scholarly journals Sclerosing osteomyelitis of Garré: A confusing clinical diagnosis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901987470
Author(s):  
Seungcheol Song ◽  
Hwa Jae Jeong ◽  
Hun-Kyu Shin ◽  
Eegene Kim ◽  
Se-Jin Park ◽  
...  
Keyword(s):  
Proximal Femur ◽  
Chronic Osteomyelitis ◽  
Magnetic Resonance Images ◽  
Thigh Pain ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Lower Back ◽  
Erythrocyte Sedimentation ◽  
The Right

We describe a rare case of sclerosing osteomyelitis of Garré in a 63-year-old woman with uncontrolled right thigh pain. She had suffered from lower back pain and radiating pain on the right lower leg for a year and 4 months and so had spine surgery 8 months ago. But the right thigh pain persisted, and the levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) remained abnormal. Right femur radiographs showed cortical thickening on the proximal femur. Magnetic resonance images showed T2 hypersignal intensity lesions in the proximal femur. Under suspicion of osteoid osteoma or sclerosing osteomyelitis, surgery was performed with biopsy, bone curettage, and drilling. The culture was negative, and the biopsy showed chronic osteomyelitis. Despite surgery, the levels of CRP and ESR still remained abnormal. After using venous antibiotics, the pain subsided and CRP and ESR levels turned to normal. Followed by 6 weeks of oral antibiotics, pain was relieved after 1-year follow-up.

scholarly journals One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

2017 ◽  
Vol 11 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Tao Zhang ◽  
Lihua Ma ◽  
Xu Lan ◽  
Ping Zhen ◽  
Shiyong Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Bone Grafting ◽  
Oswestry Disability Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
One Stage ◽  
Erythrocyte Sedimentation

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis.</p></sec><sec><title>Overview of Literature</title><p>There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery.</p></sec><sec><title>Results</title><p>All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.</p></sec>

scholarly journals Recurrent Empyema Thoracic Secondary to Pulmonary Nocardiosis in Immunocompetent Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Samshol Sukahri ◽  
Lily Diana Zainudin ◽  
Mohd Firdaus Hadi ◽  
Mohd Al-Baqlish Mohd Firdaus ◽  
Muhammad Imran Abdul Hafidz
Keyword(s):  
Vital Signs ◽  
C Reactive Protein ◽  
Nocardia Species ◽  
X Ray ◽  
Reactive Protein ◽  
Pulmonary Nocardiosis ◽  
Erythrocyte Sedimentation ◽  
Chest X Ray ◽  
The Right ◽  
Tomography Scan

Pulmonary nocardiosis is a rare disorder that mainly affects immune-compromised patients. We report a 37-year-old male who presented with persistent fever associated with productive cough. During this course of therapy, he had recurrent admissions for empyema thoracic. Clinically, his vital signs were normal. Blood investigations show leukocytosis with a significantly raised erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP). Sputum acid-fast bacilli (AFB) was scanty 1+ and sputum mycobacterium culture was negative. Chest X-ray (CXR) showed consolidative changes with mild to moderate pleural effusion on the right side. Skin biopsy was taken and showed Paecilomyces species. A computed tomography scan (CT thorax) was performed and revealed a multiloculated collection within the right hemithorax with a split pleura sign. Decortications were performed and tissue culture and sensitivity (C+S) growth of Nocardia species. And it is sensitive to sulfamethoxazole-trimethoprim and completed treatment for 4 months. This case highlights that pulmonary nocardiosis should be kept in mind in also immune-competent patients, especially in suspected cases of tuberculosis not responding to antitubercular therapy.

scholarly journals 1249. Images vs. C-Reactive Protein Follow-up of Patients with Organ/space Surgical Site Infections

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S449-S449
Author(s):  
Natalia Garcia Allende ◽  
Cristina Freuler ◽  
Ana Victoria Sanchez ◽  
Cecilia Ezcurra ◽  
Micaela Mayer Wolf ◽  
...  
Keyword(s):  
Imaging Study ◽  
Surgical Site Infections ◽  
Antimicrobial Treatment ◽  
Average Score ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
End Of Treatment ◽  
Intra Abdominal Infection

