scholarly journals An Uncommon Case of Pyogenic Spondylodiscitis Caused by Gemella morbillorum

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Takashi Sono ◽  
Mitsuru Takemoto ◽  
Koh Shinohara ◽  
Yasuhiro Tsuchido
Keyword(s):  
Susceptibility Testing ◽  
Epidural Abscess ◽  
Test Method ◽  
Penicillin G ◽  
Causative Organism ◽  
Resonance Imaging ◽  
Normal Flora ◽  
Pyogenic Spondylodiscitis ◽  
Severe Back Pain ◽  
Uncommon Case

An 81-year-old man presented with severe back pain. Magnetic resonance imaging detected L5/S discitis without signs of epidural abscess. Punctures of the disc revealed that the causative organism was Gemella morbillorum (G. morbillorum), which is part of the normal flora of the oral cavity and an uncommon causative pathogen of spondylodiscitis. The E-test method was useful for rapid susceptibility testing. Intravenous penicillin G treatment was effective, and the patient recovered without surgery.

scholarly journals A disease that is difficult to diagnose and treat: evaluation of 343 spondylodiscitis cases

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110601
Author(s):  
Safak Kaya ◽  
Sehmuz Kaya ◽  
Seyhmus Kavak ◽  
Senol Comoglu
Keyword(s):  
Delayed Diagnosis ◽  
High Rate ◽  
Causative Organism ◽  
Young Population ◽  
Resonance Imaging ◽  
Invasive Procedures ◽  
Radiological Findings ◽  
Pyogenic Spondylodiscitis ◽  
Tuberculous Spondylodiscitis ◽  
Paraspinal Abscess

Objective Spondylodiscitis is an important clinical a problem requiring serious approaches. In this study, we sought to raise awareness by examining the epidemiology and laboratory, clinical, and radiological findings of spondylodiscitis, which sometimes has a delayed diagnosis and which can be difficult to treat. Methods In total, 343 patients with spondylodiscitis were included in the study. Results The patients were classified as having as pyogenic (n = 153, 44.6%), brucellar (n = 138, 40.2%), or tuberculous (n = 52, 15.2%) spondylodiscitis. Meanwhile, 281 patients underwent magnetic resonance imaging, 71 underwent computed tomography, and 17 underwent scintigraphy for diagnosis. The rates of involvement at more than two segments and paraspinal abscess were significantly higher in tuberculous spondylodiscitis. However, disc involvement was significantly more common in brucellar and pyogenic spondylodiscitis. Conclusion The incidence of spondylodiscitis has increased substantially, especially in the young population. The invasive procedures and high rate of culture negativity make the diagnosis difficult. Therefore, clinical and radiological findings are useful in the diagnosis of spondylodiscitis. Despite the high rate of culture negativity, every effort should be made to identify the causative organism using invasive methods.

scholarly journals Impact of Variations in Test Method Parameters onIn VitroActivity of Surotomycin against Clostridium difficile and Surotomycin Quality Control Limits for Broth Microdilution and Agar Dilution Susceptibility Testing

2015 ◽  
Vol 54 (3) ◽  
pp. 749-753 ◽  
Author(s):  
Maria M. Traczewski ◽  
Jennifer Deane ◽  
Daniel Sahm ◽  
Steven D. Brown ◽  
Laurent Chesnel
Keyword(s):  
Quality Control ◽  
Clostridium Difficile ◽  
Calcium Concentration ◽  
Susceptibility Testing ◽  
Test Method ◽  
Test Parameter ◽  
Content Type ◽  
Parameter Variations ◽  
Agar Dilution ◽  
Control Limits

Test parameter variations were evaluated for their effects on surotomycin MICs. Calcium concentration was the only variable that influenced MICs; therefore, 50 μg/ml (standard for lipopeptide testing) is recommended. Quality control ranges forClostridium difficile(0.12 to 1 μg/ml) andEggerthella lenta(broth, 1 to 4 μg/ml; agar, 1 to 8 μg/ml) were approved by the Clinical and Laboratory Standards Institute based on these data.

scholarly journals Rapidly Progressive Spontaneous Spinal Epidural Abscess

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Abdurrahman Aycan ◽  
Ozgür Yusuf Aktas ◽  
Feyza Karagoz Guzey ◽  
Azmi Tufan ◽  
Cihan Isler ◽  
...  
Keyword(s):  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Clinical Findings ◽  
Neurological Deficits ◽  
Spinal Epidural Abscess ◽  
Low Back ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess ◽  
Spinal Epidural

Spinal epidural abscess (SEA) is a rare disease which is often rapidly progressive. Delayed diagnosis of SEA may lead to serious complications and the clinical findings of SEA are generally nonspecific. Paraspinal abscess should be considered in the presence of local low back tenderness, redness, and pain with fever, particularly in children. In case of delayed diagnosis and treatment, SEA may spread to the epidural space and may cause neurological deficits. Magnetic resonance imaging (MRI) remains the method of choice in the diagnosis of SEA. Treatment of SEA often consists of both medical and surgical therapy including drainage with percutaneous entry, corpectomy, and instrumentation.

