Delayed Infection of Occipitocervical Fixation in a Patient with Achondroplasia: A Case Report and Review of Literature

Background: Infections are a major concern in fixation surgeries. Most of the infections could occur in the first three months after the operation. Case Report: We present a 45-year-old man who known case of achondroplasia who underwent craniospinal fixation and was presented to our clinic with surgical site infection after six years. His instruments were removed, and a halo vest was fixed for the patients. Accordingly, he received intravenous antibiotics, and during nine months’ follow-up, no any significant problems were found. Conclusion: Infection of instruments in spinal surgeries might be presented years after the surgery. Hence, it needs to be considered by surgeons in patients’ follow-ups. [GMJ.2020;9:e1906]

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Cerebrospinal Fluid Shunt-Associated Surgical Site Infection With Three- Versus Twelve-Month Follow-Up in Canadian Hospitals

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.679 ◽

2020 ◽

Vol 41 (S1) ◽

pp. s157-s157

Author(s):

Kelly Baekyung Choi ◽

John Conly ◽

Blanda Chow ◽

Joanne Embree ◽

Bonita Lee ◽

...

Keyword(s):

Surgical Site Infection ◽

Age Distribution ◽

Patient Characteristics ◽

Csf Shunt ◽

Surveillance Program ◽

Site Infection ◽

Infection Surveillance ◽

Surgical Manipulation ◽

National Systems

Background: Surgical site infection (SSI) after cerebrospinal fluids (CSF) shunt surgery is thought to be acquired intraoperatively. Biomaterial-associated infection can present up to 1 year after surgery, but many national systems have shortened follow-up to 90 days. We compared 3- versus 12-month follow-up periods to determine the nature of case ascertainment in the 2 periods. Methods: Participants of any age with placement of an internal CSF shunt or revision surgical manipulation of an existing internal shunt identified in the Canadian Nosocomial Infection Surveillance Program (CNISP) participating hospitals between 2006 and 2018 were eligible. We excluded patients with external shunting devices or culture-positive CSF at the time of surgery. Patients were followed for 12 months after surgery for the primary outcome of a CSF infection with a positive CSF culture by review of laboratory and health records. Patients were categorized as adult (aged ≥18 years) or pediatric (aged < 18 years). The infection rate was expressed as the number of CSF shunt-associated infections divided by the number of shunt surgeries per 100 procedures. Results: In total, 325 patients (53% female) met inclusion criteria in 14 hospitals from 7 provinces were identified. Overall, 46.1% of surgeries were shunt revisions and 90.3% of shunts were ventriculoperitoneal. For pediatric patients, the median age was 0.7 years (IQR, 0.2–7.0). For adult patients, the median age was 47.9 years (IQR, 29.6–64.6). The SSI rates per 100 procedures were 3.69 for adults and 3.65 for pediatrics. The overall SSI rates per 100 procedures at 3 and 12 months were 2.74 (n = 265) and 3.48 (n = 323), respectively. By 3 months (90 days), 82% of infection cases were identified (Fig. 1). The median time from procedure to SSI detection was 30 days (IQR, 10–65). No difference was found in the microbiology of the shunt infections at 3- and 12-month follow-ups. The most common pathogens were coagulase-negative Staphylococcus (43.6 %), followed by S. aureus (24.8 %) and Propionibacterium spp (6.5 %). No differences in age distribution, gender, surgery type (new or revision), shunt type, or infecting organisms were observed when 3- and 12-month periods were compared. Conclusions: CSF-SSI surveillance for 3 versus 12 months would capture 82.0% (95% CI, 77.5–86.0) of cases, with no significant differences in the patient characteristics, surgery types, or pathogens. A 3-month follow-up can reduce resources and allow for more timely reporting of infection rates.Funding: NoneDisclosures: None

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Incidence, Management and Outcome of Delayed Deep Surgical Site Infection Following Spinal Deformity Surgery: 20-Year Experience at a Single Institution

Global Spine Journal ◽

10.1177/2192568220978225 ◽

2020 ◽

pp. 219256822097822

Author(s):

Muyi Wang ◽

Liang Xu ◽

Bo Yang ◽

Changzhi Du ◽

Zezhang Zhu ◽

...

