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2.
Iatreia ; 34(4): 316-324, oct.-dic. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1350831

ABSTRACT

RESUMEN Introducción: el principal patógeno en las infecciones osteoarticulares es el Staphylococcus aureus, los esquemas de tratamiento recomendados se basan en la literatura estadounidense o europea, no hay datos de estudios locales. El propósito de este estudio es conocer el perfil epidemiológico en las infecciones osteoarticulares del Hospital Infantil San Vicente Fundación (Medellín, Colombia) y las características de los pacientes afectados. Materiales y métodos: revisión retrospectiva de historias de pacientes entre los 0 y 15 años con diagnóstico de infección osteoarticular en el Hospital Infantil San Vicente Fundación, se detallaron las variables demográficas de la patología y los antecedentes relevantes para caracterizar el perfil epidemiológico de las infecciones osteoarticulares. Resultados: identificamos 72 pacientes con infección osteoarticular. La infección más común fue la artritis séptica (40 %), seguida por la osteomielitis aguda (37 %). La cadera (18 %) y la tibia (31 %) fueron la articulación y el hueso afectados con mayor frecuencia. La mayoría de las infecciones fueron secundarias a S. aureus (65 %), de estas fueron por Stafilococo aureus meticilino sensible (SAMS) el 38,9 % y por Stafilococo aureus meticilino resistente (SAMR)el 26,4 %. El tratamiento antibiótico empírico y el tratamiento definitivo se basó en cefalosporinas de primera generación en 83 % y 52,7% de los casos, respectivamente. La principal complicación fue la sepsis en 18 (25 %) pacientes. Conclusiones: se debe tener un alto índice de sospecha, no todos los pacientes se presentan con síntomas o signos típicos. El patógeno principal es el Staphylococcus aureus. En los últimos 10 años ha aumentado la incidencia de las infecciones por SAMR en nuestra institución en relación con estudios previos. Notamos una demora en el diagnóstico y, por ende, en el inicio del tratamiento.


SUMMARY Introduction: The main pathogen in osteoarticular infections is Staphylococcus aureus. The recommended treatment schemes are based on American or European literature, there are no data from local studies. The purpose of this study is to know the epidemiological profile in osteoarticular infections of the San Vicente Fundación children's hospital (Medellín/Colombia) and the characteristics of the affected patients. Materials and methods: Retrospective review of histories of patients between 0 and 15 years old with a diagnosis of osteoarticular infection in the San Vicente Fundación children's hospital detailing demographic variables, pathology and relevant antecedents to characterize the epidemiological profile of osteoarticular infections in the hospital. Results: We identified 72 patients with osteoarticular infection. The most common septic arthritis infection (40%) followed by acute osteomyelitis (37%), the most affected joint was the hip (18%) and the most affected bone was the tibia (31%). The majority of infections were secondary to S. aureus (65%) of which were by SAMS 38.9% and by SAMR 26.4%. Empirical as well as definitive antibiotic treatment was based on first generation cephalosporins 83% and 52.7% respectively. The main complication was sepsis in 18 (25%) patients. Conclusions: There must be a high index of suspicion, not all patients present with typical symptoms and / or signs. The main pathogen Staphylococcus aureushas increased the incidence of MRSA infections in our institution in the last 10 years in relation to previous studies. We note delay in diagnosis and therefore in the start of treatments.


Subject(s)
Humans , Osteomyelitis , Staphylococcus aureus , Arthritis, Infectious , Health Profile
3.
Infectio ; 25(4): 300-302, oct.-dic. 2021.
Article in Spanish | LILACS, COLNAL | ID: biblio-1286727

ABSTRACT

Resumen Caso reporte de una enfermedad infrecuente, aproximadamente 1% de las artritis sépticas son esternoclavicular, con poca respuesta a antibioterapia intravenosa, requiriendo manejo quirúrgico agresivo, el siguiente caso narra la excelente respuesta con el uso de perlas de sulfato de calcio impregnadas con antibióticos, existiendo en la literatura sólo casos reportes sobre su uso.


Abstract Case report of an infrequent disease, approximately 1% of septic arthritis are sternoclavicular, with little response to intravenous antibiotic therapy, requiring ag gressive surgical management, the following case narrates the excellent response with the use of calcium sulfate pearls impregnated with antibiotics, existing in the literature only cases reports on its use.


