1/97. Pyogenic osteomyelitis of the spine in the elderly: three cases of a synchronous non-axial infection by a different pathogen.STUDY DESIGN: A retrospective chart review of patients over 65 years of age treated at the spine Care Unit for pyogenic vertebral osteomyelitis. OBJECTIVES: To assess the reliability of peripheral blood, urine and sputum cultures in the treatment of pyogenic vertebral osteomyelitis in the elderly. SETTING: Study performed at the spine Care Unit, Meir Hospital, Kfar-Saba, israel. methods: The Meir hospital records were searched for patients over 65 years of age, treated at the spine Care Unit for pyogenic vertebral osteomyelitis. charts, culture results and imaging studies were reviewed. A medline literature search was performed to survey the literature regarding pyogenic vertebral osteomyelitis in the elderly with emphasis on diagnostic imaging modalities and surgical treatment. RESULTS: Three patients were identified with concurrent peripheral infection by a different organism than the organism causing the vertebral osteomyelitis. Delay in correct diagnosis led to neurologic impairment in all patients and surgical treatment was performed in all three to drain the epidural abscess, decompress the spinal cord and obtain direct tissue culture. Following decompression and epidural abscess evacuation, one patient has functionally recovered and was ambulating with a cane, two patients did not recover and remained paraparetic and ambulate in a wheelchair. CONCLUSIONS: Pyogenic vertebral osteomyelitis in the elderly can be caused by a different pathogen than that isolated from blood, sputum or urine cultures. In the elderly, a biopsy of the vertebral lesion should be obtained for susceptibility studies prior to conservative treatment with bracing and intravenous antibiotics.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
2/97. temporomandibular joint ankylosis: review of thirty-two cases.I have reviewed aetiology, sex, age at time of treatment, clinical features, radiographic findings, anaesthetic techniques, surgical treatment, complications, and results in 32 patients with ankylosis of the temporomandibular joint. Trauma and infection were the commonest causes of ankylosis: 50% and 41%, (n = 13), respectively. The 21-30 year age group had the most trauma cases. Twenty (63%) of the patients presented with bilateral ankylosis. Failing to do jaw-opening exercises was the main cause of relapse.- - - - - - - - - - ranking = 27.361545954895keywords = jaw (Clic here for more details about this article) |
3/97. Florid osseous dysplasia of the mandible: report of a case.In 1986, a 60-year-old African American woman visited the Marquette University School of dentistry with a complaint of a vague, dull pain in her lower left quadrant. tooth No. 19 was extracted 10 years earlier because of extensive decay, and tooth No. 18 had received root canal therapy. A panoramic radiograph revealed the presence of ill-defined, multilocular, mixed (radiopaque-radiolucent) lesions present throughout the lower jaw. She was treated with antibiotics and scheduled for follow-up visits. When the symptoms persisted, tooth No. 18 was re-treated with root canal therapy and a representative biopsy was taken from the left mandibular area. The biopsy showed the presence of chronic osteomyelitis. The patient was treated with antibiotics and was scheduled for periodic check-up visits. In February 1995, she returned with the same symptoms in the left mandible. A panoramic radiograph showed persistence of the mixed radiopaque-radiolucent lesions throughout her mandible; however, the mass on the left side was more radiopaque and had assumed a "cotton wool" appearance. tooth No. 18 was extracted and a biopsy was taken from the area. After correlating the clinical behavior, radiographic appearance, and histopathologic features, a diagnosis of florid osseous dysplasia with osteitis was made. This case represents a classic example of the difficulty in diagnosing fibro-osseous lesions using radiographic interpretation alone and the need to correlate the clinical, radiographic, and histopathologic features to reach a diagnosis. Additionally, the present case clearly shows treatment problems of an otherwise self-limiting condition when secondary involvement with osteomyelitis is also present. A brief description of the conditions that were included in the differential diagnosis and their management is presented.- - - - - - - - - - ranking = 27.361545954895keywords = jaw (Clic here for more details about this article) |
4/97. Report of a kindred with bone lesions and subcutaneous abscesses of unknown etiology.This case report concerns a 12-year-old boy who had a 9-year history of mandibular lesions of unknown origin. The mandible showed changes resembling chronic osteomyelitis. The tibia and temporal bone also exhibited radiolucencies. Many subcutaneous abscesses were present. The boy died at the age of 14 years as a result of rupture of the aorta. In his family, there were seven members who had bone lesions and eleven who suffered from skin abscesses.- - - - - - - - - - ranking = 4.0418063603284keywords = bite (Clic here for more details about this article) |
5/97. Pyogenic osteomyelitis of the spine.The records of 30 patients who had suffered from vertebral osteomyelitis were reviewed. They conformed to a constant pattern, though varying in tems of: (i) the severity of the disease due to host-organism interrelationship; and (ii) age distribution. Causative organisms could not always be identifed, though all lesions settled with conservative measures of rest and antibiotics. A high proportion of the patients who were followed up for more than one year were back at work. The anatomical distribution of the lesions can be explained by our knowledge of the vascular supply to the vertebral bodies.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
