Salmonella Typhi sternoclavicular abscess with osteomyelitis-a rare case report.

Salmonella Typhi osteomyelitis is a rare occurrence as compared to enteric fever and diarrhoea which are common manifestations caused by this microorganism. In reported cases of Salmonella osteomyelitis, commonly involved sites are long bones like the femur and humerus. Uncommon reports of Salmonella osteomyelitis from sites such as radius, ulna, tibia and vertebrae have also emerged. Extremely rare incidences of the same have been reported from the clavicle, skull and small bones of hands. Osteomyelitis could be bacterial or non-bacterial, and among bacterial osteomyelitis, Salmonella Typhi is a very rare entity. We present a case of Salmonella osteomyelitis and discuss the importance of microbiological diagnosis of osteomyelitis in diagnosing unusual pathogens from unusual sites. This case report is unique due to its site and difference in clinical presentation. The difference in presentation in an elderly immunocompetent male with no major comorbidities was different from other reported cases. Our patient was successfully managed with surgical debridement followed by a series of vacuum dressings and intravenous antibiotics for 6 weeks.

Reprocessing of N95 masks: Experience from a resource-limited setting in India.

OBJECTIVES: Due to the surge in demand for N95 masks during the Covid-19 pandemic, and considering the situation in countries grappling with acute shortages of N95 masks, this study investigated the possibilities of decontamination and reuse of masks. METHODS: Three N95 masks of different makes (A, B and C) were subjected to six decontamination methods: ultraviolet (UV) irradiation, isopropyl alcohol (IPA) dip, plasma sterilization (Sterrad®), ethylene oxide (ETO, 3M®), dry heat sterilization, and moist heat sterilization (autoclaving). The integrity of the N95 masks was assessed by measuring their particle filtering efficiency at particle sizes ranging 0.3-0.5 microns. RESULTS: All the masks decontaminated with ETO and plasma sterilization retained over 95% particle filtering efficiency. Masks decontaminated using IPA dip and autoclaving showed a drop, and UV irradiation showed variations in particle size efficiency degradation after decontamination. CONCLUSIONS: Plasma sterilization is recommended for decontamination of N95 masks in low-resource settings. ETO is not recommended due to hazards associated with handling of ethylene oxide, although the filtering efficiency was retained. Since the UV irradiation method showed variations in results, evaluation of UV decontamination for N95 masks needs to be performed on a case-by-case basis.