Subject(s)
Humans , Female , Middle Aged , Osteomyelitis , Calcium Sulfate , Arthritis, Infectious , Disease
4.
Rev. venez. cir. ortop. traumatol ; 53(1): 10-19, jun. 2021. ilus
Article in Spanish | LILACS, LIVECS | ID: biblio-1252872

ABSTRACT

El manejo de pseudoartrosis infectadas, osteomielitis y defectos óseos representa un reto enorme para el cirujano ortopedista. Hace diez años, Masquelet presentó la técnica de inducción de membrana como alternativa al manejo de las complicaciones mencionadas arriba con excelentes tasas de consolidación y erradicación del proceso infeccioso. Estudiamos una de serie de 14 casos, prospectiva, con seguimiento clínico y radiológico mínimo de 2 años (enero 2015-diciembre 2018), donde evaluamos múltiples variables en pacientes a quienes se les realizó el protocolo de Masquelet. Obtuvimos una tasa de consolidación de 85,7% (12/14). Con un tiempo promedio para alcanzarla de 6,1 meses (3-9m). Todos los pacientes que lograron la consolidación se encontraban libres de infección al final del seguimiento. Por su reproducibilidad y alta tasa de consolidación, consideramos la técnica de inducción de membrana, como una excelente opción en el manejo de pseudoartrosis infectadas complejas(AU)


The management of infected nonunions, osteomyelitis, and bone defects represents an enormous challenge for the orthopedic surgeon. Ten years ago, Masquelet presented the membrane induction technique as an alternative to the management of the complications afore mentioned with excellent rates of consolidation and eradication of the infectious process. We prospectively studied a series of 14 cases, with a clinical and radiological follow-up of at least 2 years (january 2015-december 2018). Where we evaluated multiple variables in patients who underwent the Masquelet protocol. We obtained a consolidation rate of 85.7% (12/14). With an average time to reach it of 6.1 months (3-9m). All patients who achieved union were free of infection at the end of follow-up. Due to its reproducibility and high consolidation rate, we consider the membrane induction technique an excellent option in the management of complex infected nonunions(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Osteomyelitis/complications , Pseudarthrosis/complications , Bone Transplantation , Orthopedic Procedures , Bone Diseases , Traumatology
5.
Rev. cuba. estomatol ; 58(1): e2919, ene.-mar. 2021. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1156427

ABSTRACT

Introducción: La osteomielitis mandibular crónica es considerada como una infección odontogénica que cursa con tumefacción de la cara, limitación de la abertura bucal y dolor. Pocas veces es tratada a través de gammagrafías con fijación a ciprofloxacino con la consiguiente obtención de resultados efectivos. Objetivo: Describir un caso clínico de osteomielitis mandibular crónica tratada con terapia antibiótica y quirúrgica. Presentación de caso: Paciente femenina de 63 años de edad que acudió al servicio de estomatología del Hospital María Auxiliadora, Lima, Perú; con un historial de tres meses de hinchazón creciente a nivel del borde inferior izquierdo de la mandíbula desde que le realizaron una extracción dentaria. Los exámenes tomográficos, gammagrafía, biopsia y antibiograma confirmaron la osteomielitis y la susceptibilidad bacteriana. La decorticación, debridamiento, exodoncia y la administración de metronidazol más vancomicina por dos meses permitió la remisión del cuadro. Conclusiones: El seguimiento clínico de dos años y las gammagrafías de evaluación permitieron verificar la presencia de regeneración ósea y ausencia de focos de reactivación. La osteomielitis crónica puede ser provocada por restos de exodoncias dentarias. Su diagnóstico y seguimiento clínico requiere de múltiples exámenes y controles a largo plazo(AU)


Introduction: Chronic mandibular osteomyelitis is considered to be an odontogenic infection manifesting as facial tumefaction, limited mouth opening and pain. It is not often enough treated with ciprofloxacin fixation gammagraphies with the consequent achievement of effective results. Objective: Describe a clinical case of chronic mandibular osteomyelitis treated with antibiotic and surgical therapy. Case presentation: A female 63-year-old patient attends the dental service at María Auxiliadora Hospital in Lima, Peru, with a history of three-months' swelling of the lower left edge of her mandible upon performance of a dental extraction. Tomographic examination, gammagraphy, biopsy and antibiograms confirmed the presence of osteomyelitis and bacterial susceptibility. Decortication, debridement, exodontia and administration of metronidazole plus vancomycin for two months led to remission of the patient's status. Conclusions: Two-year clinical follow-up and evaluation gammagraphies made it possible to verify the presence of bone regeneration and the absence of reactivation foci. Chronic osteomyelitis may be caused by remains of dental exodontias. Its diagnosis and clinical follow-up require a large number of long-term tests and controls(AU)


Subject(s)
Humans , Female , Middle Aged , Osteomyelitis/diagnostic imaging , Surgery, Oral/methods , Vancomycin/therapeutic use , Anti-Bacterial Agents/administration & dosage , Metronidazole/therapeutic use
6.
Infectio ; 25(1): 55-58, ene.-mar. 2021.
Article in Spanish | LILACS, COLNAL | ID: biblio-1154403

ABSTRACT

Resumen La infección del muñón después de amputaciones traumáticas tiene una prevalencia hasta del 34%. Las bacterias más frecuentemente aisladas son Staphylococcus aureus, Enterobacterales como Escherichia coli; Pseudomonas aeruginosa, entre otras. Estas infecciones ocurren por la inoculación directa en el momento del trauma o por gérmenes nosocomiales; la realización de curaciones de las heridas con emplastos vegetales es una práctica aún frecuente en zonas rurales de nuestro país pero su relación con infección del sitio operatorio ha sido poco explorada en la literatura. Leuconostoc spp. es un coco Gram positivo encontrado en territorio agrícola y utilizado en la industria de alimentos. Se presenta un caso de infección de un muñón transfemoral por Leuconostoc, después de una amputación traumática del miembro inferior en una paciente previamente sana con una posible asociación a curaciones con emplastos vegetales.


