Bandemia in sickle cell disease: a marker for differentiating osteomyelitis from vaso-occlusive crisis

Find out if bandemia [increase in the absolute band cell count] can differentiate osteomyelitis from vaso-occiusive crisis involving the bones in patients with sickle cell disease. Meaningful cut-off-points in the absolute band count [>/= 1000 and >/= 500] differentiation are also looked at. A retrospective review of records of 50 patients from each category for comparison was performed. Two cut-off-points were considered namely bandemia of >/= 1000 and >/= 500 and these were subjected to analysis. Bandemia [both >/= 1000 and >/= 500] was generally more prominent in cases of osteomyelitis as compared to VOC. There were problems with sensitivity and specificity of bandemia as a single criterion for differentiation between the two entities. Although seemingly we encounter higher counts of band white blood cells in cases of osteomyelitis occurring in patients with SCD as compared to VOC, yet because of low sensitivity in case of >/= 1000 as a cut-off-point and low sensitivity as well as non-specificity in case of >/= 500 as a cut-off-point, bandemia cannot be recommended as single diagnostic criterion

Closed tibial fracture complicated by acute hematogenous osteomyelitis

Osteomyelitis that followed a closed fracture is very rare. Although it has been reported that trivial trauma may be associated with the subsequent development of acute hematogenous osteomyelitis. This case report describes a condition of acute hematogenous osteomyelitis at the site of lower shaft tibial fracture in 58-year-old diabetic woman. The causative microorganism was E. coli

Osteomielite de face em hemofílicos aidéticos: avaliaçäo cintigráfica / Facial osteomyelitis in haemophiliacs aids patients: scintigraphic evaluation

Säo relatados seis casos de osteomielite de face, que surgiram como complicaçäo de sinusite crônica em pacientes hemofílicos aidéticos. A verificaçäo da velocidade de hemossedimentaçäo elevada nestes pacientes levou à suspeita de osteomielite. O diagnóstico foi confirmado pela cintigrafia óssea com 99mTc- MDP positiva. A velocidade de hemossedimentaçäo e os estudos com citrato de 67-Gálio foram obtidos para acompanhar a evoluçäo da terapia. Os resultados sugerem que a cintigrafia com MDP é sensível e específica para detecçäo precoce de osteomielite em sinusite; e os achados com Gálio, valiosos no acompanhamento da infecçäo

Avaliaçäo do estado nutricional em 23 casos consecutivos de crianças com pioartrite e osteomielite / Nutritional status evaluation in 23 consecutive cases of children with septic arthritis and osteomyelitis

Os autores avaliam o estado nutricional de 23 crianças internadas com pioartrite e/ ou osteomielite no Pronto-Socorro de Ortopedia do Hospital das Clinicas da Faculdade de Medicina da Universidade de Säo Paulo no ano de 1987. Os pacientes foram avaliados clínica e laboratorialmente, sendo estudados: peso,altura, perímetro cefálico, perímetro torácico, prega cutânea tricipital, hemoglobinemia, hematócrito e proteínas totais e fraçöes. Essesvalores foram comparados com as tabelas preexistentes padronizadas para o sexo e a faixa etária. Foram estudadas também os parâmetros para o diagnóstico e o tratamento do quadro infeccioso. Colheita de hemoculturas, culturas do material da lesäo e exames bacterioscópicos. Os resultados mostraram que neste grupo de pacientes as crianças näo apresentaram alteraçöes significativas do estado nutricional segundo as faixas etárias e o sexo. Mostraram também que o agente etiológico mais freqüentemente encontrado foi o Staphilococcus aureus e que a localizaçäo predominante foi na articulaçäo do joelho, estando esses dados de acordo com a literatura. Nesta série estudada, näo foi possivel determinar se a desnutriçäo protéico-calórica constituiu fator desencadeante, ou de piora, da poliartrite e/ ou osteomielite

Treatment of fractures complicating haematogenous osteomyelitis by cancellous bone chips graft

Twenty cases of pathological fracture of long bones due to haematogenous osteomyelitis were collected with an average age of 39.4 years. they were treated by sequestrectomy and insertion of cancellous bone chips, in the same operation, then immobilized in a plaster cast. Bony union was obtained in 99% of the cases