Calcaneal Osteomyelitis Treated with Antibiotic Mixed Calcium Sulphate Pellets. A Case Report

2021 ◽  
Vol 11 (10) ◽  
Author(s):  
Alok Chandra Agrawal ◽  
Mukund Madhav Ojha ◽  
Deepak Kumar Garg ◽  
E Pandiyarajan Pandiyarajan
Keyword(s):  
Case Report ◽  
Functional Outcome ◽  
Calcium Sulphate ◽  
Definitive Treatment ◽  
Purulent Discharge ◽  
Resonance Imaging ◽  
Poor Functional Outcome ◽  
Culture Studies ◽  
Outcome Management ◽  
Systemic Antibiotics

Background: Calcaneal osteomyelitis is a complicated entity and much more challenging to treat. We present a case of calcaneal osteomyelitis treated with debridement, curettage and filling bone defect with antibiotic mixed calcium sulphate pellets. Case Report: A female patient presented with pain, swelling and purulent discharge from the left heel. Culture studies and magnetic resonance imaging findings were suggestive of osteomyelitis of the calcaneum. The patient was planned for definitive treatment, and remission was achieved with systemic antibiotics, debridement, curettage, and filling dead space with antibiotic mixed calcium sulphate pellets. Conclusion: Calcaneal osteomyelitis is very resistant to treatment and results in poor functional outcome. Management of calcaneal osteomyelitis with single-stage strategy using antibiotic mixed calcium sulphate effectively eradicates the disease to attain overall good functional outcome for the patient. Keywords: Calcaneum, osteomyelitis, debridement, calcium sulphate.

scholarly journals Lumbosacral Spondylodiscitis- An Atypical Localisation of SalmonellaTyphi Infection: A Case Report

2020 ◽  
Author(s):  
Sruthi Vinayan ◽  
Vimal Karnaker ◽  
V Sreelatha ◽  
Sanjana Nair
Keyword(s):  
Case Report ◽  
Salmonella Typhi ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
Culture Studies ◽  
Early Management ◽  
Lower Back ◽  
The Family ◽  
Spine Tuberculosis ◽  
Magnetic Resonance Imaging Mri

Salmonella belongs to the family Enterobacteriaceae. The various members of the genus cause diseases that are important public health problems. Apart from causing typhoid, Salmonella can cause an array of diseases ranging from osteomyelitis to meningitis, though rare. Herein, authors report one such uncommon scenario, in an otherwise healthy 40-year-old female who presented with lower back pain. Magnetic Resonance Imaging (MRI) was suggestive of lumbosacral spondylodiscitis and she underwent a spine stabilisation surgery. The pathogen was confirmed to be Salmonella Typhi by microbiological workup. She responded well to treatment with ceftriaxone. This case report implies the significance of culture studies in the early management of the patient. It is imperative for the diagnosis, as the symptoms of the aforementioned disease are usually non-specific and imaging studies are indiscernible from spine tuberculosis.

Computed tomography and magnetic resonance imaging findings of primary bladder angiosarcoma: a case report

2014 ◽  
Vol 38 (2) ◽  
pp. 212-214 ◽  
Author(s):  
Mehmet Beyazal ◽  
Necip Pirinççi ◽  
Alpaslan Yavuz ◽  
Sercan Özkaçmaz ◽  
Gülay Bulut
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Case Report ◽  
Magnetic Resonance ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Primary Bladder

GCS-Pupil Score Has a Stronger Association with Mortality and Poor Functional Outcome than GCS Alone in Pediatric Severe Traumatic Brain Injury

2021 ◽  
pp. 1-8
Author(s):  
Binod Balakrishnan ◽  
Heather VanDongen-Trimmer ◽  
Irene Kim ◽  
Sheila J. Hanson ◽  
Liyun Zhang ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Functional Outcome ◽  
Cerebral Performance Category ◽  
Regression Tree ◽  
Classification And Regression Tree ◽  
Continuous Variables ◽  
Poor Functional Outcome ◽  
Severity Scores ◽  
Pupil Reactivity

