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 9,689 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The results of efficacy and safety of ciprofloxacin administered by parenteral and oral route in the treatment of severe infections-particularly, osteomyelitis and bacteremia-due to gram-negative bacilli are studied in the present work. The group consisted of 34 patients, there were 25 men and 9 women, whose age ranged from 5 to 84 years. Two patients were excluded from the study and did not enter in the efficacy analysis, although they accounted for the evaluation of incidence of side effects. Ten patients presented osteomyelitis, 16 patients had bacteremia (one of them, with endocarditis), and six patients suffered from other types of infection (one of them had meningitis). All patients recovered or presented clinical improvement with the treatment, except three of them, which accounted for a response rate of 90.6%. In 28 of the 32 evaluable cases, microbiologic eradication was achieved (eradication rate, 87.5%). Infection due to Pseudomonas aeruginosa persisted or recurred in three patients with chronic osteomyelitis; in two of them, the strain become resistant to ciprofloxacin, and in the third patient, the results of cultures persisted positive along the whole course, thus, the eradication of the microorganism was not achieved. One woman presented bacteremia due to Acinetobacter which persisted despite antibiotic therapy. Side effects were mild and obliged to withdraw the treatment in two cases (dizziness). Ciprofloxacin is a new fluoroquinolone that is easily administered by parenteral and oral route. In the present study, it has revealed as safe and highly efficacious, even in particularly severe or resistant bacterial infections.
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PMID:[Evaluation of ciprofloxacin for the treatment of severe bacterial infections]. 249 Jun 38

A 39-year-old African American man with no significant past medical history presented to our hospital with right hand weakness and pain in both arms. He had no fever, neck pain, headache, dizziness, vision changes, or weakness in his lower extremities. Magnetic resonance imaging of the cervical spine showed extensive abnormal enhancement of the C7-T1 vertebral bodies as well as the prevertebral and epidural spaces. Open biopsy of the lesion showed inflammatory changes consistent with osteomyelitis. Culture of the biopsy specimen grew Group B Streptococcus (GBS). HIV ELISA and blood cultures were negative. The patient was treated with intravenous vancomycin for 6 weeks with complete resolution of symptoms. GBS classically affects newborns and pregnant females. However, the incidence of infection from this pathogen in nonpregnant adults is increasing. Vertebral osteomyelitis due to GBS in nonpregnant adults is exceedingly rare. To our knowledge, this is the first reported case of GBS cervical vertebral osteomyelitis in an adult without risk factors for invasive GBS infection. This case illustrates that GBS should be included in the differential diagnosis of pyogenic vertebral osteomyelitis, irrespective of immune status and predisposing factors.
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PMID:Vertebral osteomyelitis in a healthy young adult. 1764 54

A 51-year-old man developed anorexia, dizziness, nausea, vomiting, and weight loss. He had orthostatic hypotension, hyponatremia, hyperkalemia, and hypocortisolemia, and the diagnosis of adrenal insufficiency was made. Magnetic resonance imaging (MRI) showed asymmetrically enlarged adrenal glands. Biopsy of a hypoechoic, enlarged, inguinal lymph node showed caseating granulomas. Lumbar MRI showed vertebral body height loss and abnormal signal in L1 and L2; vertebral biopsy showed chronic, necrotic, caseating granulomatous inflammation consistent with tuberculous osteomyelitis. Clinical improvement occurred with isoniazid, rifampicin, pyrazinamide, and corticosteroids. The differential diagnosis of adrenal insufficiency should include tuberculosis, especially in geographic regions where tuberculosis is endemic.
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PMID:Acute adrenal insufficiency associated with tuberculous vertebral osteomyelitis and lymphadenopathy: case report. 2264 55

In the same manner as syphilis, tuberculosis (TB) was often called "The Great Imitator". We have to consider not only malignancies but also TB as a differential diagnosis when we find any tumorous regions. We report herein on a rare case, clavicular osteomyelitis due to TB. A 72-year-old female, with diabetic nephropathy, was on maintenance hemodialysis. She had a fall 2 months prior to admission followed by pain around her right clavicle. Ulceration occurred in that region a month prior to admission, and CT scan revealed a fracture of the right clavicle with a tumor surrounding that area. Seven days prior to admission, she went to a neurologist because of dizziness. MRI of the brain revealed a tumor in her pons. The physician suspected the tumor was metastasis. Needle biopsies revealed only necrotic tissue so the medical oncologist consulted us because they suspected it was caused by infection of some kind. From the patient's history and the physical examination, we suspected TB osteomyelitis and grew some more cultures, but only MRSA and E. coli were detected. We administered vancomycin and cefmetazole for the secondary bacterial osteomyelitis. After a month of hospitalization, we found miliary regions on her chest CT and Mycobacterium tuberculosis was grown from the needle biopsy specimen. We started multi-antituberculosis therapy and the patient had a good prognosis. We report herein on a rare case of clavicular osteomyelitis due to TB, together with a review of the literature.
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PMID:[The Great Imitator; Clavicular Tuberculosis Mimics a Metastatic Neoplasm]. 2663 Jul 91