scholarly journals Intracortical haematogenous osteomyelitis

2014 ◽  
Vol 96 (2) ◽  
pp. e13-e16
Author(s):  
AJL Jowett ◽  
SWF Middleton ◽  
MC Quaye ◽  
H Chesterfield ◽  
I Lasrado ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Unusual Case ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Bowel Resection ◽  
Bone Lesion ◽  
Methicillin Resistant ◽  
Haematogenous Osteomyelitis

We present an unusual case of haematogenous osteomyelitis in the diaphysis of the tibia of an adult leading to a subacute presentation with an extracortical abscess. Fluid from the abscess grew methicillin resistant Staphylococcus aureus (MRSA) on culture; MRSA with the same antibiogram had been grown from the patient’s blood seven years earlier following a bowel resection. Drainage of the abscess and curettage of the bone lesion together with appropriate antibiotic therapy led to resolution of the osteomyelitis.

Recurrent Methicillin-Resistant Staphylococcus Aureus Osteomyelitis: Combination Antibiotic Therapy with Evaluation by Serum Bactericidal Titers

1995 ◽  
Vol 29 (7-8) ◽  
pp. 694-697 ◽  
Author(s):  
Sherrie L Aspinall ◽  
David M Friedland ◽  
Victor L Yu ◽  
John D Rihs ◽  
Robert R Muder
Keyword(s):  
Staphylococcus Aureus ◽  
Back Pain ◽  
Antibiotic Therapy ◽  
Sedimentation Rate ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Blood Cultures ◽  
Low Back ◽  
Methicillin Resistant ◽  
Trough Concentrations

Objective: To report on a patient with recurrent methicillin-resistant Staphylococcus aureus (MRSA) osteomyelitis and bacteremia successfully treated with combination antibiotic therapy. Case Summary: Two sets of blood cultures from a 55-year-old man with fever, malaise, and low back pain grew MRSA. Radiologic studies of the spine showed bony changes consistent with osteomyelitis. Soon after completing 6 weeks of vancomycin, the patient experienced a recurrence of back pain. Laboratory values included an increase in the sedimentation rate to 53 mm/h and positive blood cultures for MRSA. Vancomycin, gentamicin, and rifampin were administered for 8 weeks. Serum inhibitory and bactericidal titers were more than 1:1024 for both the peak and trough concentrations. Radiologic studies of the spine showed healing osteomyelitis. Two years after completion of antibiotic therapy, the infection has not recurred. Discussion: Antibiotic therapy alone was attempted because the patient was considered a risky surgical candidate. Serum inhibitory and bactericidal titers documented the high in vivo activity of the vancomycin, gentamicin, and rifampin combination. Initiation of vancomycin therapy led to disappearance of the fever and back pain. Cure was documented by sustained normalization of the erythrocyte sedimentation rate and radiologic evidence of healing. Conclusions: Combination antibiotic therapy with vancomycin, rifampin, and low-dose gentamicin (1 mg/kg q12h) may be useful for deep-seated tissue infection caused by MRSA.

scholarly journals Utilizing Pharmacy Records to Assess Antibiotic Prescribing Patterns on the Incidence of Community-Acquired Methicillin-Resistant Staphylococcus aureus Infections in Children

2007 ◽  
Vol 12 (2) ◽  
pp. 91-101
Author(s):  
Peter N. Johnson ◽  
Robert P. Rapp ◽  
Christopher T. Nelson ◽  
J.S. Butler ◽  
Sue Overman ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Prescribing Patterns ◽  
Control Group ◽  
Antibiotic Prescribing ◽  
Antibiotic Exposure ◽  
Pharmacy Records ◽  
Methicillin Resistant ◽  
Prior Antibiotic Therapy

