scholarly journals Case report: Candida krusei spondylitis in an immunocompromised patient

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Audrey J. C. Overgaauw ◽  
David C. de Leeuw ◽  
Susanne P. Stoof ◽  
Karin van Dijk ◽  
Joost C. J. Bot ◽  
...  
Keyword(s):  
Myeloid Leukemia ◽  
Surgical Intervention ◽  
Immunocompromised Patient ◽  
Case Reports ◽  
Candida Krusei ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Invasive Infections ◽  
Antimycotic Treatment

Abstract Background Invasive infections with Candida krusei are uncommon and rarely complicated by spondylitis. Previous described cases were solely treated with antimycotic therapy, despite guidelines recommending surgical interventions. Case presentation We describe a case of C. krusei spondylitis in a patient treated with chemotherapy for acute myeloid leukemia. After induction chemotherapy, the patient developed a candidemia, which was treated with micafungin. One month after the candidemia, the patient was admitted with severe lumbar pain. Spondylitis of the L4 and L5 vertebra was diagnosed on MR-imaging, with signs suggesting an atypical infection. The patient was treated with anidulafungin combined with voriconazole. Despite maximal conservative management symptoms gradually worsened eventually requiring surgical intervention. Conclusions In contrast to previous case reports, antimycotic treatment alone could be insufficient in treating C. krusei spondylitis.

scholarly journals Dual Ureaplasma parvum arthritis: a case report of U. parvum septic arthritis following contralateral reactive arthritis in an immunosuppressed patient

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lea Lemoine ◽  
Cecile Le Brun ◽  
Francois Maillot ◽  
Camille Thorey ◽  
Annaelle Boucaud ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Reactive Arthritis ◽  
Immunocompromised Patient ◽  
Immunosuppressed Patient ◽  
Sample Treatment ◽  
Case Presentation ◽  
Ureaplasma Parvum ◽  
High Prevalence ◽  
Invasive Infections ◽  
Immunosuppressed Patients

Abstract Background Ureaplasma parvum is usually part of the normal genital flora. Rarely can it cause invasive infections such as genitourinary infections, septic arthritis, or meningitis. Case presentation Here we present the first description of chronic ureterocystitis in a 56-year-old immunocompromised patient, complicated first by reactive arthritis and secondarily by contralateral septic arthritis due to U. parvum infection. U. parvum was detected in synovial fluid and in a urine sample. Treatment consisted of double-J stenting and targeted antibiotic therapy. Evolution showed resolution of urinary symptoms and clinical improvement of arthritis despite functional sequelae. Conclusions Given the high prevalence of U. parvum colonisation, this diagnosis should remain a diagnosis of exclusion. However, because of the difficulty in detecting this microorganism, it should be considered in unexplained subacute urethritis or arthritis, including reactive arthritis, especially in immunosuppressed patients. Real-time PCR positivity in the absence of a differential diagnosis should not be overlooked.

scholarly journals A Comparison of Treatment Options for Carpal Boss: A Critically Appraised Topic

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Megan Collins ◽  
Matthew Rivera
Keyword(s):  
Conservative Treatment ◽  
Range Of Motion ◽  
Case Studies ◽  
Conservative Management ◽  
Surgical Intervention ◽  
Case Reports ◽  
Treatment Options ◽  
Surgical Interventions ◽  
Increased Risk

