Postmortem submersion interval (PMSI) estimation from the microbiome of sus scrofa bone in a freshwater lake.

While many studies have developed microbial succession-based models for the prediction of postmortem interval (PMI) in terrestrial systems, similar well-replicated long-term decomposition studies are lacking for aquatic systems. Therefore, this study sought to identify temporal changes in bacterial community structure associated with porcine skeletal remains (n = 198) for an extended period in a fresh water lake. Every ca. 250 ADD, one cage, containing 5 ribs and 5 scapulae, was removed from the lake for a total of nineteen collections. Water was also sampled at each interval. Variable region 4 (V4) of 16S rDNA was amplified and sequenced for all collected samples using Illumina MiSeq FGx Sequencing platform; resulting data were analyzed with the mothur (v1.39.5) and R (v3.6.0). Bacterial communities associated with ribs differed significantly from those associated with scapulae. This difference was mainly attributed to Clostridia, Holophagae, and Spirochaete relative abundances. For each bone type, α-diversity increased with ADD; similarly, ß-diversity bacterial community structure changed significantly with ADD and were explained using environmental parameters and inferred functional pathways. Models developed using 24 rib and 34 scapula family-level taxa allowed the prediction of PMSI with root mean square error of 522.97 ADD (~57 days) and 333.8 ADD (~37 days), respectively.

Postmortem submersion interval (PMSI) estimation from the microbiome of Sus scrofa bone in a freshwater river.

Due to inherent differences between terrestrial and aquatic systems, methods for estimating the postmortem interval (PMI) are not directly applicable to remains recovered from water. Recent studies have explored the use of microbial succession for estimating the postmortem submersion interval (PMSI); however, a non-disturbed, highly replicated and long-term aquatic decomposition study in a freshwater river has not been performed. In this study, porcine skeletal remains (N = 200) were submerged in a freshwater river from November 2017-2018 (6322 accumulated degree days (ADD)/353 days) to identify changes and successional patterns in bacterial communities. One cage (e.g., 5 ribs and 5 scapulae) was collected approximately every 250 ADD for twenty-four collections; baseline samples never exposed to water acted as controls. Variable region 4 (V4) of 16S rDNA, was amplified and sequenced via the Illumina MiSeq FGx sequencing platform. Resulting sequences were analyzed using mothur (v1.39.5) and R (v3.6.0). The abundances of bacterial communities differed significantly between sample types. These differences in relative abundance were attributed to Clostridia, Holophagae and Gammaproteobacteria. Phylogenetic diversity increased with ADD for each bone type; comparably, ß-diversity bacterial community structure ordinated chronologically, which was explained with environmental parameters and inferred functional pathways. Models fit using rib samples provided a tighter prediction interval than scapulae, with a prediction of PMSI with root mean square error of within 472.31 (∼27 days) and 498.47 (∼29 days), respectively.

Aspergillus Osteomyelitis of the Scapula: A Case Report.

CASE: A 52-year-old man known for a recent cardiac transplantation presented with 6 weeks of incapacitating left shoulder pain with normal x-rays and CT scans. MRI revealed bone edema of the coracoid and glenoid neck with a supraspinatus abscess. Biopsy of the coracoid demonstrated Aspergillus osteomyelitis of the scapula. CONCLUSION: Aspergillus osteomyelitis is a rare manifestation of invasive aspergillosis and mostly manifests as spondylodiscitis. In this report, we describe a case of Aspergillus osteomyelitis of the scapula treated with combined antifungal therapy and surgery.

[Winged scapula in lyme borreliosis]. / Scapula alata nach Borreliose-Infektion.

Here we present the case of a young patient with one-sided winged scapula and lyme borreliosis. This disease can be very delimitating in daily life. If non-operative treatment fails, dynamic or static stabilization of the scapula can be a therapeutic option.

Cryptococcal osteomyelitis of the scapula and rib in an immunocompetent patient.

Cryptococcal osteomyelitis is extremely rare and almost always occurs in immunocompromised patients. We describe a case of osteomyelitis due to Cryptococcus neoformans involving both scapula and rib in an immunocompetent and previously healthy patient. The patient received treatment with amphotericin B deoxycholate and flucytosine for 4 weeks, followed by oral fluconazole 400 mg per day for 8 weeks and 200 mg per day for 9 months. The 12-month course of antifungal therapy resulted in complete clinical recovery and undetectable serum cryptococcal antigen. Cryptococcal osteomyelitis should be suspected in any immunocompetent patient with osteolytic lesions on radiological images.

Disseminated subcutaneous Nocardia farcinica abscesses in a nephrotic syndrome patient.

We describe an unusual case of disseminated subcutaneous abscesses caused by Nocardia farcinica in a 49-year-old man with nephrotic syndrome. He had received systemic corticosteroid therapy for 5 months. He developed a submandibular abscess associated with sialoadenitis on the right submaxillary gland. Magnetic resonance imaging revealed connection between the submandibular abscess and the right submaxillary gland. The subcutaneous abscess spread from the submandibular triangle to the left axillary region, the left upper arm, the left hypochondriac region, the left scapular region, the right epigastric region, and the bilateral legs. A chest radiograph and computed tomograms of the chest and the brain did not reveal any pathologic changes. The patient was successfully treated by surgical drainage of the abscesses and by oral administration of minocycline.