Cases reported "Staphylococcal Infections"

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1/56. flatfoot and calcaneal deformity secondary to osteomyelitis after neonatal heel puncture.

    Deformity of the calcaneus was observed in three patients who developed osteomyelitis after neonatal heel puncture for newborn blood studies. Septic involvement of the calcaneal apophysis may produce an abnormal and early closure of this growth plate. Progressive deformity of the calcaneus, despite appropriate treatment, develops into an asymptomatic flatfoot. A strictly aseptic technique is mandatory for neonatal puncture of the heel to avoid this unusual complication. An infectious cause of flatfoot is proposed in this report.
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2/56. Infectious complications related to the use of the angio-seal hemostatic puncture closure device.

    One hundred and eight coronary angiography procedures in which the Angio-Seal device was utilized were complicated by eight (7.4%) hematomas, of which two (1.9%) subsequently developed infection (staphylococcus aureus endarteritis and S. aureus septic hematoma). The Angio-Seal device may be a risk factor for infection for two reasons: excessive hematoma formation (a known risk factor for endarteritis), and foreign material remaining within the arterial lumen and wall, thereby creating a nidus for infection.
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3/56. Septic arthritis of a lumbar facet joint caused by staphylococcus aureus.

    STUDY DESIGN: Case report of a 35-year-old woman with septic arthritis of a lumbar facet joint. OBJECTIVES: To report a rare case of severe low back pain and the specific differential diagnostic problems. SUMMARY OF BACKGROUND DATA: Differential diagnosis between spondylodiscitis and facet joint septic arthritis on a clinical basis is very difficult. The lesions of the joint appear on a plain film only approximately 1.5 months after onset of the symptoms. Although the radionuclide bone scan is sensitive and shows a more laterally and vertically localized uptake than in spondylodiscitis, this technique is not very specific. Computed tomography scan and magnetic resonance imaging are the most reliable investigations even at the very early stages of the disease. Confirmation of the diagnosis has to be obtained by blood cultures or, in exceptional cases, by direct puncture of the joint. Appropriate antibiotic treatment is in most cases sufficient to heal this lesion. methods: The etiology, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Computed tomography scan and magnetic resonance imaging complemented by positive blood cultures led to the very early diagnosis of septic arthritis of the lumbar facet joint in this relatively young patient. CONCLUSIONS: With our case report we confirm the very small number of data reported in the literature, indicating that infections of the facet joint can be detected at a very early stage using magnetic resonance imaging and computed tomography scan.
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4/56. Prosthetic valve endocarditis in a patient with Marfan's syndrome following acupuncture.

    Active prosthetic valve endocarditis (PVE) as a complication of acupuncture requiring valve surgery has not been reported previously. We report a case of PVE in a patient with Marfan's syndrome as a complication of acupuncture, who underwent emergency redo aortic root and valve replacement with a homograft. This report highlights the need for prophylactic antibiotics before acupuncture in patients with prosthetic valves, and also describes the use of a homograft as an effective surgical strategy.
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5/56. Spontaneous spinal epidural abscess in a neonate. With a review of the literature.

    Spinal epidural abscess is uncommon in neonates and infants, and is usually related to previous lumbar puncture or epidural anaesthesia. Diagnosis is often delayed because of the non-specific presentation. We present a 7-week-old girl who developed paraplegia 3 weeks after transient fever and a self-limiting skin rash. MR imaging revealed an epidural contrast-enhancing lesion compressing the spinal cord. At operation, an organised granulated abscess was identified with staphylococcus aureus the causative organism. laminectomy and removal of the organised abscess and systemic intravenous antibiotics resulted in complete neurological recovery. The patient did not develop late spinal deformity following the decompressive laminectomy. The rapid onset of paraplegia can often be missed in such a young child but should be promptly investigated, as surgical treatment of cord compression carries an excellent prognosis for neurological recovery. We review the literature on the initial presentation, usual investigations, causative organisms and surgical management of paediatric spinal epidural abscesses.
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6/56. Arterial infection and staphylococcus aureus bacteremia after transfemoral cannulation for percutaneous carotid angioplasty and stenting.

    In this report, we present a patient who developed an infected femoral artery after repuncture cannulation for carotid angioplasty and intraluminal stenting. The case was complicated by persistent bacteremia and a delay in diagnosis before it was managed successfully with an autogenous replacement graft and appropriate antibiotics. Overt stent infection is exceedingly rare, but according to the literature describing transfemoral coronary artery intervention, the spectrum of clinical syndromes related to infection of the arterial puncture site includes local invasion, pseudoaneurysm formation, septic embolization to the distal limb, and bacteremia. The diagnosis requires a high degree of clinical suspicion and is often delayed. Although the incidence of infectious complications reported for percutaneous intra-arterial interventions historically has been low, the absolute number of these complications almost certainly will increase in the future because of the expanding array of interventional procedures that is becoming available.
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7/56. CT-guided drainage of a mediastinal pancreatic pseudocyst with a transhepatic transdiaphragmatic approach.

    We describe a mediastinal pancreatic pseudocyst treated with a catheter drainage placed under computed tomographic guidance using a newly applied approach. A needle was angled cephalad with the computed tomographic gantry tilt technique, and was inserted into the lowest portion of the cavity through the liver and through the diaphragm. The needle pathway was necessitated by the location of the pseudocyst cavity. The drainage alleviated completely the symptoms with no complications. The puncture technique should be an option for accessing mediastinal lesions percutaneously.
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8/56. Acupuncture-associated arthritis in a joint with an orthopaedic implant.

    Viral infection is a well-recognized complication of acupuncture therapy. Bacterial infection however is rare. We report a rare case of intra-articular bacterial knee infection due to inadvertent acupuncture needle penetration.
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9/56. osteomyelitis following puncture wounds of the foot in children.

    review of the laboratory and clinical findings and treatment of eight patients with osteomyelitis of the foot after puncture wounds revealed that: 1) osteomyelitis after puncture wounds is a infrequent but potentially serious complication, with significant morbidity; 2) osteomyelitis is frequently preceded by inadequate primary care for simple puncture wounds, and when treatment is appropriate, osteomyelitis usually can be avoided; 3) P. aeruginosa is the most commonly recovered organism; 4) the clinical presentation is characterized by a lack of systemic toxicity, paucity of laboratory abnormalities, and evidence of a localized infection process and the patient may be asymptomatic for a few days to several months after the injury before presentation of the osteomyelitis; and 5) once the infection has become established, treatment must be aggressive, including surgical debridement.
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10/56. staphylococcus aureus subcutaneous abscess complicating acupuncture: need for implementation of proper infection control guidelines.

    We report a case of staphylococcus aureus subcutaneous abscess centered over the Jizhong acupuncture point (DU 6) which lies along the Du (Back midline) meridian after acupuncture at the corresponding acupuncture point for low back pain. The patient recovered after surgical debridement and drainage and 5 weeks of cloxacillin therapy. Among the 16 anecdotal case reports of pyogenic bacterial infections complicating acupuncture described in the English literature (medline Search 1996-2002), S. aureus was documented to be the causative agent in 9 (56%). Three patients had septic arthritis, 2 had chronic osteomyelitis, 2 had abscess formation, 1 had chondritis, and 1 had infective endocarditis. Five patients had S. aureus bacteremia. All patients who recovered required prolonged antibiotic treatment of 5-6 weeks, and 6 required drainage and/or debridement. overall, 3 patients (30%) died. S. aureus causes significant morbidity and mortality in patients who receive acupuncture treatment. More resources should be spent on implementation of proper infection control guidelines, as the money lost due to prolonged hospitalization and medication would far exceed that used for implementation.
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