1/59. 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 = organ (Clic here for more details about this article) |
2/59. Brucella disc infection mimicking lumbar disc herniation: a case report.brucellosis is a zoonotic disease and still a major health problem in many geographical areas. In this paper a forty year-old woman with spinal brucellosis associated with epidural abscess formation and mimicking lumbar disc herniation is presented. Compression of spinal nerve root(s) by epidural masses due to brucella disc infection is a rare condition and should be kept in mind in differential diagnosis of lumbar disc herniation. The crucial role of magnetic resonance imaging in differential diagnosis is also emphasised.- - - - - - - - - - ranking = 1.119451303155keywords = nerve (Clic here for more details about this article) |
3/59. Deep venous thrombosis associated with acute brucellosis--a case report.Vascular complications, including arteries and veins associated with Brucella infection, have rarely been reported. To date, only three cases of deep venous thrombosis (DVT) of the lower extremities associated with brucellosis have been previously reported. The authors describe another case of DVT of the right leg in association with acute Brucella infection. Since infection with Brucella may be asymptomatic, and the manifestations of acute brucellosis are exceedingly nonspecific, and in view of the potential for Brucella to cause unexplained or unusual illness involving almost any organ including blood vessels, the authors' case and those previously reported suggest that brucellosis should be included among the causes and infections taken into account in patients suffering from DVT, particularly in those coming from Brucella-endemic areas.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
4/59. Difficulties in diagnosing Brucella spondylitis.We describe a case of culture-proven Brucella spondylitis in a 28-y-old Turkish male asylum seeker who had arrived to norway 6 months earlier. Several diagnostic difficulties, including rapid in vitro growth and misidentification of the causative microorganism in biochemical gallery strip tests, resulted in late diagnosis.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
5/59. diabetes insipidus in neurobrucellosis.brucellosis is an infection due to Brucella species and is characterized by acute febrile illness, chilly sensations, sweats, weakness, generalized malaise, body aches and headache. The involvement of the nervous system is rare. A few cases have been reported with symptoms and sign of optic neuritis, meningoencephalitis, meningomyelitis and cranial nerve palsy. We report a case with culture proven neurobrucellosis who presented with diabetes insipidus along with systemic signs. neuroimaging revealed multiple lesions in brain parenchyma, including the suprasellar region. Both diabetes and suprasellar lesions improved markedly with specific antibiotic therapy.- - - - - - - - - - ranking = 1.119451303155keywords = nerve (Clic here for more details about this article) |
6/59. Neurobrucellosis--a rare complication of renal transplantation.brucellosis is an intracellular bacterial infection contracted by consuming raw milk or by contact with infected cattle. Neurobrucellosis is a rather rare manifestation of brucellosis and has protean clinical presentations characterized by meningoencephalitis, myelitis, myelopathies, subarachnoid hemorrhage and psychiatric manifestations. A depressed immune status is believed to be a risk factor for developing neurobrucellosis. We report a case of neurobrucellosis in a patient 13 years after a cadaveric renal transplantation. Even though a Brucella organism was not isolated from body fluids she satisfied other criteria for establishing the diagnosis. Treatment with doxycycline and rifampin led to a clinical cure as well as to marked improvement in the Brucella titer.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
7/59. Infective endocarditis in renal transplant recipients.Because of the increasing number of renal transplantations performed and the rarity of reported cases of infective endocarditis in these patients, we studied the clinical characteristics of this infection in this population. We report on two cases from our experience and review reported cases of infective endocarditis in renal transplant recipients retrieved from the medline system. In addition, we reviewed a large series of infective endocarditis looking for patients with renal transplants. In addition to our 2 cases, 12 previously reported cases were found. The mean time from transplantation to diagnosis of infective endocarditis was 3.5 years (range 2 months to 15 years). Causative organisms included fungi, staphylococcus aureus (3 cases each), corynebacterium sp. (2 cases), streptococcus viridans, VRE, Brucella sp., clostridium sp., nocardia sp. and erysipelothrix sp. (one case each). skin manifestations of endocarditis and/or splenomegaly were not reported in these patients. Septic emboli and mycotic aneurysms were relatively common. The overall mortality rate was 50% (7 of 14 patients died). Infective endocarditis seems to be rare in renal transplant recipients. The few reported cases are characterized by unusual causative micro-organisms and atypical clinical presentation. Further studies are needed to delineate the magnitude and scope of this association.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
8/59. Neurobrucellosis.brucellosis, which is endemic in saudi arabia, can present as a disease with multisystem involvement. Occasionally the organisms invade the central nervous system producing varied neurological manifestations. Often the clinical diagnosis of neurobrucellosis is not straight forward and is obscure. Certain criteria have to be fulfilled for the definitive diagnosis of neurobrucellosis. We report 2 cases of neurobrucellosis which were encountered for the first time during the past 10 years at this hospital.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
9/59. Paravertebral abscess formation and knee arthritis due to brucellosis in a patient with rheumatoid arthritis.OBJECTIVE: To report a case of brucellosis causing severe joint and vertebra destruction in a patient with rheumatoid arthritis (RA). SETTING: Ankara, turkey. CASE REPORT: A 47-year-old man with a known diagnosis of (RA) for 5 years developed paravertebral and epidural abscesses and vertebral fractures and nerve root compression due to brucellosis. The patient underwent surgery for L3-L4 vertebra stabilisation and medical treatment for knee arthritis. CONCLUSION: It is important to be aware of the possibility of brucellosis in endemic areas, even among patients with a known diagnosis of RA presenting with clinical pictures that may be confused with a flare-up of the RA itself. steroids and NSAIDs may have the potential to mask disease manifestations.- - - - - - - - - - ranking = 1.119451303155keywords = nerve (Clic here for more details about this article) |
10/59. Medically treated splenic abscess due to brucella melitensis.brucellosis may lead to complications that affect different organ systems, including the liver and spleen. In acute disease, hepatosplenic abscess is a rare complication. We report herein a woman with splenic abscess due to acute brucella melitensis infection who was successfully treated with antibiotics alone.- - - - - - - - - - ranking = 0.5keywords = organ (Clic here for more details about this article) |
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