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CMAJ : Canadian Medical Association... Dec 2016
Topics: Anti-Bacterial Agents; Diabetic Foot; Humans; Magnetic Resonance Imaging; Orthopedic Procedures; Osteomyelitis; Patient Education as Topic; Radiography; Radionuclide Imaging; Shoes
PubMed: 27754891
DOI: 10.1503/cmaj.160228 -
Journal of Orthopaedic Surgery (Hong... Aug 2016To review the records of 24 paediatric patients treated for acute bacterial osteomyelitis.
PURPOSE
To review the records of 24 paediatric patients treated for acute bacterial osteomyelitis.
METHODS
Records of 14 male and 10 female paediatric patients (mean age, 9.4 years) who underwent medical treatment alone (n=3) or combined with surgery (n=21) for acute bacterial osteomyelitis were reviewed. Medical treatment included use of antibiotics and supportive care. Surgery was indicated when the largest dimension of fluid collection was >1 cm.
RESULTS
Of the 24 patients, Staphylococcus aureus was isolated in 18, group-D salmonella in 3, and no organism in 3. The mean time from admission to diagnosis was 1.87 days. For those treated surgically, the mean time from diagnosis to surgery was 1.19 days and the mean time from admission to surgery was 2.86 days. Four patients underwent multiple surgeries, 2 of whom developed chronic osteomyelitis and also had negative culture and delayed surgery by >10 days previously. No other patient had any complications.
CONCLUSION
Early surgical intervention for acute bacterial osteomyelitis in children increased diagnostic yield with cultures. For patients with fluid collection <1 cm in the largest dimension, medical treatment alone was effective. Patients with complications were characterised by negative culture, multiple surgeries, and delayed surgery.
Topics: Acute Disease; Anti-Bacterial Agents; Child; Combined Modality Therapy; Female; Humans; Male; Osteomyelitis; Retrospective Studies; Salmonella Infections; Staphylococcal Infections
PubMed: 27574272
DOI: 10.1177/1602400225 -
Journal of Infection and Public Health Sep 2021Campylobacter fetus is a rare pathogen in humans. It mainly causes invasive infections in immunosuppressed patients. Herein, we report the first case of cervical... (Review)
Review
Campylobacter fetus is a rare pathogen in humans. It mainly causes invasive infections in immunosuppressed patients. Herein, we report the first case of cervical vertebral osteomyelitis in a previously healthy man with a history of daily alcohol consumption. Treatment was given for six weeks with excellent clinical recovery and normalization of laboratory markers.
Topics: Campylobacter Infections; Campylobacter fetus; Humans; Male; Osteomyelitis
PubMed: 34454173
DOI: 10.1016/j.jiph.2021.08.017 -
Expert Review of Anti-infective Therapy Feb 2010In children, osteomyelitis is primarily hematogenous in origin and acute in nature. The principal cause of osteomyelitis in children is Staphylococcus aureus, and both... (Review)
Review
In children, osteomyelitis is primarily hematogenous in origin and acute in nature. The principal cause of osteomyelitis in children is Staphylococcus aureus, and both the epidemiology and pathogenesis of S. aureus infections, including osteomyelitis, have changed in recent years owing to the emergence of community-associated methicillin-resistant S. aureus. This review focuses on advances in the diagnosis and overall management of acute hematogenous osteomyelitis in children with these changes in mind.
Topics: Acute Disease; Anti-Infective Agents; Child; Humans; Osteomyelitis; Staphylococcal Infections
PubMed: 20109047
DOI: 10.1586/eri.09.130 -
BMC Musculoskeletal Disorders Nov 2017We evaluated treatment of osteomyelitis in the foot in the presence of Charcot neuroarthropathy, a devastating condition with progressive degeneration and joint...
BACKGROUND
We evaluated treatment of osteomyelitis in the foot in the presence of Charcot neuroarthropathy, a devastating condition with progressive degeneration and joint destruction. We hypothesized that there was a difference in (1) amputation rate, (2) amputation level, (3) duration of antibiotic therapy, and (4) duration of immobilization for treatment of osteomyelitis within versus outside the Charcot zone.
METHODS
Forty patients (43 ft) diagnosed with Charcot neuroarthropathy and osteomyelitis of the same foot were retrospectively analyzed. Some patients were successfully treated for osteomyelitis at different sites on the same foot at different times, thus 60 cases of osteomyelitis were identified in 40 treated patients. Cases were divided according to osteomyelitis localization: Group 1 had osteomyelitis outside the active Charcot region; Group 2 had osteomyelitis within the active Charcot region.
RESULTS
Male patients (n = 29; mean age 58.2, range 40.1 to 77.5 years) were younger than female patients (n = 11; mean age 70.4, range 51.4 to 87.5, p = 0.02 years). Amputation rate was 52% overall (26/40 patients; 26/43 ft): 63% of 30 Group 1 cases and 40% of 30 Group 2 cases (p = 0.09). Amputation level (p = 0.009), duration of antibiotic treatment (p = 0.045) and duration of immobilization (p = 0.01) differed significantly between the groups.
