scholarly journals Isolation of Brucella abortus biovar 1 from human lumbar disc bulging: a case report of brucellar discitis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saeed Alamian ◽  
Afshar Etemadi ◽  
Mohammad Reza Samiee ◽  
Maryam Dadar
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Brucella Abortus ◽  
Clinical Symptoms ◽  
Present Report ◽  
Lumbar Disc ◽  
Human Brucellosis ◽  
Intravenous Contrast ◽  
Serological Tests ◽  
Mri Examination

Abstract Background Brucellosis is an endemic zoonotic disease with rising health and economic concerns in many areas worldwide. Musculoskeletal pains are among the main complications of human brucellosis, which are often difficult to diagnose due to the variability of clinical symptoms. Brucellar discitis is a very disabling problem in some chronic forms of the disease which may lead to serious vertebral and neurological consequences. Case presentation In this case report, we reported the isolation of Brucella abortus from lumbar disc bulging in a woman who had rheumatoid arthritis and diabetes mellitus as underlying conditions. The patient had several negative brucellosis serological tests and dorsolumbar pains with urinary incontinence over a 2-month period. The diagnosis was confirmed by magnetic resonance imaging (MRI) examination of lumbar spine as well as disc culture. MRI examination was performed without intravenous contrast and revealed the presence of disc bulging, left foraminal narrowing at L5-S1, left foraminal narrowing, anterolisthesis grade II at L4-L5. The diagnosis was also confirmed by isolation of B. abortus biovar 1 from bulging disc culture. The isolate was characterized by AMOS PCR, Bruce-ladder PCR and biotyping, resulting in the identification of B. abortus from L4-L5 and L5-S1 disc bulging regions. The patient was treated with two drugs i.e. doxycycline and rifampin for 3 months. In the follow-up, in addition to improving the patient’s general condition, low-back pain was also significantly reduced. Conclusions MRI, serology, cultural and molecular test along with patient history are important to make a rapid diagnosis of brucellosis’ discitis, thereby decreasing the delay for the brucellosis treatment. The present report suggests that the infection by Brucella spp. should be fundamentally considered among the causative agents of back pain especially in the endemic areas of Brucella infections.

scholarly journals Spontaneous regression of extruded lumbar disc herniation: case report and its pathogenesis

2017 ◽  
Vol 31 (3) ◽  
pp. 399-403
Author(s):  
Prajapati Hanuman Prasad ◽  
Singh Deepak Kumar ◽  
Singh Rakesh Kumar ◽  
Ahmed Faran
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Annulus Fibrosus ◽  
Spontaneous Regression ◽  
Lumbar Disc ◽  
Radicular Pain ◽  
Diagnostic Tools ◽  
Common Disease

Abstract Lumbar disc herniation is a common disease that present with back pain and radicular pain. The most efficient method for the treatment of lumbar disc herniation is still controversial. Spontaneous regression of lumbar disc herniation has been recognized with the advancement of radiological diagnostic tools and can explain the reason of spontaneous relief of symptoms without treatment. The proposed hypothesis are; dehydration, retraction of the disc herniation in the annulus fibrosus, enzymatic catabolism and phagocytosis. In this study we present a case with large lumbar disc herniation regressing by itself and the potential mechanisms of disc regression have been discussed.

scholarly journals Unusual Etiology and Diagnosis of Oroantral Communication due to Late Implant Failure

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Rabah Nedir ◽  
Nathalie Nurdin ◽  
Marion Paris ◽  
Marc El Hage ◽  
Semaan Abi Najm ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Present Report ◽  
Implant Failure ◽  
Implant Placement ◽  
Posterior Maxilla ◽  
Oroantral Communication

Oroantral communication (OAC) rarely occurs long after implant placement. The present report describes the rare etiology and the difficulty of the diagnosis of an uncommon OAC occurring 10 years after the implant placement in the posterior maxilla. The difficulty of the diagnosis lies in the absence of clinical symptoms of sinusitis and presence of multiunit prosthesis hiding implant failure. This case report supports the need for sinus check-up during a routine implant examination.

scholarly journals Microbiological Laboratory Diagnosis of Human Brucellosis: An Overview

Pathogens ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1623
Author(s):  
Giovanni Di Bonaventura ◽  
Silvia Angeletti ◽  
Andrea Ianni ◽  
Tommasangelo Petitti ◽  
Giovanni Gherardi
Keyword(s):  
Clinical Symptoms ◽  
Early Stage ◽  
Point Of Care ◽  
Laboratory Diagnosis ◽  
Cross Reactivity ◽  
Diagnostic Methods ◽  
Nucleic Acid Amplification ◽  
Human Brucellosis ◽  
Microbiological Analysis ◽  
Serological Tests

