip. The pitfalls in diagnosis are many, and plain radiograms of unossified epiphyses are often misleading. A high index of suspicion and the use of imaging modalities are useful in making an early diagnosis of epiphyseal slip. The optimal treatment is controversial, and the long-term prognosis is uncertain. The potential for recovery appears to be excellent, provided an early diagnosis is made and prompt treatment by anatomic reduction of the displaced epiphysis is instituted.
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3/33. Chondroblastic osteosarcoma: case presentation.

    The prognosis of jaw osteosarcoma is better with early diagnosis and radical surgery. The prognosis is also improved with adjunctive radiation and chemotherapy.
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4/33. Pyogenic vertebral osteomyelitis.

    Pyogenic vertebral osteomyelitis is a disease of adults that should be distinguished from true disk space infection. It is due to a hematogenous seeding (either venous or arterial) of the subchondral bony elements of the vertebral body. The disk space is involved secondarly, later in the course of the disease. The underlying bacteremia is from another focus of infection, frequently in the urinary tract. Disk space infection in adults is caused by direct violation of the disk, most commonly at the time of surgical excision of the nucleus pulposus. The bony elements of both adjacent vertebral bodies are secondarily involved. The clinical feature common to both types of infection is back pain that generally begins insidiously and then gradually increases in severity and becomes continuous and is accompanied by marked muscle spasm. The sedimentation rate is always increased; it decreases only with resolution of the infection. The diagnosis of vertebral infection is often not suspected because fever and leukocytosis generally are absent. The most common organism is staphylococcus aureus, although gram-negative bacterial infections also occur. Bacteriologic diangosis should be sought in each case by blood cultures (generally negative with postoperative disk space infection) or percutaneous needle biopsy. Soft tissue abscesses may require open debridement and drainage. Treatment of both types consists of rest, immobilization, and specific antibiotic treatment. The prognosis for resolution of the infectious process within six to nine months, with adequate treatment, is excellent.
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5/33. Aspergillus osteomyelitis after liver transplantation.

    A 57-year-old woman underwent liver transplantation and developed osteomyelitis in the femur attributable to aspergillus fumigatus. The patient was treated successfully with amphotericin b and 5-fluorocytosine for 30 days, and then switched to itraconazole for 12 months. plasma (1->3)-beta-D-glucan levels decreased significantly after the chemotherapy. early diagnosis by (1->3)-beta-D-glucan measurement and extended treatment with itraconazole can improve the prognosis of invasive Aspergillus infection.
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6/33. Primary multifocal osseous hodgkin disease: a case report and review of the literature.

    PURPOSE: hodgkin disease (HD) typically involves the lymphatic system at one or more sites. Rarely, hodgkin disease presents as an osseous lesion without involvement of lymph nodes. Therefore, the histologic diagnosis of osseous HD can be problematic. We present a rare case of multifocal osseous HD and a review the literature with special emphasis on treatment and prognosis. methods: osteomyelitis and lymphoma are the main differential diagnoses and can only be excluded histologically by the presence of Sternberg Reed cells or by immunohistochemical examinations. This case reports a 21-year old man with a Hodgkin lymphoma located at the proximal femur and the proximal tibia. RESULTS: Staging studies revealed no other tumor manifestations. Regarding the Ann Arbor classification, the presented case should be a stage IV disease. The patient is without evidence of disease 4 years after curettage, local radiation therapy, and systemic chemotherapy despite the poor prognosis considering the Ann Arbor classification. CONCLUSION: Reviewing the few reported cases, osseous HD must be distinguished from systemic HD with diffuse bone marrow involvement and from osseous metastases in advanced stage of disease because it seems to have a better prognosis.
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7/33. lymphoma masquerading as infection.

    During surgical training, medical students and residents constantly are reminded to culture every suspected tumor and send tissue for pathologic evaluation for every suspected abscess. A diagnosis of cancer can be missed easily if this procedure is not followed, delaying the diagnosis and possibly adversely affecting the patient's prognosis. The confusion also may be compounded by a sterile abscess, positive culture results or a negative biopsy specimen. Therefore it is imperative to do a biopsy and a culture on any suspect lesion. An additional workup and possible biopsy may be warranted for a nonhealing wound that has been treated appropriately. The cases of three patients with lymphoma that were treated as infectious processes are presented. In all three instances, the appropriate treatment was delayed because of a delay in diagnosis.
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8/33. Metastatic squamous cell carcinoma resembling cellulitis and osteomyelitis of the fifth toe.

    Statistically, metastasis of carcinomas to pedal phalanges is rare. However, true to all bone metastases of the body, its presence is associated with a very poor prognosis. A case of metastatic sinonasal squamous cell carcinoma to the fifth toe is presented followed by a review of the literature.
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9/33. A case of bilateral psoas abscesses and lumbar osteomyelitis due to recurrent salmonella infection.

    psoas abscess and lumbar osteomyelitis due to salmonella infection is very rare, although it is frequently seen all over the world. These two complications have severe clinical progress, poor prognosis and high mortality. Here, we report a case of salmonellosis presenting with bilateral multiple psoas abscesses and lumbar osteomyelitis, which resolved completely following medical treatment and percutoneous drainage of abscess.
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10/33. Open subtalar dislocation.

    Open subtalar dislocation is a rare injury, accounting for about 0.1% of all dislocations and, consequently, the natural history and outcome of this injury and their relevance to treatment are not well documented. A retrospective study at Westmead Hospital revealed 10 patients who presented with this injury between 1978 and 1988. We had the opportunity to review all of these patients in 1987 and again in 1989. We found a high incidence (60%) of poor results, and that the only factor that influenced the outcome was infection. It is concluded that the poor prognosis is due to the nature of the injury itself, rather than any particular factors in the subsequent management. Specifically, there was no relation to the direction of the dislocation, the presence of fractures in the foot, the time elapsed before reduction, or the period of immobilization.
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