CONCLUSIONS
Osteomyelitis within the Charcot region is associated with a higher level of amputation and longer durations of antibiotic therapy and immobilization. Osteomyelitis outside and within the Charcot affected region should be considered separately. If osteomyelitis occurs outside the active Charcot region, primary amputation may be preferred to internal resection.
LEVEL OF EVIDENCE
Retrospective cohort chart review study.
Topics: Adult; Age Factors; Aged; Aged, 80 and over; Amputation, Surgical; Anti-Bacterial Agents; Arthropathy, Neurogenic; Female; Foot; Foot Orthoses; Humans; Male; Middle Aged; Orthopedic Fixation Devices; Osteomyelitis; Patient Compliance; Retrospective Studies; Sex Factors; Time Factors; Treatment Outcome
PubMed: 29145857
DOI: 10.1186/s12891-017-1818-4 -
Frontiers in Immunology 2022Chronic non-bacterial osteomyelitis (CNO) is a rare polygenic autoinflammatory bone disease. We aimed to characterize the clinical manifestations and gene variants of...
OBJECTIVES
Chronic non-bacterial osteomyelitis (CNO) is a rare polygenic autoinflammatory bone disease. We aimed to characterize the clinical manifestations and gene variants of Chinese adult patients with CNO.
METHODS
By reviewing data of all CNO patients being diagnosed and followed up at the Center for Adult Autoinflammation Diseases, Department of Rheumatology, Peking Union Medical College Hospital, clinical and genetic features of these patients were evaluated and concluded.
RESULTS
The median age of disease onset was 19 (6-64) years old, and adult-onset was observed in 6 (60%) patients. The mean time of diagnosis delay was 92 ± 78 months. The common symptoms were bone pain (10, 100%), fever (9, 90%), and arthritis (6, 60%). In total, there were 54 skeletal lesions, and each patient had no less than 2 lesions. The most frequently affected sites included lower limbs (20.5%), mandible, vertebrae and pelvis (17.5%, separately). Variants of 4 genes were detected in our study including , , and . In seven patients who were treated with combination therapy containing tumor necrosis factor (TNF) α inhibitors, five (55.6%) had a complete response and 2 (44.4%) had a partial response.
CONCLUSION
This is the first and largest case series of CNO in the Chinese adult patients. Four novel genetic mutations potentially associated with CNO were identified. Notably, CNO should be considered in the differential diagnosis of adult patients with long disease course and recurrent multifocal osteomyelitis of unknown cause, and these patients might benefit from combination therapy containing TNFα inhibitors.
Topics: Adult; China; Chloride Channels; Graft vs Host Disease; Humans; Mandible; Middle Aged; Osteomyelitis; Remission Induction; Young Adult
PubMed: 35422809
DOI: 10.3389/fimmu.2022.860646 -
Journal of the American Veterinary... Nov 2021To describe signalment, clinical signs, serologic test results, treatment, and outcome of dogs with Coccidioides osteomyelitis (COM) and to compare those findings with...
OBJECTIVE
To describe signalment, clinical signs, serologic test results, treatment, and outcome of dogs with Coccidioides osteomyelitis (COM) and to compare those findings with findings for dogs with osteosarcoma (OSA).
ANIMALS
14 dogs with COM and 16 dogs with OSA.
PROCEDURES
Data were retrospectively gathered from electronic medical records.
RESULTS
Dogs with COM were younger and weighed less than dogs with OSA. Six dogs with COM had appendicular lesions, 5 had axial lesions, and 3 had both appendicular and axial lesions; 9 had monostotic disease, and 5 had polyostotic disease. Axial lesions and nonadjacent polyostotic disease were more common in dogs with COM than in dogs with OSA, but radiographic appearance was not different between the 2 groups. Median IgG titer at diagnosis of COM was 1:48 and was significantly decreased after 6 and 12 months of treatment. Percentage of dogs with COM that had clinical signs was significantly decreased after 1, 3, 6, and 12 months of treatment. One year after initiation of treatment, 9 of 9 dogs were still receiving fluconazole and 8 of 9 dogs had positive results for serum IgG titer testing.
CLINICAL RELEVANCE
Dogs with COM typically had a rapid improvement in clinical signs after initiating treatment with fluconazole but required long-term antifungal treatment. Dogs with COM differed from dogs with OSA, but radiographic features had a great degree of overlap between groups, confounding the ability to make a diagnosis on the basis of diagnostic imaging alone.
Topics: Animals; Bone Neoplasms; Coccidioides; Dog Diseases; Dogs; Osteomyelitis; Osteosarcoma; Retrospective Studies; Treatment Outcome
PubMed: 34780352
DOI: 10.2460/javma.20.12.0696 -
Rheumatology (Oxford, England) Feb 2023Chronic nonbacterial osteomyelitis (CNO) is a rare inflammatory bone disease. The distinct CNO subtype that affects the anterior chest wall is descriptively named... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Chronic nonbacterial osteomyelitis (CNO) is a rare inflammatory bone disease. The distinct CNO subtype that affects the anterior chest wall is descriptively named sternocostoclavicular hyperostosis (SCCH) and mainly occurs in adults. Literature on CNO/SCCH is scattered and lacks diagnostic and therapeutic consensus.
