ABSTRACT
Posterior facet arthritis is rarely described. The authors report a case of arthritis of the posterior lumbar facet in a woman consulting for back pain associated with relative functional impairment. Modern imaging, in slices, enables better examination of the posterior arch and better diagnosis of pathologies. Tuberculosis is one of the conditions affecting the posterior lumbar facet, and its characteristics on MRI are well-defined. This case shows that tuberculosis is a not uncommon cause of posterior facet arthritis and should be considered even before the appearance of clinical and bacteriological signs to avoid catastrophic situations for the patient.
Subject(s)
Arthritis, Infectious/microbiology , Tuberculosis, Spinal/diagnostic imaging , Zygapophyseal Joint/microbiology , Adult , Arthritis, Infectious/diagnosis , Burkina Faso , Female , Humans , Low Back Pain/etiology , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Zygapophyseal Joint/diagnostic imagingABSTRACT
The aim of the study was to describe the bacterial microflora of diabetic foot infection and to identify the factors which determine the bacterial spectrum in order to increase empiric antibiotic prescription in Ouagadougou. The study was a cross-sectional one, carried from July 1st, 2011 to June 30, 2012 in the departments of internal medicine and general and digestive surgery in Yalgado Ouédraogo teaching hospital. Samples for bacteriological tests consisted of aspiration of pus through the healthy skin, curettage and swab of the base of the ulceration or tissue biopsy from foot lesions. The bacteria's sensitivity to antibiotics has been tested by the qualitative method (Kirby-Bauer). The frequency of diabetic foot infection was 14.45% and the monthly incidence 5.33. The mean age of patients was 56 years and the sex ratio 1.37. Foot ulcerations were chronic in 33 (51.56%), necrotic in 51 (79.69%) and associated with osteitis in 40 (62.5%) patients. Infection was grade 3 in 70.3% cases. Thirty-nine patients had received antibiotics before hospital admission. Among the 71 samples, 62 (87.32%) cultures were positive: 53 (85.48%) monomicrobial and 9 (14.52%) bimicrobial. Aerobic Gram-positive cocci (76%) were the most frequent from ulcerations: Staphylococcus aureus (32.39%), Streptococcus sp (18.30%). Negative coagulase staphylococci have been found in 23.94% cases. Aerobic gram-negative bacilli have been isolated from 24% ulcerations. No factor was associated with the type of bacteria. Gram-positive pathogen cocci showed a high sensitivity to amoxicillin-clavulanic acid and oxacillin. No methicillin-resistant Staphylococcus aureus (MRSA) or extended-spectrum beta lactamase Enterobacteriaceae (ESBL) have been isolated. A better design is necessary to a clarification of bacterial flora in diabetic foot infections. Prevention of bacterial resistance is also needed.