Abstract Infection of a traumatic amputation stump has a prevalence of 34%. The most common bacteria isolated are Staphylococcus aureus, Pseudomonas aeruginosa and Enterobacterales such as Escherichia coli. These infections occur by direct inoculation in the moment of the trauma or by nosocomial germs. Infections secondary to manipulation of the wounds with vegetable plasters have few case reports in the literature. Leuconostoc spp. is a Gram-positive coccobacillus commonly found in agricultural territory and used in the food industry. There are few case reports in the literature about bone infections by Leuconostocs pp. We present a case of an infection of the operative site of a transfemoral stump by Leuconostoc spp. after a traumatic amputation of the lower limb in a previously healthy patient who had a possible association to cures with vegetable plasters.


Subject(s)
Humans , Female , Adult , Amputation, Traumatic , Infections , Osteomyelitis , Surgical Wound Infection , Review Literature as Topic , Cocos , Leuconostoc
7.
Rev. méd. Minas Gerais ; 31: 31407, 2021.
Article in English, Portuguese | LILACS | ID: biblio-1291382

ABSTRACT

Objetivo: relatar e descrever a evolução satisfatória de uma Angina de Ludwig decorrente de uma infecção amigdaliana, que evoluiu para mediastinite e choque séptico. O trabalho visa detalhar os aspectos clínicos e diagnósticos desta grave doença, além da terapêutica empregada neste caso. Método: as informações foram obtidas do prontuário do paciente, bem como dos laudos dos exames de imagem realizados. A revisão da literatura foi feita na base de dados PUBMED. Considerações finais: o caso estudado relata um raro desfecho favorável de uma Angina de Ludwig que evoluiu para mediastinite, cuja taxa de mortalidade é de até 50% dos casos. A abordagem cirúrgica combinada com antibioticoterapia precoce se mostra ser a melhor conduta para estes casos.


Objective: report and describe the satisfactory evolution of Ludwig's Angina due to a tonsillary infection, which evolved to mediastinitis and sept shock. The work aims to detail the clinical and diagnostic aspects of this serious illness, in addition to the therapy used in this case. Method: the information was obtained from the patient's medical record, as well as from the reports of the imaging tests performed. The literature review was carried out in the PUBMED database. Final considerations: the case studied has great importance for the medical community, since it reports a rare favorable outcome for a case of Ludwig's Angina complicated with an mediastinitis, whose mortality is described up to 50% of the cases. The surgical approach combined with early antibiotic therapy is shown to be the best approach for these cases.


Subject(s)
Humans , Male , Middle Aged , Ludwig's Angina , Mediastinitis , Osteomyelitis , Tonsillitis , Airway Obstruction , Infections , Anti-Bacterial Agents/therapeutic use
8.
Iatreia ; 33(4): 377-382, oct.-dic. 2020. graf
Article in Spanish | LILACS | ID: biblio-1143090

ABSTRACT

RESUMEN La osteomielitis (OM) en el periodo neonatal es una condición rara y trascendental. Su incidencia estimada corresponde al 0,1 de casos por cada 100 admisiones hospitalarias. El subdiagnóstico es frecuente dada la presentación paucisintomática de este grupo etario, que lleva a demoras en el inicio del tratamiento y puede conducir a secuelas permanentes. Presentamos un caso de osteomielitis multifocal con fracturas asociadas, causada por la bacteria Staphylococcus aureus meticilina resistente (SAMR), secundaria a una infección asociada a catéter en un neonato nacido a las 37 semanas de gestación, con antecedente de asfixia perinatal y encefalopatía hipóxica isquémica. El caso debutó con sepsis, edema y artritis, pero el diagnóstico fue confirmado con ultrasonografía y radiografías que evidenciaron múltiples fracturas patológicas. Al no ser candidato para el manejo quirúrgico, se concertó una adecuación del esfuerzo terapéutico dirigiendo el manejo a la terapia antibiótica de amplio espectro y al control del dolor con adecuada respuesta clínica.


SUMMARY Osteomyelitis in the neonatal period is a rare but serious condition. Its estimated incidence corresponds to 0.1 case per 100 hospital admissions. Underdiagnosis is frequent given the paucisymtomatic presentation of this age group, leading to delays in the beginning of treatment and potential permanent sequelae. We present a case of osteomyelitis with associated fractures, caused by meticillin resistant Staphylococcus aureus secondary to catheterrelated bloodstream infection, in a term neonate with history of perinatal asphyxia and hipoxicischaemic encephalopathy. The newborn debuted with sepsis associated with edema and arthritis and the diagnosis was confirmed with ultrasonography and radiographs that showed multiple pathologic fractures. Not being a candidate for surgical management, the therapeutic effort was adapted, directing management to broadspectrum antibiotic therapy and pain control, with adequate clinical response.


