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BMC Infectious Diseases Mar 2022Disseminated mucormycosis presenting with multiple subcutaneous nodules is a rare condition with a poor prognosis, and delayed diagnosis and treatment is common. (Review)
Review
BACKGROUND
Disseminated mucormycosis presenting with multiple subcutaneous nodules is a rare condition with a poor prognosis, and delayed diagnosis and treatment is common.
CASE PRESENTATION
We report a case of 64-year-old Thai woman with colorectal cancer who initially presented with Acinetobacter baumannii pneumonia and respiratory failure. Following 10 days after her admission to the intensive care unit, she developed hospital-acquired pneumonia. Five days later, multiple subcutaneous nodules appeared on both arms and both legs. Bronchoalveolar lavage and skin biopsy cultures both grew Mucor spp. She was diagnosed with disseminated mucormycosis and was treated with liposomal amphotericin B at a dose of 5 mg/kg/day. Despite treatment, our patient succumbed to septic shock and multiorgan failure on the third day after definitive diagnosis.
CONCLUSIONS
This case demonstrates that the subcutaneous nodules caused by hematogenously disseminated mucormycosis are unusual in a patient with a solid tumor. Clinicians should be aware of this atypical presentation of mucormycosis in patients with solid tumors.
Topics: Antifungal Agents; Female; Humans; Middle Aged; Mucormycosis; Multiple Organ Failure; Pneumonia, Bacterial; Shock, Septic; Thailand
PubMed: 35246058
DOI: 10.1186/s12879-022-07187-8 -
Anales de Medicina Interna (Madrid,... Jan 1993Pubic osteoarthritis is a little known pathological entity with a very controversial etiology. We present four cases of public osteoarthritis in which the infectious... (Review)
Review
Pubic osteoarthritis is a little known pathological entity with a very controversial etiology. We present four cases of public osteoarthritis in which the infectious etiology was hematogeneous. The causal germs were: Staphilococcus aureus, Pseudomona aeruginosa, Mycobacterium tuberculosis and Brucella melitensis. In the first three cases, a surgical approach was used, allowing us to establish the etiological diagnosis of the process and to perform the local debridement. In the case of brucellar etiology, an isolated medical treatment was applied, according to the therapeutical guidelines recommended for brucellar bone infections. We have not observed recurrence of the septic process in any of the four cases, with a follow-up period ranging from one to three years.
Topics: Adult; Female; Humans; Male; Middle Aged; Osteoarthritis, Hip
PubMed: 8448328
DOI: No ID Found -
Der Orthopade Oct 1997The clinical features, diagnosis and treatment of haematogenous multifocal osteomyelitis, a rare illness, are described. Of clinical note are the pain, pseudoparalyses...
The clinical features, diagnosis and treatment of haematogenous multifocal osteomyelitis, a rare illness, are described. Of clinical note are the pain, pseudoparalyses and restriction of movement. Staphylococcus aureus was the pathogen in both of the cases we described. Sonography is a useful diagnostic tool for the localization of subperiosteal abscesses; scintigraphy is a supplementary examination for cases where it is difficult to establish a diagnosis. MR-tomography is the most reliable method for examination of proximal infected foci (spondylitis, pelvis osteomyelitis). In our view, the earliest possible removal of all infected foci by means of operation and parenteral antibiotics mare the most important treatment.
Topics: Abscess; Adolescent; Anti-Bacterial Agents; Arthritis, Infectious; Child; Combined Modality Therapy; Diagnostic Imaging; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Osteomyelitis; Sepsis; Spondylitis; Staphylococcal Infections; Ultrasonography
PubMed: 9446095
DOI: 10.1007/s001320050167 -
International Journal of Surgery Case... Aug 2022• Haematogenous bacterial spondylodiscitis due to infection with a well-treatable but easily overlooked and often underdiagnosed pathogen. • An argument against...
• Haematogenous bacterial spondylodiscitis due to infection with a well-treatable but easily overlooked and often underdiagnosed pathogen. • An argument against short pedicle screw instrumentation, when urgent surgical therapy of the infected spine is required, in patients with PD and poor general condition. • Especially in cases where a bacterial infection is suspected clinically and by imaging, the detection of germs must be forced by all means in order to be able to treat the patients well.
