Cases reported "Pseudomonas Infections"

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21/74. Pseudomonal osteomyelitis of the medial sesamoid bone.

    Because osteomyelitis may complicate puncture wounds about the first metatarsophalangeal joint, we believe sesamoid roentgenograms are mandatory. These views may show subtle demineralization, which cannot be seen on standard films. Treatment must include excision of the sesamoid and culture-directed antibiotics.
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22/74. Idiopathic osteomyelitis at the base of the skull.

    osteomyelitis of the skull base is a rare disorder, and even more so when the etiology is noninfectious. Symptoms are noisome and include headache and cranial nerve deficits. Because of the possibility of neoplasia, thorough evaluation, accurate diagnosis, and effective treatment are mandatory. In the case reported herein, a 58-year-old man with a 3-month history of symptoms is presented. physical examination disclosed cranial nerve involvement. Nasopharyngeal biopsy and culture in combination with MRI and a gallium bone scan established the diagnosis of osteomyelitis at the base of the skull. The patient was effectively treated with antibiotics and had a complete recovery.
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23/74. hallux hammer toe secondary to pseudomonas osteomyelitis.

    The authors present two cases of resultant hallux hammer toe secondary to the definitive treatment of hallux sesamoidal osteomyelitis. Pseudomonas osteomyelitis developed in both cases following puncture wounds to the first metatarsophalangeal joint complex. The authors also review the literature on pseudomonas osteomyelitis secondary to puncture wounds and the development of hallux hammer toe after removal of the involved sesamoid bones.
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24/74. aztreonam-induced myelosuppression during treatment of pseudomonas aeruginosa pneumonia.

    aztreonam is a synthetic, monobactam antibiotic structurally related to the beta-lactam class of drugs. It has inhibitory activity against many aerobic gram-negative bacteria, although it does not inhibit gram-positive or anaerobic bacteria. Administration of aztreonam occasionally is associated with minimal and transient adverse effects. This case report describes a patient we believe experienced bone marrow suppression approximately ten days after aztreonam was given for treatment of pneumonia caused by pseudomonas aeruginosa. This untoward effect primarily was manifested as neutropenia, although normochromic, normocytic anemia and thrombocytopenia were noted as well. One week after aztreonam was discontinued, the patient's bone marrow suppression resolved spontaneously. Although the mechanism responsible for myelosuppression is unclear, aztreonam may be implicated as the offending agent based on the temporal relationship between the development of neutropenia and its administration, and the resolution of neutropenia upon its discontinuation.
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25/74. osteomyelitis of the skull base, etiology unknown.

    OSB can occur in the absence of an obvious contiguous source of infection. When a patient has persistent unilateral headache, elevated ESR, and radiographic evidence of a lytic skull-base lesion, the clinician should consider OSB as a potential diagnosis. A baseline gallium scan should be obtained before biopsy, since surgery or trauma can also produce positive results on radionuclide scans. technetium-phosphate bone scans should also be performed before any surgical manipulation. However, positive results from a gallium or technetium scan in this setting are not conclusive evidence of infection. At biopsy, the otolaryngologist-head and neck surgeon should consider sending a specimen to the microbiology department for culture in addition to the specimen sent for routine pathologic study; this procedure could minimize delay in diagnosis. Establishing the diagnosis in these patients without obvious contiguous infection can be difficult, demanding perseverance and an appropriate index of suspicion. Once the diagnosis is confirmed, intravenous antibiotic therapy should begin immediately. The duration of therapy must be individualized; patients may require from 4 weeks to several months of treatment. Response to therapy is indicated by resolution of symptoms, normalization of ESR, and reversal of abnormalities on radionuclide scans. Serial gallium scans are particularly useful in following response to treatment.
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26/74. Computed tomography in malignant external otitis.

    Malignant external otitis is a severe infection of the external auditory meatus occurring predominantly in diabetics and usually caused by pseudomonas aeruginosa. The infection may spread along several routes: directly by bony erosion into the adjacent mastoid bone, anteriorly into the parotid gland and temporomandibular joint and inferiorly into the soft tissues of the infratemporal fossa. We present four cases of malignant external otitis that illustrate the typical patterns of spread of this disease and the role that radiology, and in particular computed tomography, plays in its diagnosis and management.
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27/74. An unusual case of candida tropicalis sepsis in a patient submitted to allogeneic bone marrow transplantation.

    We describe an exceptional case of candida tropicalis sepsis in a patient submitted to allogeneic BMT; the diagnosis was made on a peripheral blood smear, when the pt was neutropenic and only mildly febrile. The combination of GM-CSF to accelerate hematological recovery and the possibility of administering large doses of a liposomal form of amphotericin b were the contributing factors to the resolution of the infection.
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28/74. Flavimonas oryzihabitans septicaemia in a T-cell leukaemic child: a case report and review of the literature.

    We describe the first case of septicaemia with Flavimonas oryzihabitans reported from germany and possibly associated with colonisation of a venous port system. The patient, an 8-year-old T-cell leukaemic girl, was receiving a third course of chemotherapy before bone marrow transplantation. The cardinal symptom, fever, subsided when the venous port system for administration of drugs was no more used. The organism was tested extensively for characteristic biochemical features and antimicrobial susceptibility. We discuss the relevant literature and suggest the means of making a definitive microbiological diagnosis.
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29/74. Nasopharyngeal mass: a manifestation of inflammatory otologic disease.

    A nasopharyngeal mass with cranial neuropathies usually indicates an advanced neoplastic process. We present three patients with these findings and concurrent invasive Pseudomonas otitis in whom repeated nasopharyngeal biopsies were negative for tumor. All of the nasopharyngeal masses resolved following treatment of the otitis. Mechanisms of disease spread from the temporal bone to the nasopharynx are discussed. Clinicians may choose to modify diagnostic and therapeutic approaches to the nasopharyngeal mass in patients with concurrent invasive otologic disease.
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30/74. ciprofloxacin: a study of usage in pedal infections with case reports.

    ciprofloxacin, an antibiotic of the quinolone class, has exhibited properties that may lead to frequent use in the febrile patient. Particularly important to the podiatrist is the bactericidal action of the drug on penicillinase producing staphylococcus aureus and Pseudomonas species. ciprofloxacin also kills many gram-negative bacteria, and some anaerobic bacteria. Infections of this nature have been classically treated with parenteral antibiotics in a hospital setting. ciprofloxacin has demonstrated, in clinical studies, the ability to kill these organisms in skin, soft tissues, and bone while using an oral route of administration. When considering cost-containment strategies in the patient with osteomyelitis, ciprofloxacin can cost between 50% to 80% less than parenteral therapy.
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