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Query: UMLS:C0004623 (bacterial infection)
 15,226 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pyomyositis is a bacterial infection of skeletal muscle. We describe the clinical case of a 77-year-old woman affected by gait disturbance, repetitive falls, low back pain and left thigh and groin pain, but without symptoms of systemic infection. Computed tomography and magnetic resonance imaging of the abdomen and pelvis showed abscesses in the left psoas and adductor brevis muscles. Investigations of urogenital tract and gastrointestinal system were normal. Systemic antibiotic treatment alone was not efficient, while surgical drainage improved the clinical picture. The aetiological organism, isolated from the abscess, was Staphylococcus aureus. We suggest that this patient had a primary pyomyositis rather than a secondary form. This is the first report of concomitant abscesses of psoas and adductor brevis muscles with early neurological involvement.
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PMID:Acute iliopsoas and adductor brevis abscesses presenting with proximal leg muscle weakness. 1681 11

This article describes the development of minimally invasive methods in the treatment of lumbar discopathy, with particular attention to percutaneous laser disc decompression (PLDD). The authors discus the therapeutic operating mechanism of PLDD, emphasizing the importance of the thermal characteristics of laser light, which is responsible for the vaporization and ablation of a small amount of tissue from the nucleus pulposus. This causes a significant reduction in pressure in the closed structure of the disc, and consequently reduced compression exerted by the disk on the dural sac and the nerve roots. Improvement in the flow of cerebro-spinal fluid has also been observed on the level at which the operation is performed. On the basis of our own experience and the reports of other authors, we have specified indications and contra-indications for PLDD. Our conclusion is that PLDD is an effective treatment method for low back pain and ischialgia caused by protrusion or herniation of the nucleus pulposus, with elimination or significant reduction in symptoms in over 75% of those treated; reduction or resolution of neurological deficits that arise in the course of lumbar discopathy has also been observed. This method enables one-stage treatment of multi-level degenerative changes in the intervertebral disc. The only absolute contraindications for PLDD are the presence of sequestration, disturbances in blood coagulation, and bacterial infection.
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PMID:Percutaneous laser lumbar disc decompression - mechanism of action, indications and contraindications. 1767 91

The spondyloarthritides (SpA) are often included in the differential diagnosis of early arthritis with or without low back pain. This is namely true for reactive arthritis which occurs as acute or subacute arthritis in association with urogenital or gastrointestinal bacterial infection. Reactive arthritis can result in chronic or relapsing disease. The SpA group also includes ankylosing spondylitis (axial form or with peripheral arthritis), psoriatic arthritis and SpA in association with inflammatory bowel disease. (Early) undifferentiated SpA has now come into the focus of many researchers since more effective and specific therapy has become available for the SpA. Diagnostic algorithms have been developed and evaluated.
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PMID:[Early spondyloarthritis]. 1826 56

Postoperative infections following spine surgery are usually attributable to bacterial organisms. Staphylococcus aureus is known to be the most common single pathogen leading to this infection, and the number of infections caused by methicillin-resistant Staphylococcus aureus is increasing. However, there is a paucity of literature addressing postoperative infection with Mycobacterium tuberculosis. We encountered a case of tuberculous spondylitis after spine surgery. A man had fever with low back pain three weeks after posterior interbody fusion with instrumentation for a herniated intervertebral disc at the L4-L5 level. He had been treated with antibiotics for an extended period of time under the impression that he had a bacterial infection, but his symptoms and laboratory data had not improved. Polymerase chain reaction for Mycobacterium tuberculosis turned out to be positive. The patient's symptoms finally improved when he was treated with antituberculosis medication.
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PMID:A case of postoperative tuberculous spondylitis with a bizarre course. 1988 99

Primary bilateral iliopsoas abscesses in the elderly are very rare in Europe. We report a case of an elderly male misdiagnosed with rheumatic low back pain. The delay in accurate diagnosis and therapy led to severe worsening of his general condition and septic shock. The diagnosis was established by multi-slice computed tomography (MSCT) and the patient was successfully treated by MSCT-guided percutaneous drainage of both psoas muscles. Septic shock and miscellaneous complications required continuous intensive care. The patient was discharged after 42 days of hospital treatment. Antibiotic therapy continued for the next six weeks until his complete recovery. Pain remains the most frequent and predominant symptom of spinal pathology regardless of the etiology. Immunocompromised patients or signs suggestive of bacterial infection require caution and a more comprehensive diagnostic work-up.
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PMID:Primary bilateral iliopsoas abscess in an elderly man. 2292 7