Abstract Background End-of-treatment images of infections after intra-abdominal infection could increase costs. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are used to define and predict the evolution of infectious diseases. The aim of this study was to describe clinical outcomes of adult patients with end-of-treatment images or CRP and ESR follow-up, during treatment of organ/space (OS) (intra-abdominal) surgical site infection (SSI). Methods Observational retrospective cohort. Hospitalized patients older than 16 years were included, who developed OS SSI after abdominal surgery, in a general hospital, from June 2014 to June 2018. Population variables: age, gender, comorbidities (cancer, diabetes mellitus, cirrhosis, chronic renal failure, tobacco, immunosuppressants, Charlson score and obesity), ESR, quantitative CRP, imaging study (tomography (CT)/ ultrasound), type of drainage route (surgical, percutaneous). Outcomes variables: antibiotic patient-days, time to infection (TTI), CRP and ESR at the time of diagnosis (TD) and at the end of treatment (TET), rate of relapsing infection. Statistical analysis: Description of variables sort by patients under images follow-up and patients under CRP and ESR follow-up. Fisher test of relapsing infection was calculated between groups. Results Included: 76 patients. Twenty-six were followed with CT or ultrasound and 50 were followed with CRP and ESR. Forty women, with a mean age of 55 years (19–91) and an average score of the Charlson of 3.64 (0–10). Forty patients had cancer before surgery (52.63%). Microbiological diagnosis: 70/76 patients, the majority was polymicrobial. Average of antibiotics patient-days was 24.4 days (14 days of intravenous therapy). TTI: 8.65 days. Average CRP at the TD was 87.5 mg/L and 17.5 mg/L at TET. No differences in ESR values (31.9 mm to 33.5 mm). Percutaneous drainage: 46 patients. Surgical procedure: 27. Relapsing infection: 11,5% in images group vs. 4% in no images group; P = 0.33. Conclusion Quantitative CRP monitoring was useful to guide the duration of antimicrobial treatment. No differences of relapsing infection between groups was found. Disclosures All authors: No reported disclosures.

scholarly journals An assessment of the C-reactive protein, erythrocyte sedimentation rate and white blood cell count, values during the post-operative period of infected tibial nonunions treated with antibiotic- loaded PMMA-coated nails

2021 ◽  
Vol 7 (3) ◽  
pp. 644
Author(s):  
Ferdi Dırvar ◽  
Raşit Özcafer ◽  
Kubilay Beng
Keyword(s):  
Blood Cell ◽  
Cell Count ◽  
Sedimentation Rate ◽  
Postoperative Period ◽  
C Reactive Protein ◽  
Blood Cell Count ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Significant Difference

<p>In this study, our aim was to assess the changes in the serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC) values during the follow-up period of infected tibial pseudoarthrosis treated using antibiotic-loaded nails. Three patients with infected femoral nonunions and 11 patients with infected tibial nonunions were included in the study. All patients were treated with intramedullary nails coated with antibiotic-loaded PMMA after local extensive debridement. Postoperatively, parenteral antibiotic therapy was administered. The CRP, ESR and WBC values were noted preoperatively and on the first day, and then on the second, sixth, and 12<sup>th</sup> weeks postoperatively. The changes in these values over time were analyzed comparatively. The preoperative CRP level was found to be significantly lower than the early postoperative period (1<sup>st</sup> day), while no significant differences were detected during the follow-up period. The CRP level constantly decreased between the first postoperative control (1<sup>st</sup> day) and the final follow-up time (12<sup>th</sup> week). The postoperative ESR showed a significant difference when compared to the preoperative value, and also showed a decreasing trend in the postoperative period, having its highest value on the first day. The WBC did not exhibit a significant difference when comparing the preoperative and postoperative values. C-reactive protein level and ESR can be used to monitor the adequacy of the treatment after antibiotic-loaded nail application, whereas WBC may be insufficient in the diagnosis and follow-up of osteomyelitis treated with antibiotic-loaded nails.</p>