PubMed: 35905674
DOI: 10.1016/j.ijscr.2022.107453 -
Unfallchirurgie (Heidelberg, Germany) Nov 2022We present a case of a nondislocated clavicular fracture that was conservatively treated for 4 weeks with a sling. The patient was a smoker and suffered from type 2...
We present a case of a nondislocated clavicular fracture that was conservatively treated for 4 weeks with a sling. The patient was a smoker and suffered from type 2 diabetes mellitus. After 2 months a suppurative infection occurred due to an escalation based on a clavicular osteomyelitis. Through antibiotic treatment and an aggressive surgical approach the infection was cured but ended up with a painful malunion of the clavicle. The bone reconstruction was achieved with a long locking plate with an additional vascularized medial femoral condyle free flap. After 18 months the patient was subjectively very satisfied with the outcome, had no pain and excellent functional results in the Constant Murley and DASH (Disabilities of Arm, Shoulder and Hand) scores. The X‑ray assessment showed full bone union.
Topics: Humans; Clavicle; Conservative Treatment; Diabetes Mellitus, Type 2; Fracture Fixation, Internal; Treatment Outcome; Fractures, Bone; Osteomyelitis
PubMed: 35175405
DOI: 10.1007/s00113-022-01149-0 -
Journal of Neurosciences in Rural... Jul 2014Pasteurella infections are common in domestic animals and very rare in human. We report a hematogenously acquired Pasteurella haemolytica brain abscess, mimicking brain...
Pasteurella infections are common in domestic animals and very rare in human. We report a hematogenously acquired Pasteurella haemolytica brain abscess, mimicking brain tumor on magnetic resonance imaging, in an 18-year-old female patient known with cardiac interventricular communication, without recent history of animal contact. The outcome was good after abscess complete removal and antimicrobials therapy for 6 weeks. To the best of our knowledge, this is the first reported case of P. haemolytica brain abscess.
PubMed: 25002776
DOI: 10.4103/0976-3147.133608 -
Frontiers in Oncology 2020In primary breast tumors, cancer cells hematogenously disseminate through doorways in the vasculature composed of three-cell complexes (known as Tumor MicroEnvironment...
In primary breast tumors, cancer cells hematogenously disseminate through doorways in the vasculature composed of three-cell complexes (known as Tumor MicroEnvironment of Metastasis) comprising a perivascular macrophage, a tumor cell overexpressing the actin-regulatory protein Mammalian Enabled (Mena), and an endothelial cell, all in direct physical contact. It has been previously shown that once tumor cells establish lymph node metastases in patients, TMEM doorways form in the metastatic tumor cell nests. However, it has not been established if such lymph node-TMEM doorways actively transit tumor cells into the peripheral circulation and on to tertiary sites. To address this question in this short report, we used a mouse model of lymph node metastasis to demonstrate that TMEM doorways: (1) exist in tumor-positive lymph nodes of mice, (2) are restricted to the blood vascular endothelium, (3) serve as a mechanism for further dissemination to peripheral sites such as to the lungs, and (4) their activity can be abrogated by a pharmaceutical intervention. Our data suggest that cancer cell dissemination via TMEM doorways is a common mechanism of breast cancer cell dissemination to distant sites and thus the pharmacological targeting of TMEM may be necessary, even after resection of the primary tumor, to suppress cancer cell dissemination.
PubMed: 33194666
DOI: 10.3389/fonc.2020.571100 -
World Journal of Clinical Cases Feb 2021Haematogenous osteomyelitis is an extremely rare disease occurring in adults, especially in developed countries. It is clearly a systemic infection, because bacteraemia...
BACKGROUND
Haematogenous osteomyelitis is an extremely rare disease occurring in adults, especially in developed countries. It is clearly a systemic infection, because bacteraemia spreads over proximal and distal long bones or paravertebral plexuses, resulting in acute or chronic bone infection and destruction.