Context: Carpal bossing is a bony growth or mass that typically occurs at the 2nd or 3rd carpometacarpal joint. Carpal bossing is often overlooked placing the patient at an increased risk for pain or injury, such as osteoarthritis or inflammatory joint disease if left untreated. Individuals such as combat sport athletes who experience repetitive trauma to this area are at a high risk to develop carpal bossing. The literature suggests conservative or surgical interventions to manage symptoms. The goal of this systematic review is to synthesize the current literature for clinical knowledge and intervention outcomes for carpal bossing. Methods: A systematic search of the literature was performed across 3 electronic databases (Science Direct, PubMed, and EBSCOhost) to identify articles that investigated the effects of surgical intervention or conservative management for carpal bossing. A combination of the keywords and Boolean operators (Carpal Bossing, Carpal Boss, Surgical Intervention, Wedge Resection, Excision, Conservative Treatment, and Intervention) related to the research question were used. The search was restricted to full text, human studies (including cadaveric studies) research, and manuscripts available in English. Articles were included if they examined the effect of either conservative or surgical interventions for the treatment of carpal bossing. Articles were excluded from the review if the study did not examine carpal bossing treatment options or did not include pain, range of motion, strength, or functional measures of the hand and wrist. Two independent reviewers used the Joanna Briggs Institute Checklist for Case Reports and the Checklist for Case Studies to appraise the quality of the articles. A score of 50% was used to remove low-quality studies. The Strength of Recommendation Taxonomy (SORT) method was used to grade the evidence for the articles included. Results: After the initial search, 10 articles met the inclusion criteria, while 3 were eliminated due to low quality appraisal scores. The average scores for case reports and case studies were 5.5/7 or 7.5/9 respectively. There was a total of 58 participants across the 7 studies. Generally speaking, conservative treatment reduced average daily pain and patients were able to return to full participation within 2 weeks. Conversely, patients undergoing surgical intervention experienced episodic pain, including over the surgical incision, typically averaging 2/10 on the visual analog scale. Findings from the surgical intervention showed inconsistent measurements for wrist/hand strength and range of motion. There is level C evidence on the treatment for carpal bossing. Conclusion: The limited evidence suggests conservative management may reduce pain and improve clinical outcomes. However, clinicians should consider the level C evidence with skepticism as the quality of evidence on this topic is low. Further investigations should be performed with more rigor.

Octreotide in the Treatment of Pancreatic Pseudocysts

1996 ◽  
Vol 12 (4) ◽  
pp. 165-168
Author(s):  
Annie Y Lam ◽  
Susan E Kracke
Keyword(s):  
Complete Resolution ◽  
Surgical Intervention ◽  
Case Reports ◽  
Pancreatic Pseudocysts ◽  
Treatment Alternative ◽  
Surgical Interventions ◽  
Case Summary ◽  
Reduction Of Pain ◽  
Octreotide Therapy ◽  
Potential Use

Objective: To describe the potential use of octreotide in the treatment of pancreatic pseudocysts through a brief review of anecdotal case reports. Case Summary: Octreotide has been used in a few patients to effectively inhibit pancreatic secretions and shrink the size of persistently draining pseudocysts. The dosage of octreotide is 100–200 μg bid or tid sc, for up to 36 days or until resolution of the pseudocysts is achieved. Discussion: Persistent pancreatic pseudocysts of varying size and duration have been successfully treated with the use of octreotide. Larger pseudocysts, which are unlikely to resolve spontaneously, may remain unresolved with the use of octreotide and may still require conventional surgical intervention. The use of octreotide in such cases, however, may still be beneficial. Shrinkage of the pseudocysts, even without complete resolution, may result in reduction of pain and may prevent other complications that often accompany the unresolved pseudocysts. Conclusions: Anecdotal reports suggest that octreotide may be useful as a noninvasive alternative or adjunct to traditional surgical treatment of pancreatic pseudocysts. Further research with well-designed studies involving randomized comparative controls are necessary to correlate the degree of pseudocyst shrinkage with the dosage and duration of octreotide therapy. The apparent effectiveness of octreotide in reducing the size of persistent pancreatic pseudocysts and providing pain relief suggests that it may be a useful adjunct to surgical interventions. With smaller persistent pseudocysts, octreotide may be a treatment alternative to surgery.

Aspergillus Spondylodiscitis After Spinal Stenosis Surgery: A Case Report

2020 ◽  
Vol 5 (3 And 4) ◽  
pp. 155-160
Author(s):  
Mohsen Aghapoor ◽  
◽  
Babak Alijani Alijani ◽  
Mahsa Pakseresht-Mogharab ◽  
◽  
...  
Keyword(s):  
Antifungal Drugs ◽  
The Body ◽  
Lower Limbs ◽  
Lumbar Pain ◽  
Case Presentation ◽  
Delay In Diagnosis ◽  
Death Case ◽  
Therapeutic Results ◽  
History Of ◽  
Probable Diagnosis

