Cases reported "Spondylitis"

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1/45. role of MRI in the diagnosis of cervical brucellar spondylitis: case report.

    magnetic resonance imaging (MRI) is the most suitable modality for evaluation of infectious spondylitis. It is more sensitive than other imaging modalities for detecting presence and extent of such infections. Though it is not always possible to differentiate various infections on the basis of imaging findings alone, there are certain features which along with a good clinical background, can differentiate brucellar spondylitis from other spinal infections. It is useful to follow up such patients after specific chemotherapy to further confirm the diagnosis.
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2/45. Pyogenic infectious spondylitis in a patient with diabetes: case report.

    A case of pyogenic infectious spondylitis associated with diabetes was reported. The patient experienced focal back pain 2 weeks after amputation of her left foot due to diabetic gangrene. magnetic resonance imaging of the lumbar spine revealed decreased T1-weighted signals of Th11 and Th12 vertebral bodies and prevertebral masses, and these lesions were also detected as high signal intensities in T2-weighted magnetic resonance imaging. The images were consistent with a diagnosis of pyogenic infectious spondylitis and the patient responded to treatment with broad-spectrum antibiotics. Percutaneous drainage of the abscesses was also needed. Early magnetic resonance imaging examination was particularly helpful in the accurate diagnosis and treatment of this rare disorder.
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ranking = 17.136371227869
keywords = back pain, back
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3/45. Brucella spondylitis: an important treatable cause of low backache.

    OBJECTIVES: This study was undertaken to see if brucella spondylitis existed as a cause of backache in Mumbai and to identify the clinical setting in patients of backache where brucella serology is indicated. methods: In 18 months (June 1996-Dec. 1997) we performed tube agglutination test (TAT) for brucella melitensis and abortus on 72 patients of low backache from Orthopaedics Department of a teritary health centre. All 72 patients satisfied the inclusion and exclusion criteria designed to exclude radiologically detectable congenital or degenerative cause of backache. RESULTS: Six out of 72 patients were seropositive for brucellosis. All six patients had either history of animal contact or ingestion of raw milk or milk product (cheese or paneer). The lumbosacral backache was severe, radiating to the legs and straight leg raising test was significantly positive, they had marked tenderness on spinous process of lower lumbar vertebrae. Changes of brucella spondylitis were present on plain radiogram of lumbosacral spine in three patients. Four patients had abnormalities on bone scintigraphy. CONCLUSION: Low backache of brucella spondylitis closely simulates pain of prolapsed intervertebral disc. Serologic testing for brucellosis is an important step in management of such patients, especially when history of animal contact or raw milk or milk product ingestion is present, as the disease can be eminantly treated with antibiotics.
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4/45. Vertebral osteomyelitis caused by streptococcus agalactiae.

    streptococcus agalactiae is a rare cause of vertebral osteomyelitis. We present four cases of spondylitis caused by this micro-organism and a review of 20 cases previously described in the literature. Only seven patients (29%) were under 50 years of age. diabetes mellitus and neoplasms were the most frequent underlying conditions, although 37.5% of the patients did not have any predisposition. neck or back pain was the most common symptom. diagnosis depended mainly on magnetic resonance imaging. blood cultures were positive in 50% of the patients. The duration of antibiotic therapy was 6 weeks for most patients. The outcome was favourable, with none of the patients suffering serious sequelae.
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keywords = back pain, back
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5/45. Dialysis-related spondyloarthropathy.

    OBJECTIVE: To discuss a case of dialysis-related spondyloarthropathy due to beta-2 microglobulin amyloid deposition. An emphasis is placed on the imaging findings. CLINICAL FEATURES: A 67-year-old man sought treatment for low back pain. His history revealed coronary artery bypass surgery, diabetes with bilateral foot neuropathy, gout, and bilateral renal failure that had been treated with dialysis for 2 years before left renal transplantation; the renal transplant had been performed 6 years earlier. radiography, computed tomography, and magnetic resonance imaging revealed changes characteristic of dialysis-related spondyloarthropathy. INTERVETION AND OUTCOME: The patient was initially treated with physiotherapy. He was then admitted to the hospital and treated for renal infection and medicated for low back pain. Two weeks later he returned to the chiropractor, who began a treatment plan that included spinal manipulation, physiotherapy, manual distractive traction, and a gradual increase in activities of daily living. The patient was released from care after 2 months with significantly decreased pain. CONCLUSIONS: Dialysis-related spondyloarthropathy is a relatively uncommon complication of renal dialysis. It should be suspected in those patients who present with a correlative medical history and characteristic radiographic appearance. chiropractic treatment can be effective as an adjunct to medical care in cases of chronic renal failure and associated complications.
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ranking = 34.272742455738
keywords = back pain, back
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6/45. Vertebral osteomyelitis due to infection with nontuberculous mycobacterium species after blunt trauma to the back: 3 examples of the principle of locus minoris resistentiae.

    osteomyelitis due to infection with nontuberculous mycobacterial organisms is unusual, especially in the absence of nonpenetrating trauma. We describe 3 patients with vertebral osteomyelitis due to infection with nontuberculous mycobacterial organisms that was precipitated by blunt trauma; these 3 unusual cases illustrate the principle of locus minoris resistentiae.
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7/45. Thoracic spondylitis mimicking idiopathic scoliosis: a case report.