Brucella spp. are Gram-negative, non-motile, non-spore-forming, slow-growing, facultative intracellular bacteria causing brucellosis. Brucellosis is an endemic of specific geographic areas and, although underreported, represents the most common zoonotic infection, with an annual global incidence of 500,000 cases among humans. Humans represent an occasional host where the infection is mainly caused by B. melitensis, which is the most virulent; B. abortus; B. suis; and B. canis. A microbiological analysis is crucial to identifying human cases because clinical symptoms of human brucellosis are variable and aspecific. The laboratory diagnosis is based on three different microbiological approaches: (i) direct diagnosis by culture, (ii) indirect diagnosis by serological tests, and (iii) direct rapid diagnosis by molecular PCR-based methods. Despite the established experience with serological tests and highly sensitive nucleic acid amplification tests (NAATs), a culture is still considered the “gold standard” in the laboratory diagnosis of brucellosis due to its clinical and epidemiological relevance. Moreover, the automated BC systems now available have increased the sensitivity of BCs and shortened the time to detection of Brucella species. The main limitations of serological tests are the lack of common interpretative criteria, the suboptimal specificity due to interspecies cross-reactivity, and the low sensitivity during the early stage of disease. Despite that, serological tests remain the main diagnostic tool, especially in endemic areas because they are inexpensive, user friendly, and have high negative predictive value. Promising serological tests based on new synthetic antigens have been recently developed together with novel point-of-care tests without the need for dedicated equipment and expertise. NAATs are rapid tests that can help diagnose brucellosis in a few hours with high sensitivity and specificity. Nevertheless, the interpretation of NAAT-positive results requires attention because it may not necessarily indicate an active infection but rather a low bacterial inoculum, DNA from dead bacteria, or a patient that has recovered. Refined NAATs should be developed, and their performances should be compared with those of commercial and home-made molecular tests before being commercialized for the diagnosis of brucellosis. Here, we review and report the most common and updated microbiological diagnostic methods currently available for the laboratory diagnosis of brucellosis.

scholarly journals Surgical Retreatment of an Invaginated Maxillary Central Incisor Following Overfilled Endodontic Treatment: A Case Report

2010 ◽  
Vol 04 (03) ◽  
pp. 324-328 ◽  
Author(s):  
Hakan Ozbas ◽  
Rustem Kemal Subay ◽  
Melike Ordulu
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Present Report ◽  
Mineral Trioxide Aggregate ◽  
Central Incisor ◽  
Class Iii ◽  
Root Canal Filling ◽  
Maxillary Central Incisor ◽  
Mucoperiosteal Flap ◽  
Periapical Healing

This case report presents the periapical surgical retreatment of an Oehlers Class III invaginated maxillary central incisor with extruded root canal filling into the periapical lesion. After local anesthesia, a full-thickness mucoperiosteal flap was reflected, and the granulomatous tissue and extruded gutta-percha points were curetted carefully. A deep and wide root-end cavity was prepared and filled with mineral trioxide aggregate (MTA). At 6 months and 2 years after the treatment, the tooth exhibited no clinical symptoms, and the radiograph performed during the 2-year follow-up showed a complete periapical healing around the root end. The present report indicates that MTA retrofilling can be used successfully in the surgical retreatment of dens invaginatus type III cases in which the invagination exits apically. (Eur J Dent 2010;4:324-328)

scholarly journals Cauda equina and conus medullaris syndromes due to Spinal Cord Schistosomiasis: a case report

2021 ◽  
Author(s):  
Lucas Cardoso Siqueira Albernaz ◽  
Izabel Feitosa da Mata Leite ◽  
Guilherme de Aguiar Moraes ◽  
Adelina Mouta Moreira Neto ◽  
Matheus de Campos Medeiros
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Case Report ◽  
Complete Blood Count ◽  
Clinical Symptoms ◽  
Cauda Equina ◽  
Conus Medullaris ◽  
High Morbidity ◽  
Low Back

Context: Schistosomiasis is a prevalent disease in Brazil whose medullary form can be a serious and disabling condition. Diagnosis is clinical and laboratorial, based on neurological symptoms besides Schistosoma infection exams. Spinal Cord Schistosomiasis (SCS) can be associated with cauda equina syndrome (CES) adding “saddle” anesthesia and low back pain as symptoms. Case Report: A 22- year-old male presenting progressive bilateral and proximal pelvic weakness associated with urinary and fecal incontinence besides mild low back pain during 4 months. Patient reports daily swimming practice in rivers. Neurological examination revealed grade 3 weakness of the proximal muscles, patellar hyporeflexia, saddle anesthesia and hypotonia of the proximal muscles. Magnetic resonance imaging of the lumbar spine showed conus medullaris fusiform enlargement, associated with T2 and STIR hyperintensity (edema), hyposignal in T1, findings suggestive of an inflammatory / infectious etiology. Laboratory tests revealed a complete blood count with mild leukocytosis and eosinophilia; positive IgG serology for schistosomiasis; increased protein levels in the cerebrospinal fluid; stool analysis was normal. The diagnosis of CES and conus medullaris syndrome due to SCS was established and treatment with prednisone and praziquantel was initiated, with significant improvement in clinical symptoms. Conclusion: This case emphasizes the importance of early diagnosis and the initiation of appropriate therapy in order to prevent irreversible injuries in cases of CES and conus medullaris syndrome, both conditions of high morbidity that are often overlooked.

