Cases reported "Osteomyelitis"

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1/64. A case of abnormal localization of osteomyelitis.

    A patient with osteomyelitis and abnormal localization of the changes is presented--left sterno-clavicular joint, the medial parts of the clavicular bone and the first rib, as well as the manubrium sterni. General and target radiography, tomography and chest CT-scan were performed. The reported case is of interest because of the rare localization, the characteristics of the X-ray conduct and the symptomatology in differential and diagnostic aspect.
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2/64. Neonatal cervical osteomyelitis with paraspinal abscess and Erb's palsy. A case report and brief review of the literature.

    An unusual case of pyogenic cervical osteomyelitis is reported in a newborn who immediately after birth had no movements in the left shoulder. There was a fullness in the left cervical region. Left Erb's palsy due to an unrecognized birth trauma was diagnosed in a peripheral hospital. Later, the child developed fever and a significant swelling in the left cervical region. On transfer to our institution, the x-rays of the cervical spine, ultrasound and computed tomography (CT) established the diagnosis of C(6) cervical osteomyelitis and paraspinal abscess which extended to the posterior triangle of the neck. The abscess was drained, and the lamina and lateral mass of the C(6) vertebra were debrided. Staphylococcus aureus was grown from the pus. The patient was put on long-term antibiotics to which he responded very well, and he became asymptomatic. In the immediate post-operative period, some movements at the left shoulder were noted, and at 6-month follow-up in the out-patient clinic, the child was virtually normal with near-complete regeneration of the C(6) lamina and lateral mass.
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3/64. Percutaneous treatment of chronic MRSA osteomyelitis with a novel plant-derived antiseptic.

    BACKGROUND: Antibiotic-resistant bacteria such as methicillin-resistant staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE, are an increasing problem world-wide, causing intractable wound infections. Complex phytochemical extracts such as tea tree oil and eucalypt-derived formulations have been shown to have strong bactericidal activity against MRSA in vitro. Polytoxinol (PT) antimicrobial, is the trade name of a range of antimicrobial preparations in solution, ointment and cream form. methods: We report the first use of this drug, administered percutaneously, via calcium sulphate pellets (Osteoset,TM), into bone, to treat an intractable MRSA infection of the lower tibia in an adult male. RESULTS AND DISCUSSION: Over a three month period his symptoms resolved with a healing response on x-ray and with a reduced CRP.
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4/64. Hematogenous candida osteomyelitis. Report of three cases and review of the literature.

    candida osteomyelitis of the spine and intervertebral disc developed in three patients without evidence of back trauma of overlying cutaneous infection.Two patients were prone to the development of disseminated candidiasis by the use of multiple antibiotics and other predisposing modalities following abdominal surgery. One patient had no identifiable cause for development of the infection. The diagnosis was established in all three cases by x-ray evidence of osteomyelitis and culture from needle aspirate. Two patients had bone scans consistent with infection. Each patient received different therapy. One was treated with amphotericin b, one with spinal fusion and 5-fluorocytosine, and one with no antifungal therapy. All patients had complete healing of the involved vertebrae. candida organisms have the potential to cause destructive bone infection following hematogenous dissemination. The presence of candida osteomyelitis may be helpful in diagnosing disseminated candidiasis.
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5/64. Madura foot in the U.K.: fungal osteomyelitis after renal transplantation.

    We report the case of an ethnic Asian patient who attended the renal transplant follow-up clinic complaining of pain in the right great toe. He had undergone transplantation nine months earlier and was maintained on triple immunosuppression. Initially, a clinical diagnosis of gout was made and the patient treated with analgesia. Two weeks later he remained symptomatic and developed a discharging sinus on his toe. A plain X-ray revealed a lytic lesion with minimal periosteal reaction. Aspiration of his first right metatarsal phalangeal joint was performed and fungal hyphae were observed in the fluid. Subsequently, despite surgical debridement and treatment with Itraconozaole amputation of the toe was required. Microbiological analysis revealed the organism to be madurella grisea,which was resistant to both itraconazole and amphotericin b. He has remained well since amputation. We believe this to be the first case of madurella infection to be described in a transplant patient.
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6/64. candida vertebral osteomyelitis: a case report and review of the literature.

    candida species are low virulence organisms which inhabit the skin and mucous membranes of most individuals. There has been increasing incidence of disseminated and deep-seated candida infections owing to the increasing number of immune compromised hosts. However, the candida species are still rarely suggested as causative pathogens of vertebral osteomyelitis. We present a 51-year-old man with neck pain and cervical radiculopathy. Three months prior to visiting our hospital, he had undergone a urological operation which was complicated by a urinary tract infection. magnetic resonance imaging and x-rays showed erosion of the body of the 5th cervical spine and collapse of the C5-C6 disc. After open debridement, tissue pathology results revealed candida infection. Clinical stability was achieved during the 6-month follow-up period with a combination of amphotericin b and posterior fixation method. We reviewed the literature and found a high rate of surgical intervention for patients suggested of having candida vertebral osteomyelitis. However, the surgical intervention may not be necessary. early diagnosis using noninvasive percutaneous needle biopsy may help reduce the incidence of delayed treatment.
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7/64. Calvarial sclerosing osteomyelitis.

    We report a 15-year-old boy who suffered from calvarial sclerosing osteomyelitis and presented with painful head swelling. x-rays of the skull revealed areas of irregular radiolucency. MR imaging and CT showed a well-demarcated intradiploic lesion with thickening of the skull extending from the frontal to the parietal calvarium with a low signal on T1-weighted images, strong but heterogeneous enhancement after gadolinium application and a mixed signal on T2-weighted images. Computer-navigated neurosurgery was planned, and the craniotomy defect was reconstructed by a preformed titanium implant. Sclerosing osteomyelitis of the calvarium has to be included in the differential diagnosis of osteolytic and sclerosing lesions of the skull coinciding with persistent swelling of the head.
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8/64. An unusual complication of sternal and clavicle osteomyelitis in a child with sickle cell disease.

    We report an unusual child with sickle cell disease, in which osteomyelitis of the sternum and clavicle was diagnosed at the same time. The standard x-ray failed to demonstrate the lesion. magnetic resonance imaging was very helpful in locating the site and degree of involvement. We recommend the use of magnetic resonance imaging to delineate such findings.
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9/64. An 8-year-old boy with a Pott's puffy tumor.

    An 8-year old boy with a history of trauma, sinusitis and a swelling of the frontal bone with somnolence was diagnosed with a Pott's puffy tumor (PPT). Minimal invasive surgical intervention was performed together with a strict regimen of antibiotic therapy. In this case debridement of the frontal bone was not necessary. Serial X-ray imaging of the skull showed complete ossification of the frontal bone lesion. early diagnosis using thorough radiological evaluation is necessary to effectuate the proper therapeutic approach. For this reason, a patient with a forehead swelling and a history of trauma and/or sinusitis should be suspected for a PPT.
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10/64. Surgical management of an unusual osteomyelitis involving posterior elements in lumbar spine. A case report.

    Improper and invasive management of low back pain may lead to an unexpected tragedy, vertebral osteomyelitis. A 30-year-old female patient suffering from low back pain after a lumbar strain called on a herbal therapist and was given a herb massage with some unknown medication. Unfortunately, a persistent painful ulcer with discharge developed over her back. She was referred to our clinic shortly after where x-ray showed bony destruction over the spinous process, facet, and lamina of L4. Fistulectomy, debridement and spinal fusion were performed. A satisfactory outcome was finally achieved.
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keywords = ray, x-ray
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