Reactive arthritis (ReA) is an infection-induced systemic illness characterized by an aseptic inflammatory joint involvement and occurring in genetically predisposed patients with a bacterial infection localized in a distant organ or system. We evaluated the possible role of bacterial infection in the etiology of reactive arthritis by testing peripheral blood monocytes (PBMCs) for the presence of prokaryotic 16S ribosomal RNA genes which are known as 16S rDNA. PBMCs were isolated from 40 patients with ReA and 10 healthy controls. Clinical, laboratory and radiological evaluations were carried out for all patients and controls. Bacterial DNA was extracted from the PBMCs and subjected to PCR amplification of the 16S rDNA gene followed by DNA sequencing and database comparative analysis. Bacterial DNA was detected in 16/40 (40%) patients and 3/10 (30%) healthy controls. No significant difference was detected between the PCR +ve and -ve groups of patients as regards arthritis, arthralgia, sacroiliitis, low back pain and enthesopathies (P>0.05), while a significant difference was detected in the PCR +ve females with gynaecological infection (P<0.05). A significant difference of the pattern of arthritis was also observed between the two groups of patients. Comparative analysis of 7 16S rDNA sequences from patients and controls using Basic Local Alignment Search Tool (BLAST) and the National Center for Biotechnology Information (NCB1) database revealed high % similarity with potential pathogens and nonpathogenic bacteria. Further studies are needed to establish the exact role of these organisms in the pathogenesis of ReA.
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PMID:Detection of bacterial DNA in peripheral blood mononuclear cells of patients with reactive arthritis. 2308 72

In two recent publications, the authors' hypothesis was that Modic type 1 changes seen in patients with chronic low back pain and herniated lumbar discs may be attributed to bacterial infection/inflammation. The first study showed that many herniated discs were infected with Proprionibacterium acnes, a common anaerobic skin organism, also found in sarcoidosis, and possibly, arthritic joints. In the second double-blind randomized study, 162 patients with disc herniation and Modic type 1 changes were treated with 100 days of oral Bioclavid (Amoxicillin/Clavulanic acid) vs. placebo; those treated with antibiotics improved in all dimensions (e.g., reduced chronic low back/leg pain, reduced disability). Together, the implications of these studies for spine surgeons and pain practitioners are momentous. If a few weeks of oral antibiotic treatment resolves chronic low back pain, then much currently performed spine surgery (e.g. including internal fixation/fusion), as well as chronic pain management/rehabilitation and psychological strategies may be rendered unnecessary.
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PMID:Editorial on two chronic low back pain studies: A major change in surgical management of disc disease? 2434 Feb 35

Considerable interest has been generated recently regarding an alternative hypothesis for the pathogenesis of low back pain and radiculopathy in the presence of intervertebral disc prolapse. Traditionally, back pain and radicular (sciatic) symptoms have been attributed to mechanical compression of neural tissue by herniated disc material and to inflammation caused by exposure of the nerve roots to disc tissue. Recent research however has suggested that low-grade infection within the intervertebral disc by anaerobic bacteria may be responsible. The development of Modic changes in the corresponding adjacent vertebral endplates has also been suggested as an indicator of infection. This article is a thorough review of the current literature regarding the hypothesis that low-grade anaerobic bacterial infection may be the cause of disabling low back pain and radiculopathy.
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PMID:Do bacteria play an important role in the pathogenesis of low back pain? 2564 61

Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression. A 50-year old female presented with one-week history of persistent low back pain with progressively worsening bilateral lower limb weakness for seven days and urinary retention associated with saddle anesthesia of 2-day duration. Magnetic resonance imaging with contrast of the lumbo-sacral region showed an intramuscular collection of abscess at left gluteus maximus and left multifidus muscle with a L3-L5 posteriorly placed extradural lesion enhancing peripherally on contrast, suggestive of epidural abscess that compressed the cauda equina. The pus was drained using the posterior lumbar approach. Tissue and pus culture revealed Klebsiella pneumoniae, suggestive of bacterial infection. The patient made immediate improvement of muscle power over bilateral lower limbs postoperative followed by ability to control micturition and defecation the 4th post-operative day. A good short-term outcome in delayed decompression of cauda equine syndrome is extremely rare. Aggressive surgical decompression combined with antibiotic therapy led to good short-term outcome in this patient despite delayed decompression of more than 48 hours.
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PMID:A Good Short-term Outcome in Delayed Decompression of Cauda Equina Syndrome in Klebsiella pneumoniae Spinal Epidural Abscess: A Case Report. 2902 88

Low back pain resulting from intervertebral disk degeneration is a cause of substantial disability and productivity loss. Over the past few years, growing evidence exists which suggests that low-grade bacterial infection, particularly infection with Cutibacterium acnes, may be associated with degenerative disk disease in the lumbar spine. Positive cultures are obtained in approximately 30% of intervertebral disk specimens removed at the time of surgery. In addition, one randomized trial has shown that antibiotic therapy for low back pain in patients with disk degeneration can slow the progression of degeneration and improve pain and disability levels. Although these results are encouraging, the link between infection and disk degeneration remains controversial. Investigators have attempted to address the limitations of clinical research by using translational methods and animal models. These methods have shown that seeding of the disk with bacteria can lead to increased local inflammation and an in vivo phenotype that is similar to human disk degeneration. This review seeks to provide an overview of the clinical, translational, and animal model data linking infection to disk degeneration. We review mechanisms for disk degeneration in the setting of infection and explore areas for future investigation.
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PMID:The Relationship Between Low-Grade Infection and Degenerative Disk Disease: A Review of Basic Science and Clinical Data. 3057 99


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