CASE SUMMARY
A 46-year-old Caucasian male was complaining of a left thigh pain. It is known from the anamnesis that the patient developed severe pneumonia three months ago before the onset of these symptoms. The patient was diagnosed with haematogenous osteomyelitis, which developed a turbulent course and required complex combination therapy. The primary pathogen is thought to be , which caused pneumonia before the onset of signs of osteomyelitis. Unfortunately, due to the complexity of identifying anaerobes and contributing nosocomial infections, the primary pathogen was not extracted immediately. After the manifestation of this disease, pathological fractures occurred in both femurs, as well as purulent processes in the lungs and molars accompanied. The patient received broad-spectrum antibiotic therapy and countless amounts of orthopaedic and reconstructive surgeries, but no positive effect was observed. The patient underwent osteosynthesis using an Ilizarov's external fixation apparatus, re-fixations, external AO, debridements, intrame-dullary osteosynthesis with a silver-coated intramedullary nail, abscessotomies. The right femur healed completely after the pathological fracture and osteomyelitis did not recur. Left femur could not be saved due to non-healing, knee contracture and bone destruction. After almost three years of struggle, it was decided to amputate the left limb, after which the signs of osteomyelitis no longer appeared.
CONCLUSION
To sum it all up, complicated or chronic osteomyelitis requires surgery to remove the infected tissue and bone. Osteomyelitis surgery prevents the infection from spreading further or getting even worse up to such condition that amputation is the only option left.
PubMed: 33585629
DOI: 10.12998/wjcc.v9.i4.830 -
Saudi Journal of Ophthalmology :... Apr 2012Ocular melanomas comprise uveal and conjunctival sub-types, which are very different from each other. A large majority of uveal melanomas involve the choroid, with less...
Ocular melanomas comprise uveal and conjunctival sub-types, which are very different from each other. A large majority of uveal melanomas involve the choroid, with less than 10% being confined to the ciliary body and iris. They tend to metastasize haematogenously, almost always involving the liver. Therapeutic methods include various forms of radiotherapy, surgical resection and phototherapy, which are often used in combination. Conjunctival melanomas show many similarities to their cutaneous counterparts, often metastasizing by lymphatic spread. Treatment consists of excision of invasive melanoma with adjunctive radiotherapy and/or cryotherapy and topical chemotherapy for intra-epithelial disease. The management of patients with ocular melanomas demands a good understanding of the pathology of these tumours. Pathological examination of the tumour indicates the prognosis and hence the need for further investigation and treatment. The scope of the pathologist is enhanced thanks to advances in molecular biology.
PubMed: 23960984
DOI: 10.1016/j.sjopt.2012.02.004 -
Eastern Mediterranean Health Journal =... 2003Osteomyelitis, or bone infection, affects all age groups and develops from various sources including haematogenously from distant infection foci, from external sources... (Review)
Review
Osteomyelitis, or bone infection, affects all age groups and develops from various sources including haematogenously from distant infection foci, from external sources such as post-operative or post-traumatic wound infections and from adjoining soft tissue infections. Staphylococcus aureus, Streptococcus pyogenes and Haemophilus influenzae are the most common pathogens of haematogenous osteomyelitis. Aerobic and facultative gram-negative bacteria have emerged as significant pathogens in some types of osteomyelitis while anaerobic bacteria are increasingly recognized as potential pathogens in non-haematogenous osteomyelitis. The emergence of antibiotic resistance is of increasing concern, although improvements in radiologic imaging, antibiotic treatment and heightened awareness have led to earlier detection such that long-term sequelae and morbidity are now primarily due to delays in diagnosis and inadequate treatment.
Topics: Acute Disease; Age Distribution; Amputation, Surgical; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Bacterial Infections; Chronic Disease; Combined Modality Therapy; Debridement; Developing Countries; Diagnosis, Differential; Drug Resistance, Microbial; Humans; Incidence; Morbidity; Osteomyelitis; Recurrence; Risk Factors; Seasons; Sex Distribution; Soft Tissue Infections; Wound Infection
PubMed: 15562753
DOI: No ID Found