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Vertebral Osteomyelitis

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1. Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis. (PubMed)

Selection of an appropriate empiric antibiotic regimen in hematogenous vertebral osteomyelitis. Empiric antibiotic therapy for suspected hematogenous vertebral osteomyelitis (HVO) should be initiated immediately in seriously ill patients and may be required in those with negative microbiological results. The aim of this study was to inform the appropriate selection of empiric antibiotic regimens for the treatment of suspected HVO by analyzing antimicrobial susceptibility of isolated bacteria

2019 PLoS ONE

2. Mycobacterium abscessus ssp. abscessus infection progressing to empyema from vertebral osteomyelitis in an immunocompetent patient without pulmonary disease: a case report. (PubMed)

Mycobacterium abscessus ssp. abscessus infection progressing to empyema from vertebral osteomyelitis in an immunocompetent patient without pulmonary disease: a case report. Pleural involvement by non-tuberculous mycobacteria (NTM) in patients without distinct pulmonary disease is extremely rare. Vertebral osteomyelitis (VO) with or without pulmonary disease is also a rare clinical presentation of NTM infection, and pleural spread of NTM from VO has not been reported.A 63-year-old woman

2019 BMC pulmonary medicine

3. Treatment of Multidrug-Resistant Vancomycin-Resistant Enterococcus faecium Hardware-Associated Vertebral Osteomyelitis with Oritavancin plus Ampicillin. (PubMed)

Treatment of Multidrug-Resistant Vancomycin-Resistant Enterococcus faecium Hardware-Associated Vertebral Osteomyelitis with Oritavancin plus Ampicillin. Weekly oritavancin plus ampicillin continuous infusion combination therapy was used to successfully treat a deep spine vancomycin-resistant Enterococcus faecium infection associated with hardware. Checkerboard and time-kill assays confirmed synergy between these two antibiotics. Further synergies of oritavancin and ampicillin with rifampin

2019 Antimicrobial Agents and Chemotherapy

4. Outcomes of additional instrumentation in elderly patients with pyogenic vertebral osteomyelitis and previous spinal instrumentation. (PubMed)

Outcomes of additional instrumentation in elderly patients with pyogenic vertebral osteomyelitis and previous spinal instrumentation. In patients with pyogenic vertebral osteomyelitis (PVO) and previous instrumentation requiring surgical treatment, a decision must be made between a less-invasive noninstrumented surgery, including retaining the previous instrumentation, or a more invasive additional instrumented surgery involving the complete removal of the infected tissue and firm (...) of infection recurrence and mortality compared with noninstrumented surgery despite a larger number of involved vertebral levels and greater incidence of epidural abscesses. However, instrumented patients with PVO and previous instrumentation who experienced infection recurrence had worse clinical outcomes than those of the noninstrumented patients with PVO. Severe medical comorbidities, the presence of a psoas abscess, and methicillin-resistant Staphylococcus aureus infection were associated with a higher

2019 The Spine Journal

5. Impact of diagnostic bone biopsies on the management of non-vertebral osteomyelitis: A retrospective cohort study. (PubMed)

Impact of diagnostic bone biopsies on the management of non-vertebral osteomyelitis: A retrospective cohort study. Optimal antibiotic management of patients with osteomyelitis remains a challenge for many clinicians. Although image-guided bone biopsy (IGB) remains the gold standard, its role in confirming diagnosis and guiding antibiotic management is not clear in patients with non-vertebral osteomyelitis.To determine the diagnostic yield of IGB and its impact on antibiotic management in non (...) -vertebral osteomyelitis.Retrospective cohort study.Urban academic medical center.Patients admitted for non-vertebral osteomyelitis who underwent image-guided bone biopsy.Primary outcomes were microbiologic and histopathological results. We evaluated the impact of IGB on clinician-initiated changes in antibiotic regimen before and after biopsy.We evaluated 203 bone biopsies in 185 patients with clinical suspicion of osteomyelitis. 79% of patient received antibiotics prior to biopsy. Bone cultures were