Subject(s)
Humans , Infant, Newborn , Infant , Osteomyelitis , Staphylococcus aureus , Fractures, Bone , Methicillin-Resistant Staphylococcus aureus , Bacteria , Fractures, Spontaneous
9.
Rev. Odontol. Araçatuba (Impr.) ; 41(3): 61-64, set./dez. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1121762

ABSTRACT

A displasia cemento-óssea florida (DCOF) é uma condição não neoplásica, esclerosante limitada aos ossos maxilares, relacionada ao osso do processo alveolar e, na maioria dos casos envolvendo bilateralmente a mandíbula. É uma condição rara que se apresenta nos maxilares, de forma autolimitante, evoluindo de um estágio osteolítico para osteoblástico, com prevalência pelo gênero feminino, de meia idade a idosas, melanoderma. Dessa forma, o objetivo do trabalho é relatar o caso clínico de uma paciente portadora de displasia cemento-óssea florida apresentando osteomielite local após exodontia.Paciente de 57 anos de idade, melanoderma, compareceu ao ambulatório do Hospital Manoel Victorino (Salvador, BA) do serviço de Cirurgia e Traumatologia Bucomaxilofacial, referindo histórico de exodontia do dente 47 há aproximadamente 02 anos, sem cicatrização local e presença de supuração e odor fétido. Ao exame intrabucal notou- se a presença fístula na região do dente 47 com secreção purulenta espontânea e presença de tecido necrótico. Ao exame de imagem (radiografia panorâmica), foi observado presença de lesões radiopacas multifocais das áreas posteriores mandibulares. Foi submetida a cirurgia, sob anestesia geral, para curetagem de sequestro ósseo e fechamento primário do defeito por primeira intenção e acompanhamento. O objetivo do trabalho foi relatar um caso clínico de um sequestro ósseo mandibular em uma paciente com displasia cemento- óssea florida(AU)


Flowery cementum-bone dysplasia (DCOF) is a non-neoplastic, sclerosing condition limited to maxillary bones, related to the alveolar process bone and, in most cases, bilaterally involving the mandible. When infected can lead to suppuration and kidnapping, resulting in a picture of osteomyelitis. It is a rare condition that occurs in the jaws, in a selflimiting way, evolving from an osteolytic stage to osteoblastic, with prevalence by the female gender, from middle age to the elderly, melanoderma. Therefore, the aim of this paper is to report a diagnosed case of florid cemento-ousseous dysplasia, presenting local osteomyelitis after a extraction. Patient 57 years old, melanoderma, attended the outpatient clinic of the Hospital Manoel Victorino (Salvador, BA) of the Bucomaxillofacial surgery and traumatology department, referring to a history of the right mandible exodontia for approximately 2 years, without local scarring and presence of odor and suppuration fetid The intraoral examination revealed the presence of a fistula in the region distal to the tooth 47 with spontaneous purulent secretion and necrotic tissue. At the imaging examination (panoramic radiography), the presence of multifocal radiopaque lesions of the mandibular posterior areas was observed. She underwent surgery under general anesthesia for curettage of bone sequestration and primary closure of the defect by first intention and follow-up. The objective of this study was to report a clinical case of a mandibular bone sequestration in a patient with florid cementoosseous dysplasia(AU)


Subject(s)
Cementoma , Cementoma/surgery , Osteomyelitis , Surgery, Oral , Bone Diseases, Developmental , Cementoma/diagnosis , Oral Fistula , Fibrous Dysplasia of Bone
10.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(4): 403-417, dic. 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1351416

ABSTRACT

El tratamiento de la osteomielitis asociada a la falla de la osteosíntesis representa un verdadero desafío para el cirujano ortopédico. El retiro del implante, la limpieza quirúrgica del área afectada y la fijación externa como métodos de estabilidad transitoria, sumados a la administración de antibióticos por vía sistémica son conductas habituales en el manejo inicial de la infección asociada a la falla del implante. No obstante, la suma de estas medidas puede no ser suficiente para controlar completamente el cuadro. El agregado local de cemento con antibiótico permite la liberación continua y sostenida del agente que alcanza una concentración local significativamente más alta que las concentraciones inhibitorias bacterianas mínimas necesarias, a expensas de una menor toxicidad sistémica. Se presentan dos casos de osteomielitis asociada a la falla de la osteosíntesis tratados mediante una nueva síntesis con placa revestida de cemento con antibiótico. Se logró controlar la infección y la consolidación ósea en ambos casos. El resultado funcional fue excelente con un puntaje QuickDASH de 6,3 y 4,5, respectivamente. Nivel de Evidencia: IV