    We report the case of a 12-year-old girl with thoracic spondylitis, who initially presented with a painless scoliotic deformity and was therefore misdiagnosed as having idiopathic scoliosis. Six weeks after initiation of brace therapy, increasing back pain necessitated admission. X-Ray, bone scintigraphy and magnetic resonance imaging then revealed a pathologic process in D8. To rule out a tumorous lesion, open biopsy was performed and led to the diagnosis of acute spondylitis. Treatment with oral antibiotics and bed rest led to a complete resolution of the scoliotic deformity, which clearly demonstrated that it was secondary to spondylitis. After 2 years, the girl is persistently well and free of pain. This unusual presentation of spondylitis delayed correct diagnosis and therefore specific treatment in the case of this 12-year-old girl.
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ranking = 17.136371227869
keywords = back pain, back
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8/45. Contained rupture of the aneurysm of common iliac artery associated with pyogenic vertebral spondylitis.

    STUDY DESIGN: A case report. OBJECTIVES: To report and discuss a case of contained rupture of the aneurysm of common iliac artery associated with pyogenic vertebral spondylitis, so that investigators and practitioners may avoid the diagnostic and therapeutic pitfalls associated with pyogenic vertebral spondylitis and aortic disease. SUMMARY OF BACKGROUND DATA: Pyogenic vertebral spondylitis is a rare disorder that may have serious consequences, including death, if it is not diagnosed promptly and treated effectively. The association of pyogenic vertebral spondylitis with infection of the aorta is a rare but potentially fatal condition that requires prompt diagnosis and aggressive surgical and medical therapy. To our knowledge, this is the first report of a contained rupture of the aneurysm of common iliac artery case associated with pyogenic vertebral spondylitis resulting from an infection with bacteroides fragilis,although Salmonellae infections are commonly associated with vertebral osteomyelitis and lesions of the contiguous aorta. methods: A 60-year-old man with chronic lower back pain began to experience a severe pain and had increased difficulty in walking. An MRI scan showed an increased signal in the L4-L5 disc space and an abscess extending into the spinal canal. The presumptive diagnosis was infective spondylitis. While performing a CT-guided needle biopsy, an unexpected contained rupture of the aneurysm of common iliac artery was discovered. RESULTS: A wide resection of all infected tissue, including the right common iliac artery and bony lesions, was performed in combination with antimicrobial therapy. A cryopreserved aortic allograft was used to reconstruct the artery, and an iliac strut graft was used to fill the debrided vertebral cavity. The patient's postoperative recovery was uneventful. CONCLUSION: The coexistence of pyogenic vertebral spondylitis and lesions of the aorta is rare, but may be lethal if not diagnosed promptly and treated effectively. Even if a patient's condition is stable and the hematocrit is normal, it is important to consider the possibility of a contained rupture of a mycotic abdominal aneurysm in all patients with vertebral osteomyelitis who have acute episodes of unusual severe back pain. CT is sometimes more beneficial than MRI in the identification and characterization of contained rupture of aneurysms.
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ranking = 34.272742455738
keywords = back pain, back
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9/45. Vertebral osteomyelitis due to Candida species: case report and literature review.

    Candida species uncommonly cause vertebral osteomyelitis. We present a case of lumbar vertebral osteomyelitis caused by candida albicans and review 59 cases of candidal vertebral osteomyelitis reported in the literature. The mean age was 50 years, and the lower thoracic or lumbar spine was involved in 95% of patients. Eighty-three percent of patients had back pain for >1 month, 32% presented with fever, and 19% had neurological deficits. The erythrocyte sedimentation rate was elevated in 87% of patients, and blood culture yielded Candida species for 51%. C. albicans was responsible for 62% of cases, candida tropicalis for 19%, and candida glabrata for 14%. risk factors for candidal vertebral osteomyelitis were the presence of a central venous catheter, antibiotic use, immunosuppression, and injection drug use. Medical and surgical therapies were both used, and amphotericin b was the primary antifungal agent. prognosis was good, with an overall clinical cure rate of 85%.
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ranking = 17.136371227869
keywords = back pain, back
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10/45. Brucella spondylitis with paravertebral abscess due to brucella melitensis infection: a case report.

    This report describes the case of a 45-year-old woman with a 5-month history of fever, generalized malaise, myalgia, lower back pain and difficulty in walking. Serodiagnosis for brucella, carried out at the onset of symptoms 5 months previously, was negative. When the patient was admitted to our hospital there was contracture of the paraspinal muscles but no peripheral nerve damage. Laboratory tests showed positive agglutination for Brucella and an increase in the rate of dilution from 1/160 to 1/640 over 2 weeks. Radiographs and a computed tomography scan of the spine revealed bone erosion in the posterior borders of the L4-L5 vertebral end plates and a soft tissue mass surrounding the interposed disc and protruding into the spinal canal. magnetic resonance imaging confirmed the presence of a paraspinal abscess around the affected disc and tissue edema. culture tests of the blood and abscess tissue, taken by biopsy, were negative. Rifampicin treatment (600 mg daily), combined with a bust cast to immobilize the spine, led to clinical healing without the need for surgery. Because onset symptoms are nonspecific and insidious, in nonrisk subjects a diagnosis of brucellosis may sometimes be suspected only if there are local symptoms. The phenomenon of the absence of positivity in patients with a high antibody titer should also be considered Cases such as that described herein demonstrate the need for culture tests and serodiagnosis, even in nonrisk patients with persistent fever and arthralgia, to prevent the later complications of brucellosis.
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keywords = back pain, back
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