2019 Medicine

6. Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report. (PubMed)

Cervical anaerobic vertebral osteomyelitis following surgical tracheotomy: a case report. We report a rare case of anaerobic vertebral osteomyelitis associated with surgical tracheotomy which has never been reported to the best of our knowledge.A healthy 39-year-old man was admitted to intensive care for a severe brain trauma injury where a surgical tracheotomy was performed. He was discharged to a rehabilitation centre after 54 days hospital stay. During rehabilitation, he developed (...) progressive and febrile tetraplegia associated with cervical pain, requiring an intensive care readmission. A polymicrobial anaerobic bloodstream infection was revealed and magnetic resonance imaging diagnosed cervical vertebral osteomyelitis. Both the type of anaerobic micro-organisms found and the timing of the symptoms strongly suggest that the surgical tracheotomy was responsible for this rare case of cervical vertebral osteomyelitis. The patient was successfully treated by a prolonged antimicrobial

2019 BMC Infectious Diseases

7. Pyogenic vertebral osteomyelitis of the elderly: Characteristics and outcomes. (PubMed)

Pyogenic vertebral osteomyelitis of the elderly: Characteristics and outcomes. The incidence of pyogenic vertebral osteomyelitis (PVO) has increased over the past two decades. One possible cause of this increase is the aging of the population, which results in more comorbidities in high income countries.To better characterize the clinical presentation and outcome of PVO in the elderly.We conducted a post-hoc analysis of a previously published trial that studied treatment duration in PVO

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2017 PLoS ONE

8. Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults

Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults Practice Guidelines Search Search Practice Guidelines Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary

2015 Infectious Diseases Society of America

9. An 11 Year Old Male with Vertebral Osteomyelitis and a Paraspinal Abscess. (PubMed)

An 11 Year Old Male with Vertebral Osteomyelitis and a Paraspinal Abscess. We report the case of an 11-year-old immunocompetent patient presenting with a 2-week history of upper back pain, diagnosed with thoracic vertebral osteomyelitis and a paraspinal abscess caused by Bartonella henselae. He was treated with gentamicin and doxycycline followed by oral rifampicin and doxycycline with favorable outcome.

2018 Pediatric Infectious Dsease Journal

10. Vertebral Osteomyelitis Caused by Helicobacter cinaedi Identified Using Broad-range Polymerase Chain Reaction with Sequencing of the Biopsied Specimen (PubMed)

Vertebral Osteomyelitis Caused by Helicobacter cinaedi Identified Using Broad-range Polymerase Chain Reaction with Sequencing of the Biopsied Specimen A 65-year-old man presented with gradually exacerbating low back pain. Magnetic resonance imaging revealed vertebral osteomyelitis in the Th11-L2 vertebral bodies and discs. The patient showed negative findings on conventional cultures. Direct broad-range polymerase chain reaction (PCR) with sequencing of the biopsied specimen had the highest (...) similarity to the 16S rRNA gene of Helicobacter cinaedi. This case suggests that direct broad-range PCR with sequencing should be considered when conventional cultures cannot identify the causative organism of vertebral osteomyelitis, and that this method may be particularly useful when the pathogen is a fastidious organism, such as H. cinaedi.

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2018 Internal Medicine

11. Brucella vertebral osteomyelitis misidentified as an Ochrobactrum anthropi infection (PubMed)

Brucella vertebral osteomyelitis misidentified as an Ochrobactrum anthropi infection Ochrobactrum anthropi is a Gram-negative bacillus widely distributed in nature. It is a low virulence and low pathogenic microorganism and human infection by this agent is considered rare. This microorganism can cause bacteremia and in some cases can lead to osteomyelitis and endocarditis. Included in Brucellaceae family, this bacterium is phenotypically and genetically closely related to the Brucella genus (...) and may be misidentified by rapid identification systems. The authors describe a patient admitted to the Infectious Diseases Department with vertebral osteomyelitis initially identified as Ochrobactrum anthropi. Despite appropriate antimicrobial therapy, the blood cultures remained positive and there were no signs of clinical improvement. This raised suspicion of a possible misidentification. It was decided to initiate antimicrobial therapy to include the Brucella genus, with slow but progressive