scholarly journals Sciatic Herpes Zoster Suspected of Lumbar Disc Herniation: An Infrequent Case Report and Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Fei-Long Wei ◽  
Tian Li ◽  
Yang Song ◽  
Lin-Ya Bai ◽  
Yifang Yuan ◽  
...  
Keyword(s):  
Back Pain ◽  
Case Report ◽  
Herpes Zoster ◽  
Literature Review ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Lower Limb ◽  
Lumbar Disc ◽  
Lower Limbs ◽  
The Right

Background: The symptoms of sciatic herpes zoster are sometimes difficult to distinguish from sciatica caused by lumbar disc herniation. We describe a case of suspected lumbar disc herniation with sciatic herpes zoster to reduce the rate of misdiagnosis.Case Report: A 55-year old man, male, developed low back pain after carrying heavy items 20 years ago. Characteristics of symptoms: 1. Symptoms were aggravated in the upright lumbar forward flexion position; 2. The VAS (leg) score was 8–9 points and the VSA (lumbar) score was 0 point; 3. It can be relieved when rested in the supine position; 4. It came on intermittently with radiation pain in the right lower limb. There were several attacks every year. One month ago, there was radiating pain in the right lower limb. The pain was from the back of the right hip, behind the thigh, in lateral crural region, to the back of the foot. And Symptoms worsened for 10 days. The VAS score was 8 points. Pain could not be relieved by rest or changing posture. There was no back pain, no lower limbs, weak walking, no claudication and other symptoms. Analgesics and neurotrophic drugs are ineffective. After the application of antiviral drugs, the radiation pain in the right lower extremity was significantly relieved.Conclusion: We describe this case in detail and discuss how to make an authentic diagnosis, with a concomitant literature review.

scholarly journals Development of an Immunodiagnostic Test for Screening Human Brucellosis Cases Using the Whole-Cell Antigens of Brucella abortus

2020 ◽  
Vol 27 (6) ◽  
pp. 15-26
Author(s):  
Nidhi M Bhartiya ◽  
Aliabbas A Husain ◽  
Hatim F Daginawala ◽  
Lokendra Singh ◽  
Rajpal S Kashyap
Keyword(s):  
Brucella Abortus ◽  
Clinical Symptoms ◽  
Cost Effective ◽  
Diagnostic Methods ◽  
Cell Protein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Human Brucellosis ◽  
Serum Samples ◽  
Whole Cell ◽  
Specificity And Sensitivity

Background: Human brucellosis is an important zoonotic disease of public health and often remains neglected owing to lack of sensitive and efficient diagnostic methods. This study evaluates diagnostic utility of in-house designed enzyme-linked immunosorbent assay (ELISA) using whole-cell antigens of Brucella abortus (B. abortus) S19 against the commercially available kits. Methods: A prospective cohort study involving different populations within the Vidarbha regions of Maharashtra, India was conducted through camps organised from May 2009 to October 2015. A total of 568 serum samples were collected from high-risk people recruited as study cohorts based on inclusion criteria, additional risk factors and clinical symptoms. Samples were evaluated by indirect ELISA using the whole-cell antigens of B. abortus. The results were compared with the commercially available IgG detection ELISA kit to ascertain the specificity and sensitivity of the developed test. Results: Fever, body ache, joint pain, lower back pain, loss of appetite and weight loss were major symptoms associated with the disease. With the cut-off of > 0.8, the positivity of brucellosis infection was at 12.32% (70/568) compared to 9.33% (53/568) as detected by the commercial kit. The in-house developed ELISA method yielded a sensitivity of 87.5% and specificity of 99.18% as compared to the commercial kits (sensitivity –80.30% and specificity –99.6%). Discussion: The B. abortus S19-derived whole-cell protein-based ELISA is rapid and cost- effective and can be used for screening brucellosis infection in lieu of the commercially available ELISA kits.

Chapter 10: Diagnosis

2019 ◽  
Author(s):  
Gerhard Dobler
Keyword(s):  
Cerebrospinal Fluid ◽  
Viral Encephalitis ◽  
Clinical Symptoms ◽  
Serological Tests ◽  
Specific Antibodies ◽  
Cross Reactions ◽  
Neuro Imaging ◽  
Tbev Infection

• TBE appears with non-characteristic clinical symptoms, which cannot be distinguished from oth-er forms of viral encephalitis or other diseases. • Cerebrospinal fluid and neuro-imaging may give some evidence of TBE, but ultimately cannot confirm the diagnosis. • Thus, proving the diagnosis “TBE” necessarily requires confirmation of TBEV-infection by detec-tion of the virus or by demonstration of specific antibodies from serum and/or cerebrospinal fluid. • During the phase of clinic symptoms from the CNS, the TBEV can only rarely be detected in the cerebrospinal fluid of patients. • Most routinely used serological tests for diagnosing TBE (ELISA, HI, IFA) show cross reactions resulting from either Infection with other flaviviruses or with other flavivirus vaccines.

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