scholarly journals Salmonella Typhi dorsolumbar spondylodiscitis mimicking tuberculosis – An interesting case report

2020 ◽  
Vol 11 ◽  
pp. 184
Author(s):  
Shailesh Hadgaonkar ◽  
Pradhyumn Rathi ◽  
Bharat Purandare ◽  
Ashok Shyam ◽  
Parag Sancheti ◽  
...  
Keyword(s):  
Spinal Surgery ◽  
Spinal Tuberculosis ◽  
Salmonella Typhi ◽  
Interesting Case ◽  
Healthy Individuals ◽  
Gastrointestinal Infections ◽  
Pyogenic Spondylodiscitis ◽  
Lower Back ◽  
Gastrointestinal Pathology ◽  
Spinal Infections

Background: Salmonella rarely causes spinal infections in patients other than those who are immunocompromised or have sickle cell anemia. Further, most cases occurring in healthy individuals have preexisting gastrointestinal infections. Here, we present a case of pyogenic spondylodiscitis attributed to Salmonella Typhi, in an immunologically normal patient without gastrointestinal pathology. Case Description: A 58-year-old diabetic female complained of lower back pain and malaise. The workup for spinal tuberculosis was negative, but her MRI revealed findings consistent with pyogenic spondylodiscitis (e.g., destruction and instability) for which she required posterior spinal surgery. The organism proved to be S. Typhi; she was treated for 2 months and followed-up for 2 years. Conclusion: Salmonella spondylodiscitis should be considered among the differential diagnoses for patients with features of infective spondylodiscitis. Culture-specific antibiotics are the cornerstone of treatment, along with appropriate and timely surgery.

scholarly journals Antibody response to Salmonella typhi lw human Schistosomiasis mansoni

1996 ◽  
Vol 29 (5) ◽  
pp. 441-445 ◽  
Author(s):  
Maria Imaculada Muniz-Junqueira ◽  
José Tavares-Neto ◽  
Aluizio Prata ◽  
Carlos Eduardo Tosta
Keyword(s):  
Immune Response ◽  
Antibody Response ◽  
Blood Stream ◽  
Salmonella Typhi ◽  
Healthy Individuals ◽  
Typhoid Vaccine ◽  
Schistosomiasis Mansoni ◽  
Positive Antibody ◽  
Before And After ◽  
Hepatosplenic Schistosomiasis

Antibody response to Salmonella typhi O and H antigens was evaluated in 24 individuals with either hepatointestinal or hepatosplenic schistosomiasis mansoni before and after typhoid vaccination, and compared with that of non-infected controls. Before vaccination, Schistosoma-infected patients showed a higher frequency of positive antibody to O antigen and the same frequency to H antigen when compared with that of healthy individuals. However, those with hepatosplenic schistosomiasis showed higher titres of antibody to H antigen than those with hepatointestinal disease or healthy individuals. Infected subjects, particularly those with hepatointestinal disease, showed a decreased response after typhoid vaccine. Tins diminished ability to mount an immune response towards typhoid antigens dining schistosomiasis may interfere ivith the clearance of the bacteria from blood stream and, therefore, play a role in the prolonged survival of salmonella as obsewed in some patients with chronic salmonellosis associated with schistosomiasis.

scholarly journals Electrical impedance myography for assessing paraspinal muscles of patients with low back pain

2019 ◽  
Vol 10 (1) ◽  
pp. 103-109 ◽  
Author(s):  
Yun Wang ◽  
Laura Freedman ◽  
Martin Buck ◽  
Jose Bohorquez ◽  
Seward B. Rutkove ◽  
...  
Keyword(s):  
Back Pain ◽  
Electrical Impedance ◽  
Receiver Operating Curve ◽  
Low Back ◽  
Healthy Individuals ◽  
Paraspinal Muscles ◽  
Lower Back ◽  
Early Evidence ◽  
Pain Patients ◽  
Screening History