6/97. eikenella corrodens vertebral osteomyelitis secondary to direct inoculation: a case report.STUDY DESIGN: A case report. OBJECTIVE: To present a unique method of inoculation with an unusual bacterial organism, eikenella corrodens, which led to vertebral osteomyelitis and to heighten awareness of different bacterial organisms that may cause orthopedic infections. SUMMARY OF BACKGROUND DATA: E. corrodens has been known to cause orthopedic infections for more than 20 years. The usual mechanism is from "Fight bite" injuries to the hand or metacarpal phalangeal joint. Eikenella osteomyelitis of the vertebral body is extremely rare. methods: A 65-year-old man from indonesia developed slowly progressive vertebral collapse and worsening neck pain. history suggested a previous pharyngeal injury while eating fish. work up for malignancy was negative, and imaging studies were suggestive of osteomyelitis. An open biopsy and culture as well as fusion were performed for treatment of the osteomyelitis. RESULTS: After a complete work up was undertaken, cultures grew out E. corrodens as the causative organism of this patient's osteomyelitis. Computed tomography scan and history were consistent with inoculation of the paravertebral space with E. corrodens secondary to a fish bone transgressing the patient's pharynx. The patient was treated with surgery and the appropriate antibiotics and healed without any significant sequela. CONCLUSION: Vertebral osteomyelitis due to E. corrodens is extremely rare. Direct inoculation as a cause of vertebral osteomyelitis with Eikenella has never been reported. If diagnosed properly with appropriate cultures and antibiotic sensitivities, Eikenella osteomyelitis can be treated successfully according to standard orthopedic practices including debridement, fusion, and appropriate antibiotics. awareness of unusual bacteria as potential causative organisms of osteomyelitis is imperative for appropriate treatment.- - - - - - - - - - ranking = 4.0418063603284keywords = bite (Clic here for more details about this article) |
7/97. Cryptococcal osteomyelitis. Report of a case with aspiration biopsy of a humeral lesion with radiologic features of malignancy.BACKGROUND: osteomyelitis due to cryptococcus neoformans typically exhibits lytic lesions on radiographs. Extensive periosteal reaction is an uncommon feature. CASE: A 68-year-old man presented with pain and swelling in the left elbow. Radiologic studies exhibited a lytic humeral lesion with extensive periosteal reaction, interpreted as a malignant neoplasm. Fine needle aspiration biopsy (FNA) revealed abundant cryptococcal organisms. CONCLUSION: Cryptococcus is an uncommon cause of lytic osseous lesions that may mimic malignant neoplasms. Extensive periosteal reaction may support a radiologic diagnosis of primary osseous malignancy in rare cases. FNA with examination of Diff-Quik-stained slides may be employed for distinguishing cryptococcal osteomyelitis from malignant tumors and for prompt identification of the organisms.- - - - - - - - - - ranking = 4.0418063603284keywords = bite (Clic here for more details about this article) |
8/97. Candida osteomyelitis and diskitis after spinal surgery: an outbreak that implicates artificial nail use.Postoperative wound infection after laminectomy is uncommon. In February 1997, 3 patients were confirmed to have postlaminectomy deep wound infections due to candida albicans. No similar case had been seen during the previous 10 years. The infections were indolent, with a mean time from initial operation to diagnosis of 54 days (range, 26-83 days). All patients were successfully treated. Pulsed-field gel electrophoresis revealed the Candida isolates to be identical. A case-controlled study and medical record review revealed that a single operating room technician scrubbed on all 3 infected case patients but on only 32% of the uninfected controls. The technician had worn artificial nails for a 3-month period that included the dates of laminectomy site infections, and C. albicans was isolated from her throat. She was treated with fluconazole and removed from duty. No subsequent cases have occurred during the ensuing 3 years. Artificial nails are known to promote subungual growth of gram-negative bacilli and yeast. This may be clinically relevant, and hospitals should enforce policies to prevent operating room personnel from wearing artificial nails.- - - - - - - - - - ranking = 1keywords = record (Clic here for more details about this article) |
9/97. Pyknodysostosis--a report of two cases with a brief review of the literature.Pyknodysostosis is a rare sclerosing bone disorder that has an autosomal dominant trait. It is characterized by short stature, brachycephaly, short and stubby fingers, open cranial sutures and fontanelle, and diffuse osteosclerosis, where multiple fractures of long bones and osteomyelitis of the jaw are frequent complications. We present a report of two cases of pyknodysostosis with evidence of long bone fractures and chronic suppurative osteomyelitis of the jaws in one of the cases. Some of the specific oral and radiological findings that are consistent with pyknodysostosis are reported, along with a brief review of the literature.- - - - - - - - - - ranking = 54.72309190979keywords = jaw (Clic here for more details about this article) |
10/97. Tuberculous osteomyelitis of the mandible: a case report.osteomyelitis of jaws caused by infection with mycobacterium tuberculosis is uncommon, especially in children. We present a case of tuberculous osteomyelitis in a young child. Its clinical presentation, with features similar to a dento-alveolar abscess, underline the importance of considering it in the differential diagnosis of jaw lesions. We discuss of the diagnostic techniques, management and preventive measures, and stress the importance of history taking during clinical examination.- - - - - - - - - - ranking = 54.72309190979keywords = jaw (Clic here for more details about this article) |
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