Keyword(s):

Surgical Site Infection ◽

Spinal Deformity ◽

Recurrent Infection ◽

Implant Removal ◽

Site Infection ◽

Initial Surgery ◽

Spinal Deformity Surgery ◽

Solid Fusion ◽

Deep Surgical Site Infection

Study Design: A retrospective study. Objectives: To investigate the incidence, management and outcome of delayed deep surgical site infection (SSI) after the spinal deformity surgery. Methods: This study reviewed 5044 consecutive patients who underwent spinal deformity corrective surgery and had been followed over 2 years. Delayed deep SSI were defined as infection involving fascia and muscle and occurring >3 months after the initial procedure. An attempt to retain the implant were initially made for all patients. If the infection failed to be eradicated, the implant removal should be put off until solid fusion was confirmed, usually more than 2 years after the initial surgery. Radiographic data at latest follow-up were compared versus that before implant removal. Results: With an average follow-up of 5.3 years, 56 (1.1%) patients were diagnosed as delayed deep SSI. Seven (12.5%) patients successfully retained instrumentation and there were no signs of recurrence during follow-up (average 3.4 years). The remaining patients, because of persistent or recurrent infection, underwent implant removal 2 years or beyond after the primary surgery, and solid fusion was detected in any case. However, at a minimum 1-year follow-up (average 3.9 years), an average loss of 9° in the thoracic curve and 8° in the thoracolumbar/lumbar curves was still observed. Conclusions: Delayed deep SSI was rare after spinal deformity surgery. To eradicate infection, complete removal of implant may be required in the majority of delayed SSI. Surgeons must be aware of high likelihood of deformity progression after implant removal, despite radiographic solid fusion.

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Long term follow-up and development of foot complaints in a surgically treated mirror foot—A case report and review of literature

Foot and Ankle Surgery ◽

10.1016/j.fas.2017.02.017 ◽

2017 ◽

Vol 23 (4) ◽

pp. e9-e13

Author(s):

S.A. Lalé ◽

E.B. Burger ◽

J.H.J.M. Bessems ◽

V. Pollet ◽

C.A. van Nieuwenhoven

Keyword(s):

Case Report ◽

Review Of Literature ◽

Mirror Foot ◽

Long Term Follow Up

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Surgical Site Infection as a Surrogate Marker of Physician Impairment

Infection Control and Hospital Epidemiology ◽

10.1086/647982 ◽

2009 ◽

Vol 30 (11) ◽

pp. 1120-1122 ◽

Cited By ~ 3

Author(s):

Robert J. Sherertz ◽

Tobi B. Karchmer

Keyword(s):

Hepatitis C Virus ◽

Hepatitis C ◽

Surgical Site Infection ◽

Surrogate Marker ◽

Surgical Site Infections ◽

Baseline Period ◽

Site Infection ◽

Hepatitis C Virus Infection ◽

Physician Impairment

Our report details an implant-associated outbreak of surgical site infections related to the adverse effects of treatment for hepatitis C virus infection administered to surgeon X. During the 12-month period of this outbreak, 14 (9.5%) of 148 of surgeon X's patients developed a surgical site infection, a rate of SSI that was 8-fold higher than the rate during the 14-month baseline period or the 14-month follow-up period (P = .001), and higher than the rate among peer surgeons (P = .02).

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Rare and favorable prognosis of pediatric acute lymphoblastic leukemia with TLS-ERG fusion gene: case report with long-term follow-up and review of literature

Cancer Genetics ◽

10.1016/j.cancergen.2021.04.003 ◽

2021 ◽

Author(s):

Sisi Li ◽

Wei Huang ◽

Yuanyuan Wu ◽

Xiaojun Xu ◽

Chan Liao ◽

...

Keyword(s):

Case Report ◽

Acute Lymphoblastic Leukemia ◽

Fusion Gene ◽

Lymphoblastic Leukemia ◽

Review Of Literature ◽

Pediatric Acute Lymphoblastic Leukemia ◽

Favorable Prognosis ◽

Long Term Follow Up

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The incidence of complications in elective cranial neurosurgery associated with dural closure material

Journal of Neurosurgery ◽

10.3171/2013.8.jns13703 ◽

2014 ◽

Vol 120 (1) ◽

pp. 278-284 ◽

Cited By ~ 10

Author(s):

Brian P. Walcott ◽

Jonathan B. Neal ◽

Sameer A. Sheth ◽

Kristopher T. Kahle ◽

Emad N. Eskandar ◽

...