Abstract The objective of this study was to determine the potential value of electrical impedance myography (EIM) for assessing lumbosacral paraspinal muscle (LPM) condition in lower back pain (LBP) patients. Standard methods for assessing the condition of LPMs, such as magnetic resonance imaging, are inconvenient and expensive. One tool that could be useful for this purpose is electrical impedance myography (EIM) a technique that can be performed rapidly at the bedside. After undergoing a screening history and examination, subjects were studied with the mView EIM device (Myolex, Inc, Boston). Bilateral LPMs were measured three times each and the two closest sets of measurements averaged on each side. Data analysis included non-parametric two-group comparisons between healthy subjects and back pain patients, receiver-operating curve analyses, and correlation analyses to age and body mass index. A total of 86 healthy individuals (median age (interquartile range) (IQR), 45.5 years (30.3–56.0 years), 42 men, 44 women) and 47 LBP (median age 51.0 year (39.5–57.5) years, 21 men, 26 women) were enrolled. Median EIM 100kHz phase was lower in the LBP patients (9.3°(IQR 8.4°–10.6°) versus 11.4°(IQR 9.4°–13.0°), p = 0.0007). Significantly increased normalized side-to-side differences were present for all three EIM variables (e.g., median 100 kHz phase 0.15 (IQR 0.07–0.31 in LBP patients versus 0.09 (IQR 0.04–0.17) in healthy individuals). A significant correlation between 100 kHz EIM phase and reactance was found with age (Rspearman=−0.46, P=0.0002 and Rspearman=−0.440, P=0.0003) but not for resistance. This study provides early evidence supporting that EIM has the potential to serve as a useful tool for evaluating the condition of LPMs.

scholarly journals Adjusted T SPOT.TB Criteria Can Increase the Specificity of Diagnosis When Differentiating Spinal Tuberculosis From Other Spinal Infections

2021 ◽  
Author(s):  
Zhongjing Jiang ◽  
Qile Gao ◽  
Mingxing Tang ◽  
Hongqi Zhang ◽  
Yanbing Li ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Sensitivity And Specificity ◽  
Mononuclear Cells ◽  
Characteristic Curve ◽  
Spinal Tuberculosis ◽  
Youden Index ◽  
Mycobacterium Tuberculosis Infection ◽  
Peripheral Blood Mononuclear ◽  
Relative Operating Characteristic ◽  
Spinal Infections

Abstract Background: The ability of T-SPOT.TB to differentiate Mycobacterium tuberculosis infection of the spine from other infections is little known. This study quantified the efficiency, sensitivity, and specificity of the T-SPOT.TB assay to distinguish between spinal tuberculosis (STB) caused by M. tuberculosis and other infections of the spine and evaluated whether diagnostic performance was improved by adjusting the T-SPOT.TB assay criteria. Methods: From January 2010 to May 2020, 147 patients with spinal infections were recruited. Peripheral blood mononuclear cells were collected, and the number of spot-forming cells was observed. Patients’ white blood cell (WBC) counts, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), procalcitonin (PCT), and TB antibodies were recorded. Specimen/tissue bacteriological culture was the reference standard for sensitivity and specificity. Results: There were 77 (52.4%) participants with confirmed TB and 70 (47.6%) with other infections. The groups were comparable in T-SPOT.TB assay results, age, sex, lesions in the segments, WBC count, CRP, procalcitonin, ESR, and TB antibodies. The sensitivity and specificity of the T-SPOT.TB assay for identifying STB was 88.3% and 40.0%, respectively. On the basis of Relative operating characteristic curve (ROC) analysis and the Youden index, when we adjusted the T-SPOT.TB assay’s diagnostic criteria, ESAT-6>12 or CFP-10>19,the sensitivity and specificity of the T-SPOT.TB assay for identifying STB was 83.1% and 64.3%, respectively. Conclusion: The T-SPOT.TB assay has great sensitivity to distinguish STB from other spinal infections; however, the specificity is extremely low. Specificity can be significantly improved while sensitivity is guaranteed by adjusting the diagnostic criteria.

scholarly journals TUBERCULOSIS INFECTION MIGHT INCREASE THE RISK OF INVASIVE CANDIDIASIS IN AN IMMUNOCOMPETENT PATIENT

2015 ◽  
Vol 57 (3) ◽  
pp. 273-275 ◽  
Author(s):  
Xiao-Hua CHEN ◽  
Yun-Chao GAO ◽  
Yi ZHANG ◽  
Zheng-Hao TANG ◽  
Yong-Sheng YU ◽  
...  
Keyword(s):  
Candida Albicans ◽  
Invasive Candidiasis ◽  
Rare Case ◽  
Spinal Tuberculosis ◽  
Immunocompetent Patient ◽  
Antituberculous Therapy ◽  
Lower Back ◽  
Immunosuppressed Patients ◽  
History Of ◽  
Candida Infections