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2018 IDCases

12. Vertebral Osteomyelitis, Discitis, and Epidural Abscess: A Rare Complication of Cardiobacterium Endocarditis (PubMed)

Vertebral Osteomyelitis, Discitis, and Epidural Abscess: A Rare Complication of Cardiobacterium Endocarditis In this article, we report the case of a 75-year-old man who was presented with new low back pain for 2 weeks. His past history was significant for severe aortic stenosis necessitating bioprosthetic aortic valve placement 4 years ago, hypertension, and coronary artery disease. His physical examination was positive for point tenderness over the lower lumbar spine. He was found (...) to be bacteremic with Cardiobacterium hominis. Magnetic resonance imaging of the spine showed lumbar (L4-L5) epidural abscess and vertebral osteomyelitis, discitis. He underwent a computed tomography-guided needle biopsy of L4-L5. The biopsy culture was also positive for Cardiobacterium hominis. A transesophageal echocardiogram showed small vegetation on the mitral valve with mild regurgitation. He was started on intravenous ceftriaxone 2 g once daily for a planned duration of 6 weeks and was discharged

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2018 Journal of investigative medicine high impact case reports

13. Vertebral Osteomyelitis Secondary to Pneumococcal Infection (PubMed)

Vertebral Osteomyelitis Secondary to Pneumococcal Infection Vertebral osteomyelitis secondary to pneumococcal infection is an uncommon condition caused by Streptococcus pneumoniae. Fever, back pain, and raised ESR are common features in the clinical setting. We report a 62-year-old female patient who presented with an unusual presentation. Later on, vertebral osteomyelitis secondary to pneumococcal infection was confirmed at T8, 9 by CT scan, MRI, and cytology. The patient was treated

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2018 Case reports in infectious diseases

14. Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess (PubMed)

Diagnostic Quandary: Salmonella Agbeni Vertebral Osteomyelitis and Epidural Abscess Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only (...) mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture. The patient's pain continued to increase in severity over the next several weeks, and he was evaluated by multiple healthcare professionals with no discovered pathology. Approximately 5 weeks following the fall, repeat CT scan and MRI were conducted which then revealed extensive findings of discitis/osteomyelitis at L5-S1 as well as an epidural abscess resulting

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2018 Case reports in orthopedics

15. Clinical effect of early bisphosphonate treatment for pyogenic vertebral osteomyelitis with osteoporosis: An analysis by the Cox proportional hazard model. (PubMed)

Clinical effect of early bisphosphonate treatment for pyogenic vertebral osteomyelitis with osteoporosis: An analysis by the Cox proportional hazard model. Patients with pyogenic vertebral osteomyelitis (PVO) are expected to have an increased risk of bone loss. Therefore, early bisphosphonate therapy would be clinically effective for PVO patients with osteoporosis.This study aimed to investigate the effect of bisphosphonate on clinical outcomes of PVO patients with osteoporosis.A retrospective (...) comparative study.PVO patients with osteoporosis.Four events of interest for Cox proportional hazard model included surgical treatment, recurrence of infection, subsequent fracture of adjacent vertebral bodies, and death.PVO patients were divided into three groups: group A (initiation of bisphosphonate within 6 weeks after PVO diagnosis), group B (initiation of bisphosphonate between 6 weeks and 3 months after PVO diagnosis), and group C (no treatment for osteoporosis). Cox proportional hazard model

2018 The Spine Journal

16. Comment on: Delayed intestinal perforation and vertebral osteomyelitis after high-intensity focused ultrasound treatment for uterine leiomyoma (PubMed)