Treatment of osteomyelitis associated with osteosynthesis failure represents a real challenge for the orthopedic surgeon. Implant removal, surgical debridement of the affected area, and external fixation as a temporary stabilization method coupled with antibiotic therapy administered by the systemic route constitute the basis for the initial management of infections associated with implant failure. However, this combined management may prove inadequate to achieve complete control of the infection. The local use of antibiotic-loaded cement allows for maintaining a sustained agent release that reaches significantly higher concentrations than the minimum required bacterial inhibitory concentrations while reducing the associated systemic toxicity. We present two cases of osteomyelitis associated with osteosynthesis failure treated with a second osteosynthesis procedure with an antibiotic cement-coated plate. Infection control and bone union were achieved in both cases. The functional outcome was excellent with Quick-DASH scores of 6.3 and 4.5 points, respectively. Level of Evidence: IV


Subject(s)
Middle Aged , Osteomyelitis , Bone Cements , Internal Fixators/adverse effects , Anti-Bacterial Agents
11.
Rev. cir. traumatol. buco-maxilo-fac ; 20(3): 29-33, jul.-set. 2020. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1253237

ABSTRACT

Introdução: O objetivo do presente estudo é apresentar um caso clínico de osteomielite como complicação de fratura mandibular não tratada. Relato do caso: Paciente de do gênero masculino, 32 anos, compareceu ao serviço de Cirurgia e Traumatologia Bucomaxilofacial relatando ter sido vítima de queda da própria altura após ingestão de bebida alcoólica há mais de dois meses, com queixa de secreção em face. No exame físico observou-se presença de fistula extra oral na região mentual à esquerda com débito ativo de secreção sero purulenta; dor local; febre; limitação de abertura oral; parestesia da região mentual à esquerda, edema significativo e pseudartrose. O exame tomográfico confirmou a presença de fratura cominutiva de mandíbula com sequestro ósseo na região basilar. Optou-se por procedimento cirúrgico sob anestesia geral, com remoção de sequestro ósseo e fixação interna rígida. Considerações finais: Houve boa evolução, com regressão dos sintomas apresentados... (AU)


Introduction: The aim of this study is to present a clinical case of osteomyelitis as a complication of untreated mandibular fracture. Case report: Male patient, 32 years old, attended the service of Buccomaxillofacial Surgery, reporting that he had fallen from his own height after drinking alcohol for more than two months, complaining of secretion in the face. In the physical examination there was presence of extra oral fistula in the left mental region with active discharge of purulent serus secretion; local pain; fever; oral opening limitation; paresthesia of the left mental region, significant swelling and pseudarthrosis. The tomographic examination confirmed the presence of a comminuted mandible fracture with bone sequestration in the basilar region. We opted for surgical procedure under general anesthesia, with removal of bone sequestration and rigid internal fixation. Final considerations: There was a good evolution, with regression of the presented symptoms... (AU)


Subject(s)
Humans , Male , Adult , Osteomyelitis , Surgery, Oral , Mandibular Fractures , Surgical Procedures, Operative , Bone and Bones , Fractures, Bone
12.
Rev. Fac. Med. (Bogotá) ; 68(3): 463-466, July-Sept. 2020.
Article in English | LILACS, COLNAL | ID: biblio-1143736

ABSTRACT

Abstract Introduction: Candida auris is an opportunistic yeast associated with multiple infections, which was first reported in 2009 in Tokyo, Japan. Provided that it has great antifungal resistance to azoles and amphotericin B, its treatment options are limited, and therefore an empiric therapy using echinocandins such as micafungin should be considered. Case presentation: A rare case of a 48-year-old male patient with osteomyelitis caused by C. auris was reported in the city of Popayán, Colombia. The patient had a history of femoral head fracture, paraplegia due to firearm-related injury and neurogenic bladder, and reported having experienced abundant purulent foul-smelling secretions through trochanteric right ulcer for 15 days. MRI images revealed myositis and bone intensity alterations, which allowed diagnosing him with osteomyelitis. Due to repeated isolations of C. haemulonii in several bone samples, antifungal management was initiated. However, since no improvement in the patient's condition was observed, a culture was sent to the Colombian National Institute of Health to identify the pathogen considering the repeated isolations of C. haemulonii and its apparent resistance to antifungals. C. auris was finally confirmed as the pathogen. Conclusion: Osteomyelitis by C. auris is a rare entity, which must be considered when treating patients with predisposing risk factors such as long hospital stays, bearing in mind that this is an inpatient-associated opportunistic infection.


