Thrombocytopenic Purpura in a 40-year-old Patient with Rothia dentocariosa-associated Endocarditis.

A 40-year-old male patient with a history of dental disease was sent to the emergency room mainly for fever, unclear consciousness, and purpura. Computed tomography reveals subarachnoid hemorrhage and blood analysis reveals platelet reduction. The patient was started daily intravenous piperacillin tazobactam glucocorticoid and gamma globulin. Two weeks later, symptoms improved but still had severe complications such as fever, platelet reduction, hepatosplenic abscess, and severe myocardial injury. Subsequently, Rothia dentocariosa was cultured from the blood samples of patient's limb. The patient was started on daily injections of tigecycline and penicillin. Ten days later, symptoms improved and amikacin was tried, which was later confirmed to be ineffective in this patient. Cardiac ultrasound revealed aortic valve vegetations and magnetic resonance imaging revealed brain abscess formation. Then, antibiotics were adjusted to vancomycin and meropenem. Finally, the patient underwent valve replacement. Infectious endocarditis - after surgery, vancomycin and meropenem were utilized for a week leading to symptom resolution. The patient was transferred to rehabilitation hospital. This case will provide clinical experience for the treatment of R. dentocariosa.

Vertebroplasty with vertebral pedicle screw plus calcium sulfate cement injection treats thoracolumbar vertebrae fractures:report of 28 cases / 第三军医大学学报

Objective To evaluate the clinical efficacy of vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection in the treatment of thoracolumbar vertebrae fractures.Methods Twenty-eight patients with thoracolumbar vertebrae fractures admitted in our department in recent 2 years were enrolled in this study,including 21 cases of type A,3 cases of type B,and 4 cases of type C.All patients were fixed with vertebral pedicle screw,and then verteplasty was performed using calcium sulfate cement injection.Results All patients were followed up for an average time of 16 months.Within the follow-up,there was no complication noted,such as loosening or breakage of internal fixation,chronical lumbar back pain,and loss of effected vertebral height.Artificial bones injected into vertebrae were absorbed in about 3 months.Conclusion Vertebroplasty using vertebral pedicle screw technique combined with calcium sulfate cement injection is an effective and safe procedure for thoracolumbar vertebrae fractures,which renders it possible to bear weight early and to maintain corrected vertebral height postoperatively.