Low-Field MR Imaging for the Assessment of Therapy Response in Musculoskeletal Infections

1995 ◽  
Vol 36 (3) ◽  
pp. 220-227 ◽  
Author(s):  
I. Hovi ◽  
M. Valtonen ◽  
O. Korhola ◽  
P. Hekali
Keyword(s):  
Mr Imaging ◽  
Therapy Response ◽  
C Reactive Protein ◽  
Musculoskeletal Infection ◽  
Reactive Protein ◽  
Low Field ◽  
Erythrocyte Sedimentation ◽  
Follow Up Studies ◽  
Wbc Count

Fifty-one patients with musculoskeletal infection were imaged by repeated MR imaging at ultra low-field and low-field strength. Soft-tissue infection, osteomyelitis, septic arthritis, and spondylitis were studied. The MR finding was scored according to the signal intensity (SI) on T2-weighted images (T2WI), and correlated with the values of serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and peripheral white blood cell (WBC) count. There was a positive correlation between the MR score and both CRP and ESR, but no correlation between MR score and WBC. The MR score between the follow-up studies decreased significantly in accordance with clinical reconstitution. The MR finding according to the SI on T2WIs corresponded better to disease activity than did the CRP or ESR.

scholarly journals Clinical and CT Characteristics of Medical Personnel with the Coronavirus Disease-2019 (COVID-19) in Wuhan

2020 ◽  
Author(s):  
Ying Xiong ◽  
Qiang Zhang ◽  
Dong Sun ◽  
Xiaoming Li ◽  
Wenzhen Zhu
Keyword(s):  
Clinical Laboratory ◽  
Early Stage ◽  
Medical Personnel ◽  
C Reactive Protein ◽  
Illness Onset ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Clinical Laboratory Test ◽  
Ct Features

Abstract Objectives: To investigate the clinical and chest CT characteristics of medical personnel infected with the Coronavirus Disease-2019 (COVID-19).Methods: The clinical, laboratory test and computed tomography (CT) features of 30 medical personnel (MP group, 26-65 years, 16 males) with COVID-19 were retrospectively analyzed, and compared to 33 non-medical related patients (non-MP group, 26-74 years, 19 males). Follow-up CT characteristics were analyzed to assess the changes of the COVID-19 infection in the period of hospitalization.Results: At admission, the main complaints of MP group, including fever (86.7%), fatigue (53.3%) and cough (43.3%), were similar to the non-MP group; the C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels of the non-MP group (55.6±45.9mg/L, 34.7±26.3mm/H and 321±117U/L) were higher than that of the MP group (17.8±19.9mg/L, 18.6±21.3mm/H and 219±54.2U/L, respectively, all p<0.05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The days from illness onset to the first CT exam, and the severity of opacities on initial CT were less in the MP group than that of the non-MP group (p<0.05). However, the days from onset to observation of the most obvious pulmonary opacities, according to CT findings, were similar in the MP group (11.5±5.9 days) and the non-MP group (12.2±3.1 days, p=0.55).Conclusions: Like the general population, medical personnel are also susceptible to the COVID-19, although with more professional knowledge and protective equipment. Occupational exposure is a very important factor. Medical personnel have a higher vigilance about the infection in the early stage of the disease.

scholarly journals Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients

2021 ◽  
Vol 18 (5) ◽  
pp. 2529
Author(s):  
Menke J. de Smit ◽  
Johanna Westra ◽  
Marcel D. Posthumus ◽  
Gerald Springer ◽  
Arie Jan van Winkelhoff ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Sedimentation Rates ◽  
C Reactive Protein ◽  
Observation Study ◽  
Etanercept Treatment ◽  
Reactive Protein ◽  
Periodontal Condition ◽  
Erythrocyte Sedimentation ◽  
Erythrocyte Sedimentation Rates

