OBJECTIVE: Spondylitis is often chemotherapy resistant and requires long-term treatment. Without adequate chemotherapy, the outcome can be fatal or result in severe neurologic damage. Therefore, differentiating the etiology of spondylitis is very important, particularly in spontaneous cases. As the prevalence of tuberculosis in Korea has decreased in recent years, updated clinical research about spondylitis is warranted.METHODS: From April 2010 to March 2016, data from spondylitis patients were collected retrospectively. In total, 69 patients (51 with pyogenic spondylitis and 18 with tuberculous spondylitis) were included. Clinical data, laboratory findings including erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, measurements of Cobb angles at the initial and final follow-up, and radiologic features on magnetic resonance imaging (MRI) scans were evaluated. To test differences between the pyogenic and tuberculous groups, numerical data were compared using the student’s t-test and Mann-Whitney U test, and categorical data were compared using the chi-square test and Fisher’s exact test.RESULTS: The patients’ mean age was 60.0 years. Male sex was slightly predominant (56.5%). There was no difference in mean age and sex between the two groups. The pyogenic group had a relatively higher proportion of immunocompromised patients. The peak CRP value was higher in the pyogenic group than in the tuberculous group (14.08 mg/dL and 8.50 mg/dL, respectively, p=0.009), whereas the ESR was not significantly different between the groups (81.5 mm/h and 75.6 mm/h, respectively, p=0.442). Radiologically, the presence of disc space sparing and vertebral body collapse differed between the groups. In the tuberculous group, the disc was more commonly preserved on contrast-enhanced MRI (50% and 23.5%, respectively, p=0.044), and vertebral body collapse was more common (66.6% and 15.7%, respectively, p < 0.001). The mean length of hospitalization was longer in the pyogenic group (56.5 days and 41.2 days, respectively, p=0.001). Four mortality cases were observed only in the pyogenic group. The most commonly isolated microorganism in the pyogenic group was Staphylococcus aureus (S. aureus) (methicillin susceptible S. aureus and methicillin resistant S. aureus [MRSA] in 8 and 4 cases, respectively).CONCLUSION: The clinical and radiological manifestations of spontaneous spondylitis differ based on the causative organism. Pyogenic spondylitis patients tend to have a higher CRP level and a more severe clinical course, whereas tuberculous spondylitis patients present with destruction of the vertebral body with disc sparing more frequently. The presence of MRSA is increasing in community-acquired spondylitis cases.
Bacterial Infections ; Blood Sedimentation ; Bone Diseases, Infectious ; C-Reactive Protein ; Discitis ; Drug Therapy ; Follow-Up Studies ; Hospitalization ; Humans ; Immunocompromised Host ; Korea ; Magnetic Resonance Imaging ; Male ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Osteomyelitis ; Prevalence ; Retrospective Studies ; Spondylitis ; Staphylococcus aureus ; Tuberculosis

Infectious and inflammatory bone diseases include a wide range of disease process, depending on the patient's age, location of infection, various causative organisms, duration from symtom onset, accompanied fracture or prior surgery, prosthesis insertion, and underlying systemic disease such as diabetes, etc. Bone infection may induce massive destruction of bones and joints, results in functional reduction and disability. The key to successful management is early diagnosis and proper treatment. Various radionuclide imaging methods including three phase bone scan, Ga-67 scan, WBC scan, and combined imaging techniques such as bone/Ga-67 scan, WBC/bone marrow scan add complementary role to the radiologic imaging modalities including plain radiography, CT and MRI. F-18 FDG PET imaging also has recently been introduced in diagnosis of infected prosthesis and chronic active osteomyelitis. Selection of proper nuclear medicine imaging method will improve the diagnostic accuracy of infectious and inflammatory bone diseases, based on understading of pathogenesis and radiologic imaging findings.
Bone Diseases ; Bone Diseases, Infectious* ; Bone Marrow ; Diagnosis* ; Early Diagnosis ; Joints ; Magnetic Resonance Imaging ; Nuclear Medicine* ; Osteomyelitis ; Prostheses and Implants ; Radiography ; Radionuclide Imaging

Bone Diseases ; complications ; pathology ; Bone Diseases, Infectious ; complications ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; complications ; microbiology ; Male ; Middle Aged ; Necrosis ; Osteomyelitis ; complications

Bone Diseases, Infectious ; microbiology ; pathology ; Cryptococcosis ; complications ; pathology ; Forearm ; Humans ; Soft Tissue Infections ; microbiology ; pathology

OBJECTIVETo investigate the treatment of acute and chronic osteomyelitis with negative pressure wound therapy.

METHODThirty cases of acute and chronic osteomyelitis were treated with negative pressure wound therapy, assisted with debridement, autodermoplasty and myo-cutaneous flap surgery.

RESULTSNo evidence of relapse was found in all cases treated with negative pressure wound therapy. All the patients were followed up, range from 6 to 23 months, the average was 13.6 months.

CONCLUSIONThe negative pressure wound therapy maybe a simple, effective and inexpensive method, and could be one of the favorable therapy in the treatment of acute and chronic osteomyelitis.

Acute Disease ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bone Diseases, Infectious ; etiology ; surgery ; Chronic Disease ; Debridement ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy ; Osteomyelitis ; surgery ; Surgical Wound Infection ; surgery

Otitls media is one of the most common diseases during childhood with a peak incidence and prevalence from 6 to 20 months of age. It is the most frequent disease managed with antibiotics in children. The infection typically develops as a result of bacterial contamination through the Eustachian tube in the presence of preexisting inflammation in the middle ear. The optimal method of management remains open to question and is the subject of continuing controversy. Over-diagnosis of the disease and unnecessary prescription of antibiotics for this condition have contributed to the spread of antimicrobial resistance. Thus, the differential diagnosis between acute otitis media and otitis media with effusion is important to determine the management strategy; whether to use antibiotics and which antibiotics to use when necessary. Otitis media may be accompanied by a variable degree of conductive hearing loss. Both infectious and noninfectious complications of otitis media may result in significant morbidity and complications, including acute and chronic mastoiditis, petrositis, and intracranial infection.
Anti-Bacterial Agents ; Child* ; Diagnosis, Differential ; Ear, Middle ; Eustachian Tube ; Hearing Loss, Conductive ; Humans ; Incidence ; Inflammation ; Mastoid ; Mastoiditis ; Otitis Media with Effusion ; Otitis Media* ; Otitis* ; Petrositis ; Prescriptions ; Prevalence

We report a case of Aspergillus osteomyelitis of the spine in a 52-year-old female with back pain. Anteroposterior and lateral roentgenograms showed narrowing of the intervertebral disc space of T12-L1 with irregular vertebral endplates. MRI showed spondylodiscitis at T12-L1. Although tuberculous spondylitis is far more prevalent that fungal spondylitis, it is difficult to differentiate one from the other radiographically.
Aspergillosis ; Aspergillus* ; Discitis ; Female ; Humans ; Intervertebral Disc ; Magnetic Resonance Imaging ; Middle Aged ; Osteomyelitis* ; Spine* ; Spondylitis

No abstract available.
Discitis*

No abstract available.
Discitis*

No abstract available.
Discitis*