1/325. ochrobactrum anthropi bacteremia.ochrobactrum anthropi (O. anthropi ), formerly known as achromobacter CDC group Vd, is a gram-negative bacillus that is aerobic, oxidase producing, and nonlactose fermenting. This organism has been found in environmental and hospital water sources and has pathogenic potential in humans. Most reports in the literature of O. anthropi bacteremia are associated with intravenous line infections. We describe a case of bacteremia with O. anthropi in a 33-month-old boy with acute osteomyelitis. O. anthropi bacteremia also has been reported in immunocompromised hosts. Rarely, O. anthropi has been a cause of soft tissue or bone infection.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
2/325. 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 = 2keywords = organ (Clic here for more details about this article) |
3/325. Fungal spinal osteomyelitis in the immunocompromised patient: MR findings in three cases.The MR imaging findings of fungal spinal osteomyelitis in three recipients of organ transplants showed hypointensity of the vertebral bodies on T1-weighted sequences in all cases. Signal changes and enhancement extended into the posterior elements in two cases. Multiple-level disease was present in two cases (with a total of five intervertebral disks involved in three cases). All cases lacked hyperintensity within the disks on T2-weighted images. In addition, the intranuclear cleft was preserved in four of five affected disks at initial MR imaging. MR features in candida and Aspergillus spondylitis that are distinct from pyogenic osteomyelitis include absence of disk hyperintensity and preservation of the intranuclear cleft on T2-weighted images. Prompt recognition of these findings may avoid delay in establishing a diagnosis and instituting treatment of opportunistic osteomyelitis in the immunocompromised patient.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
4/325. bacteremia complicated by vertebral osteomyelitis due to streptococcus bovis.The diagnosis of vertebral osteomyelitis is easily missed, especially in the elderly in whom clinical signs of bacteremia might not be manifest. Spontaneously occurring disc-space infection in adults often has an insidious presentation. The infecting microorganism can be difficult to identify. Although discitis due to streptococcus bovis is occasionally found, it is often difficult to fully confirm the diagnosis. Here, a case of vertebral osteomyelitis due to this microorganism is reported.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
5/325. Serious infections from bacillus sp.Serious infections caused by organisms of the genus bacillus developed in seven patients. Five drug abusers had either endocarditis or osteomyelitis, one leukemic patient had necrotizing fasciitis, and one patient had a ventriculoatrial shunt infection with recurrent bacteremia. All patients recovered. Experience with these cases reemphasizes the importance of not dismissing bacillus organisms as culture contaminants, especially when isolated from blood, body fluids, or closed-space infections.- - - - - - - - - - ranking = 2keywords = organ (Clic here for more details about this article) |
6/325. Community-acquired pseudomonas stutzeri vertebral osteomyelitis in a previously healthy patient: case report and review.pseudomonas stutzeri is a rare pathogen, and its recovery is often associated with colonization and contamination. We report a case that, to our knowledge, is the first of community-acquired P. stutzeri vertebral osteomyelitis in a previously healthy patient, and we review the literature regarding infections with this uncommon organism. Of the 29 previously reported cases of P. stutzeri infection cited in the literature, only two resulted in death, reflecting the relatively low degree of virulence of this organism. Predisposing risk factors for P. stutzeri infection can be categorized as follows: (1) previous surgery or procedure (implying probable nosocomial acquisition), with or without a foreign body; (2) immunocompromise (an underlying predisposition to infection by an organism with low virulence); (3) immunocompromise and a previous procedure; and (4) previous trauma or superficial infection, with or without possible nosocomial contamination. Our patient lacked any known risk factors for either pyogenic vertebral osteomyelitis or P. stutzeri infection.- - - - - - - - - - ranking = 3keywords = organ (Clic here for more details about this article) |
7/325. Postoperative mycobacterium avium osteomyelitis confirmed by polymerase chain reaction.An 18-year-old male with Escobar syndrome developed mycobacterium avium osteomyelitis after corrective osteotomy. After three surgical interventions the infection reappeared a fourth time. Repeated attempts at microbiological diagnosis of the granulomatous lesions by microscopy and culture for conventional bacteria and Mycobacteria did not reveal any organism. The diagnosis of mycobacterium avium finally was achieved by polymerase chain reaction. Extensive immunological work-up did not reveal signs of immunodeficiency. The patient was treated successfully by a combined surgical and chemotherapeutic approach consisting of clarithromycin, ethambutol and ciprofloxacin. CONCLUSION: polymerase chain reaction may be especially useful for clinical situations with a low bacterial load, especially for fastidious and slow growing pathogens like Mycobacteria. In our patient a combination of surgical therapy with a triple regimen containing clarithromycin proved successful for treatment of a localised infection with M. avium in a supposedly immunocompetent host.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
8/325. Aspergillus osteomyelitis after liver transplantation: conservative or surgical treatment?We report on a liver transplant recipient who developed coxarthritis and lumbar spondylodiscitis due to aspergillus flavus. He was treated with high-dose liposomal amphotericin b for 2 months followed by itraconazole. Because of intractable pain and severe, irreversible damage of the left hip, a Girdlestone resection was performed. The spondylodiscitis was treated successfully with anti-fungal agents only, which indicates that, in the absence of neurological impairment, good clinical outcome can be achieved without surgery. This case demonstrates that surgical therapy, which is often proclaimed as unavoidable for the treatment of Aspergillus osteomyelitis, should be considered in particular in the case of intolerable pain due to irreversible joint damage or involvement of vital organs.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
9/325. 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 = 2keywords = organ (Clic here for more details about this article) |
10/325. mycobacterium fortuitum osteomyelitis in a peripheral blood stem cell transplant recipient.mycobacterium fortuitum is an uncommon, but well-recognized, pathogen in immunocompromised hosts, with special predilection for bone and soft tissue infections in solid organ transplant recipients. We describe a case of osteomyelitis due to this pathogen in a peripheral blood stem cell transplant recipient.- - - - - - - - - - ranking = 1keywords = organ (Clic here for more details about this article) |
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