Periodontitis, a bacterial-induced infection of the supporting soft and hard tissues of the teeth (the periodontium), is common in patients with rheumatoid arthritis (RA). As RA and periodontitis underlie common inflammatory pathways, targeting the progression of RA might mediate both periodontitis and RA. On the other hand, patients with RA on immunosuppressive medication have an increased risk of infection. Therefore, the objective of this longitudinal observation study was to assess the effect of methotrexate (MTX) and anti-tumor necrosis factor-α (anti-TNF, etanercept) treatment on the periodontal condition of RA patients. Overall, 14 dentate treatment-naive RA patients starting with MTX and 12 dentate RA patients starting with anti-TNF therapy in addition to MTX were included. Follow-up was scheduled matching the routine protocol for the respective treatments. Prior to the anti-rheumatic treatment with MTX or the anti-TNF therapy in addition to MTX, and during follow-up, i.e., 2 months for MTX, and 3 and 6 months for the anti-TNF therapy in addition to MTX, the periodontal inflamed surface area (PISA) was measured. The efficacy of the anti-rheumatic treatment was assessed by determining the change in RA disease activity (DAS28-ESR). Furthermore, the erythrocyte sedimentation rates were determined and the levels of C-reactive protein, IgM-rheumatoid factor, anti-cyclic citrullinated protein antibodies, and antibodies to the periodontal pathogen Porphyromonas gingivalis, were measured. Subgingival sampling and microbiological characterization of the subgingival microflora was done at baseline. MTX or anti-TNF treatment did not result in an improvement of the periodontal condition, while both treatments significantly improved DAS28 scores (both p < 0.01), and reduced C-reactive protein levels and erythrocyte sedimentation rates (both p < 0.05). It is concluded that anti-rheumatic treatment (MTX and anti-TNF) has negligible influence on the periodontal condition of RA patients.

scholarly journals Trend of C-Reactive Protein and Erythrocyte Sedimentation Rate in Psoriatic Patients Under Treatment of Standard Protocol of Infliximab

2015 ◽  
Vol 4 (1) ◽  
pp. 8-13
Author(s):  
Abbas Zamanian ◽  
Amir Houshang Ehsani ◽  
Seyyedeh Bahareh Darvari ◽  
Golnaz Mehran ◽  
Arghavan Azizpour
Keyword(s):  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Inflammatory Biomarkers ◽  
Blood Collection ◽  
Infliximab Treatment ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Erythrocyte Sedimentation ◽  
Pasi Score

Background: Psoriasis is a chronic and inflammatory dermatologic disease. Inflammatory biomarkers such as C-reactive protein (CRP) and Erythrocyte sedimentation rate (ESR) are known as immediate and delayed inflammatory biomarkers, respectively. Due to the fact that anti-inflammatory drugs such as Infliximab are widely used in psoriasis treatment, the aim of this study was to evaluate ESR, CRP and PASI scores in patients treated with Infliximab in a 24 week trend. Materials and Methods: This study was accomplished as a before-after study. Twenty seven psoriatic patients were included and standard Infliximab therapy was applied. All patients underwent 3 times of blood collection and in each session CRP, ESR and PASI scores were measured at the beginning of study and at the 12th and 24th weeks of follow-up Results: A total of 19 (70.4%) men and 8 (29.6%) women were evaluated. Mean age was 37.85±13.68 years. All three parameters had significant decrease in treatment course (p<0.001); however, no significant correlation was found between PASI and inflammatory biomarkers. Trends of ESR and CRP were significantly correlated in all patients (r=0.504, P =0.007) and males (r=0.739, P =0.036). Conclusion: Our study demonstrated that CRP and ESR decreased in Infliximab treatment, in accordance but non-regarded to PASI score decease. Regarding other studies results, using these biomarkers for treatment follow-up might need more caution. [GMJ. 2015;4(1):8-13]

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