Background and Importance: Spondylodiscitis is an inflammatory disease of the body of one or more vertebrae and intervertebral disc. The fungal etiology of this disease is rare, particularly in patients without immunodeficiency. Delay in diagnosis and treatment of this disease can lead to complications and even death. Case Presentation: A 63-year-old diabetic female patient, who had a history of spinal surgery and complaining radicular lumbar pain in both lower limbs with a probable diagnosis of spondylodiscitis, underwent partial L2 and complete L3 and L4 corpectomy and fusion. As a result of pathology from tissue biopsy specimen, Aspergillus fungi were observed. There was no evidence of immunodeficiency in the patient. The patient was treated with Itraconazole 100 mg twice a day for two months. Pain, neurological symptom, and laboratory tests improved. Conclusion: The debridement surgery coupled with antifungal drugs can lead to the best therapeutic results.

HOSPITAL INFECTION IN SURGICAL DEPARTMENTS AT HUE UNIVERSITY HOSPITAL IN 2015

2016 ◽  
pp. 39-43
Author(s):  
Dinh Binh Tran ◽  
Dinh Tan Tran
Keyword(s):  
Surgical Site Infection ◽  
Surgical Intervention ◽  
University Hospital ◽  
Hospital Infections ◽  
Site Infection ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Hospital Acquired Infections ◽  
Tract Infections ◽  
Hospital Acquired

Objective: To study nosocomial infections and identify the main agents causing hospital infections at Hue University Hospital. Subjects and Methods: A cross-sectional descriptive study of 385 patients with surgical interventions. Results: The prevalence of hospital infections was 5.2%, surgical site infection was the most common (60%), followed by skin and soft tissue infections (35%), urinary tract infections (5%). Surgical site infection (11.6%) in dirty surgery. There were 3 bacterial pathogens isolated, including Staphylococcus aureus (50%), Pseudomonas aeruginosa and Enterococcusspp (25%). Conclusion: Surgical site infection was high in hospital-acquired infections. Key words: hospital infections, surgical intervention, surgical site infection, bacteria

Do People Trust in Robot-Assisted Surgery? Evidence from Europe (Preprint)

2020 ◽  
Author(s):  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc Saigí-Rubió
Keyword(s):  
Technology Acceptance ◽  
Surgical Intervention ◽  
Negative Relationship ◽  
Predictor Variable ◽  
Major Change ◽  
Ease Of Use ◽  
The European Union ◽  
Robot Assisted ◽  
Surgical Interventions ◽  
Robot Assisted Surgery

BACKGROUND Increasingly intelligent and autonomous robots are destined to have a huge impact on our society. Their adoption, however, represents a major change to the healthcare sector’s traditional practices, which, in turn, poses certain challenges. To what extent is it possible to foresee a near-future scenario in which minor routine surgery is directed by robots? And what are the patients’ or general public’s perceptions of having surgical procedures performed on them by robots, be it totally or partially? A patient’s trust in robots and AI may facilitate the spread and use of such technologies. OBJECTIVE The goal of our study was to establish the factors that influence how people feel about having a medical operation performed on them by a robot. METHODS We used data from a 2017 Flash Eurobarometer (number 460) of European Commission with 27,901 citizens aged 15 years and over in the 28 countries of the European Union. The research designs and tests a technology acceptance model (TAM). Logistic regression (odds ratios, OR) to model the predictors of trust in robot-assisted surgery was calculated through motivational factors, robots using experience and sociodemographic independent variables. RESULTS The negative relationship between most of the predictors of ease of use, expected benefits and attitude towards robots, and confidence in robot-assisted surgery was contrasted. The only non-sociodemographic predictor variable that has a positive relationship with trust in robots participating in a surgical intervention is previous experience in the use of robots. In this context, we analyze the confidence predictors for three different levels of robot use experience (zero use, average use, and high use). The results obtained indicate that, as the experience of using robots increases, the predictive coefficients related to information, attitude and perception of robots become more negative. Research results also determined that variables of a sociodemographic nature played an important predictive role. It was confirmed that the effect of experience on trust in robots for surgical interventions was greater among men, people between 40 and 54 years old, and those with higher educational levels. CONCLUSIONS Despite the considerable benefits for the patient that the use of robots can bring in a surgical intervention, the results obtained show that trust in robots goes beyond rational decision-making. By contrasting the reasons that generate trust and mistrust in robots, especially by highlighting the experience of use as a key element, the research makes a new contribution to the state of the art and draws practical implications of the use of robots for health policy and practice.