Resumen Introducción. Candida auris es una levadura oportunista asociada a múltiples infecciones que, en 2009, fue descrita por primera vez en Tokio, Japón. Dado que tiene una gran resistencia antifúngica a los azoles y a la anfotericina B, su manejo es limitado, por lo que se debe considerar iniciar un tratamiento empírico con equinocandinas como la micafungina. Presentación de caso. Caso inusual de osteomielitis por C. auris en un hombre de 48 años de Popayán, Colombia, con antecedentes de fractura de cabeza de fémur, paraplejia por herida con arma de fuego y vejiga neurogénica. El paciente tenía cuadro clínico de 15 días de evolución consistente en salida abundante de líquido purulento fétido en úlcera derecha por presión trocantérica. Mediante resonancia magnética se identificaron miositis y alteraciones de intensidad ósea, por lo que fue diagnosticado con osteomielitis. Debido a la identificación de aislamientos repetidos de Candida haemulonii en varias muestras óseas, se inició manejo antifúngico; sin embargo, ya que no se observó ninguna mejora en la condición del paciente, el cultivo fue enviado al Instituto Nacional de Salud para confirmar la identificación del patógeno debido a aislamientos repetidos de C. haemulonii y su aparente resistencia a los antifúngicos. Finalmente, el patógeno identificado fue C. auris. Conclusión. La osteomielitis por C. auris es una entidad inusual cuyo diagnóstico debe ser considerado en pacientes con factores de riesgo predisponente, como aquellos con larga estancia hospitalaria, ya que esta es una infección oportunista asociada a pacientes hospitalizados.


Subject(s)
Humans , Osteomyelitis , Drug Resistance, Fungal , Candida
13.
Rev. Asoc. Argent. Ortop. Traumatol ; 85(2): 157-166, jun. 2020. []
Article in Spanish | LILACS, BINACIS | ID: biblio-1125554

ABSTRACT

Introducción: La vacuna BCG (bacilo de Calmette-Guérin) para prevenir las formas graves de tuberculosis, es la vacuna más difundida en el mundo. Los efectos adversos asociados a la vacunación son poco frecuentes, y la mayoría de ellos ocurren en el sitio de inoculación. Presentamos un caso de osteomielitis de tibia secundaria a la vacuna BCG en un paciente pediátrico inmunocompetente. Conclusiones: El compromiso óseo secundario a la vacuna BCG en pacientes previamente sanos es muy raro. Es importante sospecharlo, para diagnosticarlo y administrar el tratamiento adecuado. Se obtuvieron buenos resultados administrando fármacos antituberculosos, sin necesidad de limpieza quirúrgica. Nivel de Evidencia: IV


Introduction: The Bacillus Calmette-Guérin (BCG) vaccine, used to prevent severe forms of tuberculosis (TB), is the most extensively used vaccine worldwide. Adverse events associated with BCG vaccination are rare, and most of them occur at the inoculation site. We present a tibia Osteomyelitis case secondary to BCG vaccination in an immunocompetent infant. Conclusions: Bone involvement secondary to BCG vaccination in previously healthy patients is extremely rare. Healthcare providers must consider such settings in order to make the diagnosis and institute the appropriate treatment. Antituberculous drugs produced good therapeutic results with no need for surgical toilette. Level of Evidence: IV


Subject(s)
Infant , Osteitis , Osteomyelitis , Tibia , Tuberculosis/therapy , BCG Vaccine/adverse effects
14.
Rev. cient. odontol ; 8(1): e013, ene.-abr. 2020. ilus
Article in Spanish | LILACS, LIPECS | ID: biblio-1095515

ABSTRACT

La osteomielitis focal esclerosante es un cuadro de poca frecuencia ante el cual no existen demasiadas opciones terapéuticas, al margen del tratamiento de conductos del diente afectado. En caso de no encontrarse el diente vital, los tratamientos se reducen y, respecto del hueso afectado, no existen evidencias científicas sobre la colocación de implantes. Presentamos un caso clínico en el que se maneja este cuadro eliminando el hueso y regenerándolo con PRGF-Endoret®, para colocar posteriormente un implante dental. (AU)


Focal sclerosing osteomyelitis is a rare condition with few therapeutic options other than root canal treatment of the affected tooth. If the tooth is not vital, the treatments are reduced, and there is little scientific evidence of the benefits of the placement of implants in the affected bone. We present a clinical case in which this condition is managed by removing the affected bone, regenerating it with PRGF-Endoret® and subsequently placing a dental implant in the treated area. (AU)


Subject(s)
Humans , Female , Adult , Osteomyelitis , Dental Implantation
15.
Arq. bras. med. vet. zootec. (Online) ; 72(2): 317-322, Mar./Apr. 2020. ilus
Article in English | ID: biblio-1128169