E-Test or Agar Dilution for Metronidazole Susceptibility Testing of Helicobacter Pylori: Importance of the Prevalence of Metronidazole Resistance

2021 ◽  
Author(s):  
Jinnan Chen ◽  
Yu Huang ◽  
Zhaohui Ding ◽  
Xiao Liang ◽  
Hong Lu
Keyword(s):  
Helicobacter Pylori ◽  
Susceptibility Testing ◽  
Resistance Rate ◽  
Test Method ◽  
Major Error ◽  
Metronidazole Resistance ◽  
Agar Dilution ◽  
H Pylori ◽  
High Level ◽  
Level Resistance

Abstract Background: A number of studies have shown that E-test overestimated the presence of Helicobacter pylori (H. pylori) resistance compared to agar dilution.Objective: The purpose of this study was to explore whether E-test could be an alternative for agar dilution to detect the metronidazole susceptibility of H. pylori.Method: E-test and agar dilution were used to assess susceptibility of H. pylori to metronidazole, clarithromycin and levofloxacin in 281 clinical isolates obtained from China where resistance was high. Cohen kappa analysis, McNemar test, essential and categorical agreement analysis were performed for these two methods. Results: Overall, the result of E-test showed similar prevalence of resistance rate to all antibiotics compared with agar dilution. The essential agreement (EA) of E-test method and agar dilution in the evaluation susceptibility of H. pylori to clarithromycin and levofloxacin were moderate, with 89.0% and 79.7% respectively, but only 45.9% for metronidazole. Results showed categorical agreement (CA) between E-test and agar dilution were 100% for both clarithromycin and levofloxacin. As for metronidazole, the CA was 98.7%, no major error was identified, and rate of very major error was 1.8%.Conclusion: E-test can be an alternative method to detect the metronidazole susceptibility of H. pylori in regions where high-level resistance is common.

Atlantoaxial epidural abscess secondary to grass awn migration in a dog

2014 ◽  
Vol 27 (02) ◽  
pp. 155-158 ◽  
Author(s):  
U. Geissbühler ◽  
P. Karli ◽  
F. Forterre ◽  
E. Linon
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Epidural Abscess ◽  
Cervical Vertebrae ◽  
Clinical Signs ◽  
Resonance Imaging ◽  
Mri Findings ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Grass Awn

SummaryA two-year-old female Lucerne Hound was presented with a one-week history of signs of progressive neck pain, inappetence, apathy, and an elevated rectal temperature. Findings of magnetic resonance imaging (MRI) were consistent with a foreign body abscess in the epidural space at the level of the first and second cervical vertebrae. A leftsided dorso-lateral atlantoaxial approach was performed, revealing an epidural abscess containing a grass awn. The clinical signs resolved within three days of surgery and the dog made a full recovery. This case report shows that grass awns can migrate to the atlantoaxial region in dogs and MRI findings lead to a suspicion of caudo-cranial migration within the spinal canal.

scholarly journals A Rare Case of Thoracic Pyogenic Facet Joint Infection

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Tomoyuki Setoue ◽  
Jun-ichiro Nakamura
Keyword(s):  
Epidural Abscess ◽  
Facet Joint ◽  
Joint Infection ◽  
Severe Infection ◽  
Resonance Imaging ◽  
Decompressive Laminectomy ◽  
Common Complaint ◽  
Neurologic Impairment ◽  
Magnetic Resonance Imaging Mri ◽  
Paraspinal Abscess

Pyogenic facet joint infection is a rare but severe infection. The most common complaint on presentation is pain followed by fever, then neurologic impairment. While the lumbar spine is involved in the vast majority of cases presented in the literature, the case presented here occurred in the thoracic spine. The patient was a 48-year-old immune-competent female who presented with left back pain. Magnetic resonance imaging (MRI) indicated a facet effusion, paraspinal abscess, and epidural abscess in the level of 9th-11th thoracic vertebra. On the 6th day of treatment, she presented a neurological disorder and underwent decompressive laminectomy and surgical debridement. We observed immediate improvement as a result of the surgery.

scholarly journals Spinal epidural abscess

CJEM ◽  
2005 ◽  
Vol 7 (05) ◽  
pp. 351-354 ◽  
Author(s):  
Amy Louis ◽  
Christopher M.B. Fernandes
Keyword(s):  
Spinal Surgery ◽  
Epidural Abscess ◽  
Delayed Diagnosis ◽  
Emergency Department Visits ◽  
Spinal Epidural Abscess ◽  
Intravenous Drug Use ◽  
Resonance Imaging ◽  
Uncommon Condition ◽  
Spinal Epidural ◽  
Distal Site

ABSTRACT Spinal epidural abscess is an uncommon condition. Predisposing factors include spinal surgery, recent trauma, immunosuppression, a distal site of infection and intravenous drug use; however, these are not always present, as illustrated by this case report describing a patient who had repeated emergency department visits and delayed diagnosis that was ultimately confirmed via magnetic resonance imaging.