scholarly journals Spontaneous haemorrhage of an adrenal angiomyolipoma: case report

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Danielle Whiting ◽  
Ian Rudd ◽  
Amit Goel ◽  
Seshadri Sriprasad ◽  
Sanjeev Madaan
Keyword(s):  
Case Reports ◽  
Case Presentation ◽  
Open Adrenalectomy ◽  
Large Size ◽  
History Of ◽  
Loin Pain ◽  
Benign Tumours ◽  
Spontaneous Haemorrhage ◽  
Mesenchymal Tumours

Abstract Background Angiomyolipomas are rare mesenchymal tumours arising from the perivascular epithelioid cells consisting of variable amounts of adipose, thick-walled blood vessels and smooth muscle cells. These benign tumours commonly occur in the kidney with only a few case reports of adrenal angiomyolipomas which have the potential to reach a large size and haemorrhage. Case presentation A 45-year-old lady presented with a 3-week history of right loin pain, nausea and vomiting. A CT scan revealed a right adrenal angiomyolipoma measuring 6.3 × 6.8 cm with associated haemorrhage. The lesion was successfully treated with right open adrenalectomy, and histology confirmed the diagnosis of adrenal angiomyolipoma. The patient remained well with no evidence of recurrence at the 36-month follow-up. Conclusion Adrenal angiomyolipomas are rare benign tumours that have the ability to reach a large size and potential to bleed. Here, we report the second case of spontaneous haemorrhage in an adrenal angiomyolipoma, which was successfully treated with open adrenalectomy.

scholarly journals Inappropriate surgery in a patient with misdiagnosed Robert’s uterus

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Iori Kisu ◽  
Kanako Nakamura ◽  
Tetsuro Shiraishi ◽  
Tomoko Iijima ◽  
Moito Iijima ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Uterine Wall ◽  
Septate Uterus ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Unicornuate Uterus ◽  
Uterine Malformation ◽  
Mullerian Anomaly ◽  
Future Pregnancy

Abstract Background Robert’s uterus is a rare Mullerian anomaly, which can be described as an asymmetric, septate uterus with a non-communicating hemicavity. Herein, we present the case of a misdiagnosed Robert’s uterus, resulting in an invasive and disadvantageous surgery. Case presentation A 16-year-old woman was referred to our department because of dysmenorrhea and suspicion of uterine malformation. We misdiagnosed Robert’s uterus as a unicornuate uterus with a non-communicating rudimentary horn and hematometra, and performed laparoscopic hemi-hysterectomy. Although the patient’s symptoms were relieved, our surgical procedure left the lateral uterine wall weak, making the patient’s uterus susceptible to uterine rupture in any future pregnancy. Conclusions Although the early diagnosis of Robert’s uterus is challenging, it is important in order to determine appropriate surgical interventions and management for maintaining the quality of life and ensuring safety in future pregnancies.

scholarly journals Clozapine-induced stuttering in the absence of known risk factors: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Florence Jaguga
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Side Effect ◽  
Case Reports ◽  
Extrapyramidal Symptoms ◽  
Prior History ◽  
Case Presentation ◽  
Rare Side Effect ◽  
History Of ◽  
Electrophysiological Findings

Abstract Background Stuttering is a rare side effect of clozapine. It has been shown to occur in the presence of one or more factors such as abnormal electrophysiological findings and seizures, extrapyramidal symptoms, brain pathology, and a family history of stuttering. Few case reports have documented the occurrence of clozapine-induced stuttering in the absence of these risk factors. Case presentation A 29-year-old African male on clozapine for treatment-resistant schizophrenia presented with stuttering at a dosage of 400 mg/day that resolved with dose reduction. Electroencephalogram findings were normal, and there was no clinical evidence of seizures. The patient had no prior history or family history of stuttering, had a normal neurological examination, and showed no signs of extrapyramidal symptoms. Conclusion Clinicians ought to be aware of stuttering as a side effect of clozapine, even in the absence of known risk factors. Further research should investigate the pathophysiology of clozapine-induced stuttering.

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