METHODS
Systematic review and meta-analysis aiming to characterize clinical presentation and therapeutic modalities applied in adult CNO/SCCH patients. Untransformed numerical data and double-arcsine transformed proportional data were pooled in a random effects model in R-4.0.5; proportions were reported with 95% CI.
RESULTS
Forty studies were included, containing data on 2030 and 642 patients for aim 1 and 2, respectively. A female predisposition (67%, 95% CI 60, 73) and major diagnostic delay (5 years 95% CI 3, 7) were noted. Clinical presentation included chest pain (89%, 95% CI 79, 96) and swelling (79%, 95% CI 62, 91). Patients suffered from pustulosis palmoplantaris (53%, 95% CI 37, 68), arthritis (24%, 95% CI 11, 39) and acne (8%, 95% CI 4, 13). Inflammatory markers were inconsistently elevated. Autoantibody and HLA-B27 prevalence was normal, and histopathology unspecific. Increased isotope uptake (99%, 95% CI 96, 100) was a consistent imaging finding. Among manifold treatments, pamidronate and biologicals yielded good response in 83%, 95% CI 60, 98 and 56%, 95% CI 26, 85, respectively.
CONCLUSION
CNO/SCCH literature proves heterogeneous regarding diagnostics and treatment. Timely diagnosis is challenging and mainly follows from increased isotope uptake on nuclear examination. Biopsies, autoantibodies and HLA status are non-contributory, and biochemical inflammation only variably detected. Based on reported data, bisphosphonates and biologicals seem reasonably effective, but due to limitations in design and heterogeneity between studies the precise magnitude of their effect is uncertain. Fundamentally, international consensus seems imperative to advance clinical care for CNO/SCCH.
Topics: Adult; Humans; Female; Acquired Hyperostosis Syndrome; Delayed Diagnosis; Osteomyelitis; Psoriasis
PubMed: 35961032
DOI: 10.1093/rheumatology/keac443 -
Tidsskrift For Den Norske Laegeforening... May 2019Osteomyelitis was determined in two patients following radiofrequency turbinoplasty. This is a rare complication of the procedure, and we have found no other case...
BACKGROUND
Osteomyelitis was determined in two patients following radiofrequency turbinoplasty. This is a rare complication of the procedure, and we have found no other case reports concerning osteomyelitis as a specific complication of radiofrequency turbinoplasty.
CASE PRESENTATION
Two patients underwent radiofrequency turbinoplasty. Postoperatively they presented with clinical features such as a faecal smell in the nose, crusting and local necrosis of the inferior turbinates, which led to the clinical and histological diagnosis of osteomyelitis. The infections were polymicrobial, as verified by bacterial growth in the nasal biopsies. They were treated with surgical debridement, local and systemic antibiotics and nasal saline irrigation.
INTERPRETATION
The patients underwent surgery that involved the use of more insertion channels than recommended by the distributor of the surgical equipment, and local anaesthesia included adrenaline. These two factors may well have caused or increased the likelihood of developing osteomyelitis. One patient has an open nose giving rise to no concern after treatment; the other patient has developed empty nose syndrome on the right side. We report these cases in order to raise and aid awareness regarding this possible complication of radiofrequency turbinoplasty.
Topics: Adult; Female; Humans; Male; Middle Aged; Osteomyelitis; Postoperative Complications; Radiofrequency Therapy; Rhinoplasty; Turbinates
PubMed: 31140260
DOI: 10.4045/tidsskr.18.0843 -
American Family Physician Jun 2001Acute osteomyelitis is the clinical term for a new infection in bone. This infection occurs predominantly in children and is often seeded hematogenously. In adults,... (Review)
Review
Acute osteomyelitis is the clinical term for a new infection in bone. This infection occurs predominantly in children and is often seeded hematogenously. In adults, osteomyelitis is usually a subacute or chronic infection that develops secondary to an open injury to bone and surrounding soft tissue. The specific organism isolated in bacterial osteomyelitis is often associated with the age of the patient or a common clinical scenario (i.e., trauma or recent surgery). Staphylococcus aureus is implicated in most patients with acute hematogenous osteomyelitis. Staphylococcus epidermidis, S. aureus, Pseudomonas aeruginosa, Serratia marcescens and Escherichia coli are commonly isolated in patients with chronic osteomyelitis. For optimal results, antibiotic therapy must be started early, with antimicrobial agents administered parenterally for at least four to six weeks. Treatment generally involves evaluation, staging, determination of microbial etiology and susceptibilities, antimicrobial therapy and, if necessary, debridement, dead-space management and stabilization of bone.
Topics: Acute Disease; Adolescent; Adult; Age Distribution; Anti-Bacterial Agents; Child; Humans; Infant; Magnetic Resonance Imaging; Osteomyelitis; Staphylococcus aureus
PubMed: 11430456
DOI: No ID Found