ABSTRACT

A 10-year-old male mixed-breed dog was admitted for recurrent signs of urinary tract infection (UTI). Urinary bladder ultrasonography revealed decreased thickness of its wall with floating hyperopic particles within its lumen. Ultrasonography revealed a structure invading the dorsal wall of the penile urethral lumen, located in a segment distal to the bladder. Radiographies showed bone resorption with proliferation at the caudal aspect of the penile bone, stricture of the final aspect of the penile urethra, and no radiopaque images compatible with a urethrolith. Computed tomography showed bone proliferation causing stricture of the urethral lumen at two different sites. Presumptive diagnosis of penile neoplasia was considered more likely and the dog underwent penectomy along with orchiectomy and scrotal urethrostomy. Enterobacter spp. was cultured from the urine sample and antibiotic sensitivity tests revealed that the bacterium was susceptible to amikacin, imipenem, and meropenem. Histopathology revealed severe suppurative urethritis, bone resorption, and hyperostosis, suggestive of osteomyelitis of the penile bone. Neoplastic cells were not observed at any part of the examined tissue. The findings in the present case suggest that osteomyelitis of the penile bone should be included in differential diagnosis for partial and complete urethral obstruction in dogs with recurrent UTI.(AU)


Um cão mestiço, com 10 anos, foi admitido por sinais recorrentes de infecção do trato urinário (ITU). A ultrassonografia da bexiga urinária revelou diminuição da espessura de sua parede com partículas flutuantes dentro de seu lúmen. A ultrassonografia demonstrou estrutura invadindo a parede dorsal do lúmen da uretra peniana, localizada em segmento distal à bexiga. Radiografias evidenciaram reabsorção óssea com proliferação no aspecto caudal do osso peniano, estenose do aspecto final da uretra peniana e ausência de imagens radiopacas compatíveis com uretrólito. Pela tomografia computadorizada, observou-se proliferação óssea causando estreitamento da luz uretral em dois locais diferentes. Diagnóstico presuntivo de neoplasia peniana foi considerado mais provável e o cão foi submetido à penectomia, juntamente com orquiectomia e uretrostomia escrotal. Enterobacter spp. foi cultivada da amostra de urina e testes de sensibilidade revelaram susceptibilidade ao amicacina, imipenem e ao meropenem. A histopatologia revelou uretrite supurativa grave, reabsorção óssea e hiperostose compatível com osteomielite do osso peniano. Células neoplásicas não foram observadas em nenhuma parte do tecido examinado. Os achados do presente caso sugerem que a osteomielite do osso peniano deve ser incluída no diagnóstico diferencial de obstrução uretral parcial e completa em cães com ITU recorrente.(AU)


Subject(s)
Animals , Male , Dogs , Osteomyelitis/veterinary , Penis , Urethritis/veterinary , Urinary Tract Infections/veterinary , Enterobacter , Bone and Bones , Bone Resorption , Tomography, X-Ray Computed
17.
Rev. habanera cienc. méd ; 19(1): 92-101, ene.-feb. 2020. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1099148

ABSTRACT

Introducción: La osteomielitis es la infección de estructuras óseas ya sea por inoculación directa a través de heridas, por vía hematógena a través de focos distantes o por contigüidad con estructuras vecinas como los oídos. Objetivo: Reportar un caso que demuestra la necesidad de seguimiento de las otitis medias con vistas a evitar recurrencias y complicaciones. Presentación del Caso: Paciente femenina, de 62 años de edad, tez blanca y ama de casa de la localidad de Baracoa, provincia Guantánamo, Cuba. Con antecedentes de otitis de un año de evolución que desarrolló osteomielitis crónica cervical y un cuadro neurológico caracterizado por cuadriparesia y dificultad para la acción asociado a la osteomielitis cervical. Se trató con vancomicina y levofloxacino durante 6 semanas y oxigenación hiperbárica con lo cual egresó totalmente rehabilitada. Conclusiones: El manejo inadecuado de la otitis puede desencadenar complicaciones graves y poco frecuentes como la osteomielitis cervical tal y como se presenta en este caso(AU)


Introduction: Osteomyelitis is the infection of the osseous structures associated with the direct inoculation of microorganisms through wounds, hematogenous route from distant focus of infection or the contiguity with neighboring structures like the ears. Objective: The aim of this paper is to demonstrate the need for medical follow-up of otitis media in order to avoid recurrence and complications of this disease. Case presentation: Sixty-two-year-old white woman, housewife, from Baracoa, Guantanamo Province, Cuba. The patient had antecedents of one-year history of otitis media. She developed cervical chronic osteomyelitis and a neurological picture that was characterized by quadriparesis and difficulty to carry out actions, which was associated with cervical osteomyelitis. She was treated with Vancomycin and Levofloxacin during 6 months and hyperbaric oxygenation that helped her to be totally recovered after discharge from hospital. Conclusions: Inadequate treatment of otitis can cause very serious and less frequent complications such as cervical osteomyelitis, as it is presented in this case(AU)


Subject(s)
Humans , Female , Middle Aged , Osteomyelitis/complications , Otitis Media/complications , Osteomyelitis/drug therapy
18.
Arq. bras. med. vet. zootec. (Online) ; 72(1): 87-92, Jan.-Feb. 2020. ilus
Article in English | ID: biblio-1088928