OBJECTIVE To assess the effect of prior antibiotic therapy on the incidence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections in children. METHODS This was a concurrent and retrospective review of antibiotic records for children < 18 years of age with documented CA-MRSA infection identified between January 1, 2004, and December 31, 2005. Antibiotic records were compared against a control group. The primary outcome was the incidence of CA-MRSA using linear regression as a function of age and prior antibiotic therapy (i.e., 3 months prior to admission). Secondary objectives included a comparison of antibiotic courses and classes and a description of antibiotic susceptibilities in patients with CA-MRSA RESULTS Data from 26 patients were included. Nine out of 51 patients (18%) with CA-MRSA were included. Another 17 children were enrolled in the control group. The median age was approximately 1.75 years (0.08–14 years) in the CA-MRSA group versus 2.75 years (0.005-15 years) in the control group. A statistical difference was noted in the number of patients with prior antibiotic exposure between the CA-MRSA and control group, 8 (88.9%) versus 6 (35.3%), respectively (P = .01). Antibiotic exposure was found to be a significant independent risk factor (P = .005; 95% CI, 0.167–0.846) for the development of CA-MRSA. The interaction between antibiotic exposure and age < 3 was the most significant predictor of CA-MRSA (P = .019; 95% CI, 0.139–1.40). CONCLUSIONS Prior antibiotic therapy in patients < 3 years of age was associated with a significant risk of developing CA-MRSA. A comprehensive assessment of CA-MRSA patients should include objective methods of measuring prior antibiotic exposure such as pharmacy records.

scholarly journals Methicillin Resistant Staphylococcus Aureus Shoulder Pyomyositis with Multifocal Lung Infiltrations

2020 ◽  
Vol 12 (3) ◽  
pp. 127-129
Author(s):  
Angela Troisi ◽  
Giulia Graziani ◽  
Alessandra Macaluso ◽  
Lorenzo Mambelli ◽  
Federico Marchetti
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Rare Condition ◽  
Systemic Complications ◽  
Methicillin Resistant ◽  
Low Threshold ◽  
Shoulder Motion ◽  
Local And Systemic Complications ◽  
Prompt Diagnosis

Pyomyositis is a rare condition in temperate climates. We present a case of Methicillin Resistant Staphylococcus aureus pyomyositis of the shoulder complicated by multifocal lung infiltrations, treated successfully with antibiotic therapy. After excluding shoulder septic arthritis, a low threshold of suspicion for the diagnosis of shoulder pyomyositis should be applied to patients with persistent fever, pain, and decreased range of shoulder motion. A prompt diagnosis and a rapid rise in antibiotic therapy are important to avoid local and systemic complications.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus Infections in Otolaryngology

1992 ◽  
Vol 107 (3) ◽  
pp. 434-437 ◽  
Author(s):  
Ron D. Gottlieb ◽  
Mahendra K. Shah ◽  
David C. Perlman ◽  
Charles P. Kimmelman
Keyword(s):  
Staphylococcus Aureus ◽  
Antibiotic Therapy ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Intravenous Drug ◽  
Intravenous Drug Use ◽  
Methicillin Resistant ◽  
Mrsa Strains ◽  
Hospital Acquired ◽  
Susceptibility And Resistance ◽  
Multiple Antibiotics

Soon after the introduction of methicillin, strains of Staphylococcus aureus resistant to methicillin were reported. Methicillin-resistant Staphylococcus aureus (MRSA) has become a common hospital pathogen, often resistant to multiple antibiotics, while causing significant morbidity and mortality. Community-acquired MRSA infections have been infrequently documented. Most reports have been associated with intravenous drug abuse. This report reviews 15 patients with community-acquired MRSA infections of the head and neck. None admitted to intravenous drug use. Additionally, no patient was known to be a healthcare worker. The MRSA strains showed antibiotic susceptibility and resistance profiles different from typical hospital-acquired MRSA isolates. All but one infection resolved with adequate surgical or appropriate antibiotic therapy. Clinicians should become aware of the possibility of community-acquired MRSA in the patient who has had continued infection despite antibiotic therapy.

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