Comment on: Delayed intestinal perforation and vertebral osteomyelitis after high-intensity focused ultrasound treatment for uterine leiomyoma 29569640 2018 11 14 2287-8572 61 2 2018 Mar Obstetrics & gynecology science Obstet Gynecol Sci Comment on: Delayed intestinal perforation and vertebral osteomyelitis after high-intensity focused ultrasound treatment for uterine leiomyoma. 177-178 10.5468/ogs.2018.61.2.177 Ko Jennifer K Y JKY https://orcid.org/0000-0003-0475-0645 Department of Obstetrics

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2018 Obstetrics & gynecology science

17. Comparison of Pyogenic Postoperative and Native Vertebral Osteomyelitis. (PubMed)

Comparison of Pyogenic Postoperative and Native Vertebral Osteomyelitis. Postoperative vertebral osteomyelitis (PVO) after spinal surgery is a clinical challenge. However, there is a paucity of evidence regarding the most likely etiologic organisms to guide the choice of empirical antibiotic therapy, and previous reports of treatment outcomes for PVO are scarce.To compare the microbiology, clinical characteristics, and outcomes of pyogenic PVO with native vertebral osteomyelitis (NVO (...) ).Retrospective comparative study.Patients with microbiologically proven vertebral osteomyelitis from three university-affiliated hospitals in South Korea between January 2005 and December 2015 with follow-up of at least 12 months after completion of antibiotics or until the patient was transferred. Patients who had a spine operation in the same location within 1 year of diagnosis, and all patients with remnant implants at the time of the vertebral osteomyelitis diagnosis, were defined as having PVO

2018 The Spine Journal

18. Epidemiology, Microbiological Diagnosis, and Clinical Outcomes in Pyogenic Vertebral Osteomyelitis: A 10-year Retrospective Cohort Study (PubMed)

Epidemiology, Microbiological Diagnosis, and Clinical Outcomes in Pyogenic Vertebral Osteomyelitis: A 10-year Retrospective Cohort Study Pyogenic vertebral osteomyelitis (PVO) is rising in incidence, but optimal methods of investigation and duration of antibiotic therapy remain controversial.We conducted a single-center retrospective cohort study of PVO at an Australian teaching hospital. We included all adults with a first episode of PVO between 2006 and 2015. PVO was defined based (...) ) and had a higher mean admission C-reactive protein (207 vs 54, P < .001) compared with patients without an identified pathogen. However, they were less likely to experience an adverse outcome (death or attributable readmission within 2 years; adjusted odds ratio, 0.36; 95% confidence interval, 0.13-0.99; P = .04). Open biopsy of vertebral tissue had a higher diagnostic yield (70%) than fine needle aspirate (41%) or core biopsy (30%). Despite receiving a median of 6 weeks of intravenous antibiotics

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2018 Open forum infectious diseases

19. Lomentospora prolificans vertebral osteomyelitis with spinal epidural abscess in an immunocompetent woman: Case report and literature review (PubMed)

Lomentospora prolificans vertebral osteomyelitis with spinal epidural abscess in an immunocompetent woman: Case report and literature review Lomentospora prolificans is a rare cause of vertebral osteomyelitis. We report a case of L. prolificans thoracic vertebral osteomyelitis with spinal epidural abscess in a patient without apparent immunodeficiency. Clinical manifestations and radiographic findings could not distinguish from other etiologic agents. Treatment is also challenging because L

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2018 Medical mycology case reports

20. Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis. (PubMed)

Bone mineral density in osteoporotic patients with pyogenic vertebral osteomyelitis: effect of early versus late treatment for osteoporosis. Patients with pyogenic vertebral osteomyelitis (PVO) are at greater risk of bone loss. However, treatment guidelines for bone loss have been lacking. Early bisphosphonate treatment within 6 weeks after PVO diagnosis was significantly associated with superior outcome in femoral BMD at 2-year follow-up, compared to that with late treatment.Due to absence

2018 Osteoporosis International

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