A Taxonomically Unique Acinetobacter Strain with Proteolytic and Hemolytic Activities Recovered from a Patient with a Soft Tissue Injury

A taxonomically unique bacterial strain,Acinetobactersp. A47, has been recovered from several soft tissue samples from a patient undergoing reconstructive surgery owing to a traumatic amputation. The results of 16S rRNA,rpoB, andgyrBgene comparative sequence analyses showed that A47 does not belong to any of the hitherto-known taxa and may represent an as-yet-unknownAcinetobacterspecies. The recognition of this novel organism contributes to our knowledge of the taxonomic complexity underlying infections caused byAcinetobacter.

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Magnetic resonance imaging evaluation of the cervical spine in the comatose or obtunded trauma patient

Journal of Neurosurgery Spine ◽

10.3171/spi.1999.91.1.0054 ◽

1999 ◽

Vol 91 (1) ◽

pp. 54-59 ◽

Cited By ~ 18

Author(s):

Mark D. D'Alise ◽

Edward C. Benzel ◽

Blaine L. Hart

Keyword(s):

Cervical Spine ◽

Soft Tissue ◽

Mr Imaging ◽

Trauma Patient ◽

Cervical Spine Injury ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Spine Injury ◽

Content Type ◽

Fine Print

Object. Confirmation of cervical spine stability is difficult to obtain in the comatose or obtunded trauma patient. Concurrent therapies such as endotracheal intubation and the application of rigid cervical collars diminish the utility of plain radiographs. Bony as well as supportive soft-tissue structures must be evaluated before the cervical spine can be determined to be uninjured. Although major injuries to extradural soft-tissue structures in the awake trauma patient are frequently excluded by physical examination, when the patient is obtunded the physical examination may be unreliable. Therefore, an enhanced diagnostic method for the evaluation of soft-tissue injury is desirable. The authors conducted a study in which magnetic resonance (MR) imaging was used as such a method to assess posttraumatic spinal stability in the comatose or obtunded patient. Methods. Early, limited (sagittal T1- and T2-weighted) MR imaging was performed posttruama in 121 patients to assess soft-tissue injury. In all patients the mechanism of injury potentially could be associated with cervical spine instability, and each patient was endotracheally intubated because of head injury or severe multisystem injuries. All patients underwent imaging studies within 48 hours of injury and were either treated or cleared and spinal precautions were discontinued. Patients were excluded from this study if they had an obvious cervical spine injury identified on the initial radiographic studies or if they were determined to be too medically unstable to undergo MR imaging within the acute period (<48 hours postinjury). Thirty-one (25.6%) of the 121 patients were found to have sustained significant injury to the paravertebral ligamentous structures, the disc interspace, or the bony cervical spine. These injuries were undetected by plain radiography. The other 90 patients (74.4%) were determined within 48 hours not to have sustained a soft-tissue injury. Eight patients (6.6%) ultimately underwent surgery to treat the cervical spine injury, and MR imaging was the first test that identified the injury in each of these patients. There were no complications related to imaging procedures. Conclusions. Sagittal T1- and T2-weighted MR imaging appears to be a safe, reliable method for evaluating the cervical spine for nonapparent injury in comatose or obtunded trauma patients. In the early postinjury period, nursing and medical care are thereby facilitated for patients in whom occult injury to the spine is ruled out and for whom those attendant precautions are unnecessary.

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Reactivation of Q fever: case report of osteoarticular infection developing at the site of a soft tissue injury

Access Microbiology ◽

10.1099/acmi.0.000296 ◽

2021 ◽

Vol 3 (12) ◽

Author(s):

Genevieve L. McKew ◽

Thomas Gottlieb

Keyword(s):

Soft Tissue ◽

Type Species ◽

Q Fever ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Adductor Muscle ◽

Serological Response ◽

Positive Skin ◽

Content Type ◽

Link Type

Coxiella burnetii , the causative agent of Q fever, is known to cause acute and persistent infection, but reactivation of infection is rarely reported. This case demonstrates reactivation of a distant, untreated Q fever infection after a relatively innocuous soft tissue injury in an adjacent joint without pre-existing pathology. A 52-year-old male abbatoir worker sustained an adductor muscle tear in a workplace injury. He was unable to walk thereafter, and developed a chronic, progressive, destructive septic arthritis of the adjacent hip with surrounding osteomyelitis of the femur and acetabulum. He had evidence of prior Q fever infection, with a positive skin test and serology 15 years beforehand. He was diagnosed with chronic osteoarticular Q fever on the basis of markedly elevated phase I antibodies, and symptomatic and serological response to prolonged antibiotic treatment with doxycycline and hydroxychloroquine. He required a two-stage hip arthroplasty. This case illustrates reactivation of latent C. burnetii infection at the site of a soft tissue injury. Clinicians need to be aware of this possibility in patients with previous Q fever infection, and in the setting of undiagnosed osteoarticular pathology following soft tissue injury.

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TECHNIQUE AND INDICATION OF DISTAL ARTERIAL-TO-PROXIMAL VENOUS ANASTOMOSIS AT AN AMPUTATED DISTAL PHALANX

Hand Surgery ◽

10.1142/s021881041272015x ◽

2012 ◽

Vol 17 (01) ◽

pp. 135-137 ◽

Cited By ~ 1

Author(s):

Truong Quang Vu Phan ◽

Weiguo Xu ◽

Gerald Spilker ◽

Christian Weinand

Keyword(s):

Soft Tissue ◽

Reconstructive Surgery ◽

Tissue Injury ◽

Soft Tissue Injury ◽

Distal Phalanx ◽

Venous Reflux ◽

Venous Anastomosis ◽

Finger Amputation ◽

Distal Artery

Digital finger amputation with soft tissue injury is a frequent accident in Reconstructive Surgery. Several techniques about reconstruction of digital finger amputation are described in literature. However replantation is difficult when large segments of the arteries are missing. This is especially true for distal finger phalanx amputations, where replantation is done in selected patients such as artists or musicians. In this article a microsurgical replantation techniques of a distal artery and proximal vein anastomosis is presented in a distal phalanx amputation, which successfully solved the problem of venous reflux without venous anastomosis.

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