Keyword(s):

Surgical Site Infection ◽

Corticosteroid Treatment ◽

Csf Leak ◽

Site Infection ◽

Exclusion Criteria ◽

Dural Closure ◽

Estimated Blood Loss ◽

Dural Graft ◽

Synthetic Grafts

Object Dural closure with synthetic grafts has been suggested to contribute to the incidence of infection and CSF leak. The objective of this study was to assess the contribution of choice of dural closure material, as well as other factors, to the incidence of infection and CSF leak. Methods A retrospective, consecutive cohort study of adult patients undergoing elective craniotomy was established between April 2010 and March 2011 at a single center. Exclusion criteria consisted of trauma, bur hole placement alone, and temporary CSF fluid diversion. Results Three hundred ninety-nine patients were included (mean follow-up 396.6 days). Nonautologous (synthetic) dural substitute was more likely to be used (n = 106) in cases of reoperation (p = 0.001). Seventeen patients developed a surgical site infection and 12 patients developed a CSF leak. Multivariate logistic regression modeling identified estimated blood loss (OR 1.002, 95% CI 1.001–1.003; p < 0.001) and cigarette smoking (OR 2.198, 95% CI 1.109–4.238; p = 0.019) as significant predictors of infection. Synthetic dural graft was not a predictor of infection in multivariate analysis. Infratentorial surgery (OR 4.348, 95% CI 1.234–16.722; p = 0.024) and more than 8 days of postoperative corticosteroid treatment (OR 3.886, 95% CI 1.052–16.607; p = 0.048) were significant predictors for the development of CSF leak. Synthetic dural graft was associated with a lower likelihood of CSF leak (OR 0.072, 95% CI 0.003–0.552; p = 0.036). Conclusions The use of synthetic dural closure material is not associated with surgical site infection and is associated with a reduced incidence of CSF leak. Modifiable risk factors exist for craniotomy complications that warrant vigilance and further study.

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Bone graft donor site infection with a rare organism, Aeromonas Hydrophila. A typical location, presentation and organism with 2 years follow-up. Case report

International Journal of Surgery Case Reports ◽

10.1016/j.ijscr.2018.08.037 ◽

2018 ◽

Vol 51 ◽

pp. 154-157 ◽

Cited By ~ 1

Author(s):

Obada Hasan ◽

Wajiha Khan ◽

Muneeba Jessar ◽

Aly Zaheer Pathan ◽

Riaz Hussain Lakdawala

Keyword(s):

Case Report ◽

Bone Graft ◽

Aeromonas Hydrophila ◽

Donor Site ◽

Site Infection ◽

Graft Donor

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Bifocal parosteal osteoma of femur: A case report and review of literature

Orthopedic Reviews ◽

10.4081/or.2020.8673 ◽

2020 ◽

Author(s):

Raffaele Vitiello ◽

Tommaso Greco ◽

Luigi Cianni ◽

Silvia Careri ◽

Maria Serena Oliva ◽

...

Keyword(s):

Case Report ◽

Clinical Features ◽

Compact Bone ◽

Gardner's Syndrome ◽

Review Of Literature ◽

Solitary Lesion ◽

Gardner’S Syndrome ◽

One Year

Osteoma is a benign, slowly growing, asymptomatic, bone-forming tumor arising from cancellous or compact bone. Osteoma usually is a solitary lesion, but in patients with Gardner’s Syndrome it may be multiple. osteoma may rarely have a parosteal localization. Parosteal osteoma has peculiar radiographic, histologic and clinical features. We describe a case report of a 51- years old man with a bifocal parosteal osteoma of the femur in a non-syndromic patient. This is the first described patient with a bifocal lesion. In literature only 24 cases of paraosteal osteoma are found. Our patient underwent surgery and the lesions were fully excised. At one year follow-up there was no evidence of recurrence.

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Isolated Crohn’s Disease of the Appendix Presenting as Acute Appendicitis in a 60-Year-Old South Asian Female: A Case Report, Review of Literature, and Follow-Up Recommendations

Case Reports in Surgery ◽

10.1155/2019/5285417 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Pamathy Gnanaselvam ◽

Dhanushka N. Weerakoon ◽

W. A. M. Wijayasuriya ◽

Vishva Samidi Mohottala ◽

B. M. E. S. Sinhakumara ◽

...

Keyword(s):

Crohn’S Disease ◽

Case Report ◽

Crohn's Disease ◽

Acute Appendicitis ◽

Clinical Findings ◽

Additional Treatment ◽

Histological Evaluation ◽

Histopathological Analysis ◽

Review Of Literature

The isolated appendiceal Crohn’s disease without preceding bowel symptoms is a rare phenomenon, especially in older patients. In this case report, we present a 60-year-old female with isolated appendiceal Crohn’s disease presenting with acute appendicitis. She presented with classical features of appendicitis with elevated inflammatory markers. She underwent an appendectomy which showed an excessively swollen, oedematous, and reddish appendix with swelling extending to the base of the caecum. Histological evaluation was suggestive of Crohn’s disease, and subsequent colonoscopy was unremarkable. Following appendectomy, she was asymptomatic without any recurrence of disease. The atypical morphological appearance of the appendix should raise suspicion of Crohn’s disease. This case highlights the importance of histopathological analysis of the specimen, especially in abnormal clinical findings. The prognosis of such patients seems to be good, and additional treatment is rarely needed.

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