Deep Candida infections commonly occur in immunosuppressed patients. A rare case of a multiple deep organ infection with Candida albicans and spinal tuberculosis was reported in a healthy young man. The 19-year-old man complained of month-long fever and lower back pain. He also had a history of scalded mouth syndrome. Coinfection with Mycobacterium tuberculosis and Candida albicans was diagnosed using the culture of aspirates from different regions. Symptoms improved considerably after antifungal and antituberculous therapy. This case illustrates that infection with tuberculosis might impair the host's immune system and increase the risk of invasive candidiasis in an immunocompetent patient.

scholarly journals Multiple recurrent postoperative spinal infections due to an unrecognized presacral abscess following placement of bicortical sacral screws: case report

2016 ◽  
Vol 24 (3) ◽  
pp. 502-505
Author(s):  
Laura Bloom ◽  
S. Shelby Burks ◽  
Allan D. Levi
Keyword(s):  
Spinal Surgery ◽  
Deep Infection ◽  
Wound Infections ◽  
Lumbar Surgery ◽  
Pedicle Screw Placement ◽  
Postoperative Wound ◽  
Important Complication ◽  
Intravenous Antibiotics ◽  
Presacral Abscess ◽  
Spinal Infections

Postoperative wound infections in spinal surgery remain an important complication to diagnose and treat successfully. In most cases of deep infection, even with instrumentation, aggressive soft-tissue debridement followed by intravenous antibiotics is sufficient. This report presents a patient who underwent L3–S1 laminectomy and pedicle screw placement including bicortical sacral screws. This patient went on to develop multiple (7) recurrent infections at the operative site over a 5-year period. Continued investigation eventually revealed a large presacral abscess, which remained the source of recurrent bacterial seeding via the remaining bone tracts of the bicortical sacral screws placed during the original lumbar surgery. Two years after drainage of this presacral collection via a retroperitoneal approach, the patient remains symptom free.

scholarly journals A rare case report of psoas abscess in pregnancy in a tertiary centre

2021 ◽  
Vol 11 (1) ◽  
pp. 272
Author(s):  
Niranjan N. Chavan ◽  
Umme Ammara ◽  
Zaneta Dias ◽  
Manan Boob
Keyword(s):  
Case Report ◽  
Psoas Abscess ◽  
Spinal Tuberculosis ◽  
Signs And Symptoms ◽  
Clinical History ◽  
Interesting Case ◽  
Tertiary Centre ◽  
Rare Case Report ◽  
Uncommon Condition ◽  
In Pregnancy

A psoas abscess in pregnancy is a relatively uncommon condition with nonspecific signs and symptoms. It may lead to serious complications if not diagnosed and treated promptly. Although spinal tuberculosis affects nearly half of skeletal tuberculosis patients, psoas abscess develops in only 5% of spinal tuberculosis cases. A clinical history and examination are used to make a diagnosis, which is then confirmed by microbiology and radiological findings. Here is an interesting case report on psoas abscess in pregnancy managed by pigtail catheter insertion and drainage.

scholarly journals ISOLATED ENTERIC SPLENIC LESION IN AN IMMUNOCOMPETENT HOST: AN INTERESTING CASE REPORT

2021 ◽  
pp. 1-2
Author(s):  
ANJANA A ◽  
PANKAJ SINGHAI ◽  
RANJEETA ADHIKARY ◽  
MALAVALLI V BHAVANA ◽  
REDDI P YADAVALI
Keyword(s):  
Splenic Abscess ◽  
Salmonella Typhi ◽  
Interesting Case ◽  
Emerging Infections ◽  
Splenic Lesion ◽  
Ct Guided ◽  
Endemic Diseases ◽  
Insidious Onset ◽  
Atypical Presentations ◽  
Clinical Awareness