<b><i>Background:</i></b> The Glasgow Coma Scale (GCS), used to classify the severity of traumatic brain injury (TBI), is associated with mortality and functional outcomes. However, GCS can be affected by sedation and neuromuscular blockade. GCS-Pupil (GCS-P) score, calculated as GCS minus Pupil Reactivity Score (PRS), was shown to better predict outcomes in a retrospective cohort of adult TBI patients. We evaluated the applicability of GCS-P to a large retrospective pediatric severe TBI (sTBI) cohort. <b><i>Methods:</i></b> Admissions to pediatric intensive care units in the Virtual Pediatric Systems (VPS, LLC) database from 2010 to 2015 with sTBI were included. We collected GCS, PRS (number of nonreactive pupils), cardiac arrest, abusive head trauma status, illness severity scores, pediatric cerebral performance category (PCPC) score, and mortality. GCS-P was calculated as GCS minus PRS. χ<sup>2</sup> or Fisher’s exact test and Mann-Whitney U test compared categorical and continuous variables, respectively. Classification and regression tree analysis identified thresholds of GCS-P and GCS along with other independent factors which were further examined using multivariable regression analysis to identify factors independently associated with mortality and unfavorable PCPC at PICU discharge. <b><i>Results:</i></b> Among the 2,682 patients included in the study, mortality was 23%, increasing from 4.7% for PRS = 0 to 80% for PRS = 2. GCS-P identified more severely injured patients with GCS-P scores 1 and 2 who had worse outcomes. GCS-P ≤ 2 had higher odds for mortality, OR = 68.4 (95% CI = 50.6–92.4) and unfavorable PCPC, OR = 17.3 (8.1, 37.0) compared to GCS ≤ 5. GCS-P ≤ 2 also had higher specificity and positive predictive value for both mortality and unfavorable PCPC compared to GCS ≤ 5. <b><i>Conclusions:</i></b> GCS-P, by incorporating pupil reactivity to GCS scoring, is more strongly associated with mortality and poor functional outcome at PICU discharge in children with sTBI.

scholarly journals Lymphangiography and focal pleurodesis treatment of chylothorax with an aberrant thoracic duct following oesophagectomy: a case report

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Tomoyuki Ishida ◽  
Jun Kanamori ◽  
Hiroyuki Daiko
Keyword(s):  
Magnetic Resonance Imaging ◽  
Interventional Radiology ◽  
Case Report ◽  
Magnetic Resonance ◽  
Thoracic Duct ◽  
Rare Case ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Thoracostomy Tube ◽  
Magnetic Resonance Imaging Mri

Abstract Background Management of postoperative chylothorax usually consists of nutritional regimens, pharmacological therapies such as octreotide, and surgical therapies such as ligation of thoracic duct, but a clear consensus is yet to be reached. Further, the variation of the thoracic duct makes chylothorax difficult to treat. This report describes a rare case of chylothorax with an aberrant thoracic duct that was successfully treated using focal pleurodesis through interventional radiology (IVR). Case presentation The patient was a 52-year-old man with chylothorax after a thoracoscopic oesophagectomy for oesophageal cancer. With conventional therapy, such as thoracostomy tube, octreotide or fibrogammin, a decrease in the amount of chyle was not achieved. Therefore, we performed lymphangiography and pleurodesis through IVR. The patient appeared to have an aberrant thoracic duct, as revealed by magnetic resonance imaging (MRI); however, after focal pleurodesis, the leak of chyle was diminished, and the patient was discharged 66 days after admission. Conclusions Chylothorax remains a difficult complication. Focal pleurodesis through IVR can be one of the options to treat chylothorax.

scholarly journals Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199611
Author(s):  
Evelyne Sandjojo ◽  
Vanessa AMC Jaury ◽  
Yufi K Astari ◽  
Mahendria Sukmana ◽  
Rizky A Haeruman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Atrioventricular Block ◽  
Pacemaker Implantation ◽  
Uncontrolled Hypertension ◽  
Definitive Treatment ◽  
Inferior Wall ◽  
Complete Atrioventricular Block ◽  
History Of ◽  
Complete Atrioventricular

Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.

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