ABSTRACT

Chronic septic bone nonunion requires a well-designed therapeutic planning, demanding a multimodal treatment to achieve bone consolidation and elimination of infection. A successful case of an association of the major omentum flap with surgical stabilization with an interlocking nail for treatment of a femoral septic nonunion in dog is reported. The patient had partial functional return of the limb 30 days after surgery, negative bacterial culture with radiographic signs of bone healing and total functional return of the limb at 90th days after the surgical procedure.(AU)


Não uniões ósseas associadas à osteomielite crônica necessitam de um planejamento terapêutico muito bem realizado, demandando tratamento multimodal para conseguir atingir a consolidação óssea e eliminar a infecção. Relatou-se um caso de sucesso do uso da associação de retalho do omento maior com estabilização cirúrgica com haste intramedular bloqueada para tratamento de uma não união séptica de fêmur em cão. O paciente apresentou retorno funcional parcial do membro com 30 dias após a cirurgia, cultura bacteriana estéril com sinais radiográficos de consolidação óssea e retorno funcional total do membro aos 90 dias de pós-operatório.(AU)


Subject(s)
Animals , Dogs , Omentum/transplantation , Osteomyelitis/veterinary , Transplantation, Autologous/veterinary , Fracture Fixation, Intramedullary
19.
Rev. Soc. Bras. Med. Trop ; 53: e20190328, 2020. graf
Article in English | LILACS | ID: biblio-1057298

ABSTRACT

Abstract Rat-bite fever is a rarely diagnosed illness caused by Streptobacillus moniliformis . Although this disease is distributed worldwide, there have been few cases reported in Europe. Here, we report a case of vertebral osteomyelitis and sternoclavicular septic arthritis caused by S. moniliformis in a Portuguese patient previously bitten by a rat. Laboratory diagnosis was performed using molecular identification. This is the first case report of rat-bite fever in Portugal. The case described here serves as a reminder for physicians to consider this diagnosis in patients who have developed fever syndromes after being in contact with rodents.


Subject(s)
Humans , Animals , Male , Female , Aged , Rats , Osteomyelitis/etiology , Rat-Bite Fever/complications , Sternoclavicular Joint/diagnostic imaging , Bites and Stings/complications , Arthritis, Infectious/etiology , Lumbar Vertebrae/diagnostic imaging , Osteomyelitis/diagnostic imaging , Rat-Bite Fever/diagnosis , Magnetic Resonance Imaging , Arthritis, Infectious/diagnostic imaging
20.
Artrosc. (B. Aires) ; 27(2): 64-68, 2020.
Article in Spanish | LILACS, BINACIS | ID: biblio-1118219

ABSTRACT

La infección osteoarticular por microorganismos anaerobios es infrecuente, siendo la infección por fusobacterium nucleatum en niños muy rara. Se presenta el caso de un varón de 4 años que consulta por dolor, limitación funcional, y signos inflamatorios locales en la rodilla derecha de 1 mes de evolución, con ausencia de fiebre y sin antecedente traumático previo. Las pruebas de imagen objetivan una lesión lítica en cóndilo femoral externo con una colección en el espacio articular. Con el diagnóstico de osteomielitis en cóndilo femoral externo y artritis séptica de rodilla, se realizaron dos artroscopias consecutivas para desbridamiento articular y curetaje de la lesión. Se instauró terapia antibiótica intravenosa empírica y posteriormente específica tras el aislamiento de fusobacterium nucleatum. Fue necesario la identificación microbiológica mediante PCR universal 16S r ARN, ante la negatividad repetida de los cultivos.Tras 8 años de seguimiento el niño no presenta signos de infección local, las imágenes radiológicas del defecto osteocondral han mejorado y a la exploración muestra una correcta movilidad realizando una vida normal, incluso actividad deportiva. Tipo de Trabajo: Reporte de Caso. Nivel Evidencia: V


Osteoarticular infection by anaerobic microorganisms is infrequent in children, specially caused by Fusobacterium Nucleatum.A 4-year-old male patient that consults for pain, functional limitation and local inflammatory signs on the right knee, without fever for a 1-month, and no history of trauma. The radiological images showed a lytic lesion in the external femoral condyle with a collection in the joint space. After the diagnosis of osteomyelitis in external femoral condyle and septic arthritis of the knee, two consecutive arthroscopies were carried out for joint debridement and curettage of the lesion.Previously the isolation of fusobacterium nucleatum an empirical intravenous antibiotic therapy was instituted. Microbiological identification by 16S rRNA universal PCR was necessary in view of the repeated negativity of the cultures. Once the diagnosis is carried out, a more specific antibiotic treatment could be administered. After 8 years of follow-up, the child showed no signs of local infection, the radiological images of the osteochondral defect had improved. On physical examination the child presented a correct mobility leading a normal life and even doing sport. Type of Study: Case report. Level of Evidence: V


Subject(s)
Child, Preschool , Osteomyelitis/surgery , Arthroscopy/methods , Arthritis, Infectious/surgery , Fusobacterium nucleatum , Knee Joint/pathology , Follow-Up Studies , Treatment Outcome
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