Binding of Staphylococcus aureus to milk fat globules increases resistance to penicillin-G

1997 ◽  
Vol 64 (2) ◽  
pp. 253-260 ◽  
Author(s):  
TERHI ALI-VEHMAS ◽  
PETER WESTPHALEN ◽  
VESA MYLLYS ◽  
MARKUS SANDHOLM
Keyword(s):  
Staphylococcus Aureus ◽  
Milk Fat ◽  
Susceptibility Testing ◽  
Binding Capacity ◽  
Penicillin G ◽  
Capsule Formation ◽  
Minimal Inhibitory Concentrations ◽  
Fat Globules ◽  
Milk Fat Globules ◽  
Resistance To Penicillin

The susceptibility to penicillin-G of Staphylococcus aureus strains that cause mastitis was tested in milk and in Iso-sensitest broth (ISB). The minimal inhibitory concentrations (MIC) of β-lactamase-positive strains in milk were 10–100-fold those in ISB, whereas the MIC of β-lactamase-negative strains in milk were some 10-fold those in ISB; β-lactamase production was induced by milk in β-lactamase-positive strains. Much of the increase in resistance to penicillin-G caused by milk can be attributed to milk fat globules; the increase in resistance was related to the binding capacity of the bacteria to milk fat globules as well as to capsule formation by the bacteria. It appears that the binding of the staphylococci to the fat globules and bacterial capsule formation resulted in a biofilm type of growth. In this case, the staphylococci behaved differently from the planktonic type of growth in artificial broth medium in which antibiotic susceptibility testing is usually carried out.

scholarly journals Nonspecific pyogenic spondylodiscitis: clinical manifestations, surgical treatment, and outcome in 24 patients

2004 ◽  
Vol 17 (6) ◽  
pp. 1-7 ◽  
Author(s):  
Sascha Mann ◽  
Michael Schütze ◽  
Steffen Sola ◽  
Jürgen Piek
Keyword(s):  
Surgical Treatment ◽  
Spinal Deformity ◽  
Multiorgan Failure ◽  
Vertebral Osteomyelitis ◽  
Clinical Manifestations ◽  
Neurological Deficits ◽  
Causative Organism ◽  
Delay In Diagnosis ◽  
Pyogenic Spondylodiscitis ◽  
Antibiotic Drugs

Object Pyogenic vertebral osteomyelitis is of special interest to neurosurgeons because it often results in acute neurological deterioration and requires a combination of adequate surgical and conservative treatment. The aim of the current study was to evaluate the strategy of a primary surgical approach to this disease. Methods A group of 24 patients with the clinical and radiological signs of acute pyogenic spondylodiscitis was prospectively followed from 1998 to 2004. Of these, 20 had underlying diseases such as diabetes mellitus, chronic alcoholism, and liver cirrhosis. The main causative organism was Staphylococcus aureus. Most infections were localized in the thoracic or lumbar spine (10 cases each); 15 infections were associated with epidural abscesses. Because of a delay in diagnosis, 13 patients presented with neurological deficits on admission. Patients with a complete or rapidly progressing neurological deficit underwent immediate surgery. In patients with minor or no deficits or in a stable neurological condition, surgery was delayed for 3 to 5 days. This group was treated with immobilization and intravenous antibiotic drugs before surgery. Surgical procedures included ventral, dorsal, and combined approaches in one- or two-stage operations. Antibiotic treatment included the use of broad-spectrum antibiotic drugs delivered intravenously for at least 10 days, followed by orally administered antibiotics for 3 months. Twenty patients were independent on follow-up review, 15 with no or minor handicaps. Severe septicemia and multiorgan failure developed in two patients, and these two died of their disease. Major complications were mainly due to long-term antibiotic therapy. Conclusions Surgical treatment is the modality of choice in patients with acute spinal osteomyelitis. It is especially indicated in patients with progressive or severe neurological deficits and spinal deformity. In experienced hands, surgery is safe and offers the advantages of spinal cord decompression, immediate mobilization, and correction of spinal deformity. The decision whether an anterior or posterior approach should be used must be made on an individual basis.

scholarly journals Conus medullaris dermoid tumour. Uncommon presentation of conus medullaris dermoid as an exophytic mass lesion

2017 ◽  
Vol 31 (1) ◽  
pp. 97-100
Author(s):  
Guru Dutta Satyarthee ◽  
Ashwini Kumar ◽  
Luis Rafael Moscote-Salazar
Keyword(s):  
Surgical Intervention ◽  
Conus Medullaris ◽  
Resonance Imaging ◽  
Pertinent Literature ◽  
Lumbosacral Region ◽  
Imaging Evaluation ◽  
Magnetic Resonance Imaging Evaluation ◽  
Uncommon Presentation ◽  
Uncommon Case ◽  
Dermoid Tumour

Abstract Authors report an extremely uncommon case dorsally exophytic conus dermoid in a three-years old boy, who underwent meningocele repair locate at lumbosacral region at an age of one month. The boy presented with low backache and difficulty in passing urine. Magnetic resonance imaging evaluation of spine revealed presence of a large exophytic mass located dorsally in the conus and the features suggestive of dermoid. He underwent surgical intervention during surgery lesion was dorsally exophytic containing cheesy material with hairs, excision of dermoid along capsule was carried our successfully. Pertinent literature and management of exophytic conus dermoid is discussed briefly.

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