Splenic abscess is often an unrecognized complication of enteric fever. Diagnosis is difficult because of its rarity, insidious onset, and non-specific presentation. We report an interesting case of splenic lesion in an immunocompetent adolescent with no other comorbidities, who presented with history and clinical presentation more suggestive of tubercular etiology. However, culture from the CT-guided fine-needle aspirate grew Gram-negative bacilli, identified as Salmonella Typhi which was sensitive to ampicillin, cotrimoxazole, azithromycin, and ceftriaxone. He responded favorably with oral antibiotics without any further surgical intervention. High degree of clinical awareness with timely and appropriate microbiological evaluation helped into an early definitive diagnosis of enteric splenic abscess. This case highlights that in this era of emerging infections, we should not miss the atypical presentations of the endemic diseases. Safe and minimally invasive radiological intervention with good microbiological correlation is a successful spleen conserving treatment alternative to surgery in suitable patients of splenic abscess.

scholarly journals Polymorphisms in the SP110 and TNF-α Gene and Susceptibility to Pulmonary and Spinal Tuberculosis among Southern Chinese Population

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Ying Zhou ◽  
Chun-yan Tan ◽  
Zhi-jiang Mo ◽  
Qi-le Gao ◽  
Dan He ◽  
...  
Keyword(s):  
Protective Factor ◽  
Southern China ◽  
Spinal Tuberculosis ◽  
Control Group ◽  
Case Group ◽  
Nucleotide Polymorphisms ◽  
Healthy Individuals ◽  
Single Nucleotide ◽  
Southern Chinese ◽  
Tnf Α

Objective. To investigate the association of single-nucleotide polymorphisms (SNPs) in SP110 gene and TNF-α gene among pulmonary TB (PTB) and spinal TB (STB) patients. Methods. In a total of 190 PTB patients, 183 STB patients were enrolled as the case group and 362 healthy individuals at the same geographical region as the control group. The SP110 SNPs (rs722555 and rs1135791) and the promoter -308G>A (rs1800629) and -238G>A (rs361525) polymorphisms in TNF-α were genotyped. Results. TNF-α -238G>A polymorphism was involved in susceptibility to STB, but not to PTB. The TNF-α -238 A allele was a protective factor against STB (A versus G: OR [95% CI] = 0.331 [0.113–0.972], P=0.044). Furthermore, the presence of the -238 A allele was considered a trend to decrease the risk of STB (AG versus GG: P=0.062, OR [95% CI] = 0.352 [0.118–1.053]; AA + AG versus GG: P=0.050, OR [95CI%] = 0.335 [0.113–0.999]). However, SP110 SNPs (rs722555 and rs1135791) and TNF-α -308G>A (rs1800629) showed no association with PTB and STB in all genetic models. Conclusion. The TNF-α -238 A allele appeared a protective effect against STB, whereas the SP110 SNPs (rs722555 and rs1135791) and TNF-α -308G>A (rs1800629) showed no association with susceptibility to PTB and STB patients in southern China.

Human Immunodeficiency Virus–Related Gastrointestinal Pathology: A Southern Africa Perspective With Review of the Literature (Part 1: Infections)

2012 ◽  
Vol 136 (3) ◽  
pp. 305-315 ◽  
Author(s):  
Tomas Slavik
Keyword(s):  
Human Immunodeficiency Virus ◽  
Gastrointestinal Tract ◽  
Southern Africa ◽  
Opportunistic Infections ◽  
Systemic Disease ◽  
Sub Saharan Africa ◽  
Parasitic Infections ◽  
Gastrointestinal Infections ◽  
Gastrointestinal Pathology ◽  
Immunodeficiency Virus

Context.—Human immunodeficiency virus infection is rife in sub-Saharan Africa and in southern Africa in particular. Despite the increasing availability of antiretroviral therapy in this region, opportunistic infections remain common and frequently involve the gastrointestinal tract. Objective.—To review the histopathologic findings and distinguishing features of human immunodeficiency virus–associated gastrointestinal infections in southern Africa and relate those findings to the documented international literature. Data Sources.—The available literature on this topic was reviewed and supplemented with personal experience in a private histopathology practice in South Africa. Conclusions.—In southern Africa, the range of gastrointestinal, opportunistic infectious pathology in human immunodeficiency virus afflicted patients is diverse and includes viral, bacterial, fungal, and parasitic infections. This infectious pathology is sometimes a manifestation of systemic disease. In profoundly immunocompromised patients, unusual histologic features, involvement of uncommon gastrointestinal tract sites, and more than one pathogen may be seen.

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