MyMedR

Fulltext Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report

Saturveithan C, Arieff A, Premganesh G, Sivapathasundaram N

Malays Orthop J, 2014 Jul;8(2):52-4.

PMID: 25279095 MyJurnal DOI: 10.5704/MOJ.1407.005

A one year old boy was admitted with left shoulder pain with reduced range of motion of five days' duration associated. Inflammatory markers were raised and radiograph of the left shoulder revealed widening of the metaphysis of the proximal humerus. Empirically, he was started on intravenous C-penicillin and cloxacillin after initial joint aspiration yielded only synovial fluid with negative culture. Subsequent MRI revealed acute osteomyelitis of the proximal left humerus with concurrent septic arthritis of the shoulder joint. Cultures from the arthrotomy washout grew Salmonella sp, sensitive to ampicillin. He recovered following six weeks of intravenous unasyn ( ampicillin and sulbactum). This rare case of salmonella osteomyelitis in a non-sickle cell disease patient was diagnosed with serial laboratory and radiological studies and was successfully treated with adequate duration of antibiotics and operative intervention.

Matched MeSH terms: Osteomyelitis

Fulltext C1 and C2 vertebrae osteomyelitis: A misleading presentation leading to a fatal outcome.

Radhiana, H., Win Mar Salmah, J.

International Medical Journal Malaysia, 2009;8(1):49-51.

MyJurnal

Cervical vertebral osteomyelitis is rare. While an early and correct diagnosis is critical to prevent catastrophic neurological injury, the diagnosis of cervical vertebral osteomyelitis is often difficult because of its rarity and variable symptoms. We present a case of C1 and C2 vertebrae osteomyelitis with a misleading presentation and its fatal outcome.

Matched MeSH terms: Osteomyelitis

Chronic recurrent multifocal osteomyelitis of the first metatarsal bone: a case report

Chiu CK, Singh VA

J Orthop Surg (Hong Kong), 2009 Apr;17(1):119-22.

PMID: 19398809

We report a case of chronic recurrent multifocal osteomyelitis in a 9-year-old girl. She presented with a 9-month history of gradually worsening pain and swelling in her left foot. Non-steroidal anti-inflammatory drugs were prescribed but the symptoms persisted. She underwent curettage through a small oval corticotomy window on the first metatarsal bone. The pain and swelling improved promptly and she was able to walk without pain 2 weeks later. Curettage enabled rapid symptomatic relief and induced remission, with little risk of complications.

Matched MeSH terms: Osteomyelitis/diagnosis*; Osteomyelitis/etiology; Osteomyelitis/surgery*

Fulltext A Pictorial Review of Diabetic foot Manifestations

Yang C, Tandon A

Med J Malaysia, 2013 Jun;68(3):279-89.

PMID: 23749027

The diabetic foot with its many associated complications and presentations can provide a challenge in diagnosis and subsequent treatment. MRI, being increasingly available commonly, is now the main investigative modality. In particular, it is helpful in differentiating between neuroarthropathy and osteomyelitis and in cases where the latter is superimposed on the former. By being well versed in the interpretation of the images, the radiologist can make crucial contribution to the care and management of these patients.

Matched MeSH terms: Osteomyelitis*

Fulltext Chronic osteomyelitis due to Burkholderia pseudomallei

Kareem BA, Aiyar S, Marshal DS

Med J Malaysia, 1995 Mar;50(1):116.

PMID: 7752966

Matched MeSH terms: Osteomyelitis/microbiology*

Some observations on cysts, adamantinomata and osteomyelitis of the jaws among the population in Malaya

KARIM A

Br Dent J, 1949 Sep 2;87(5):118-20.

PMID: 18146827

Matched MeSH terms: Osteomyelitis*

Melioidotic osteomyelitis in an imported primate

Britt JO, Howard EB, Kean CJ, Jones J

J. Am. Vet. Med. Assoc., 1981 Dec 1;179(11):1303-5.

PMID: 7328029

Matched MeSH terms: Osteomyelitis/pathology; Osteomyelitis/veterinary*

Benign osteoblastoma of the maxilla

Yip WK, Lee HT

Oral Surg. Oral Med. Oral Pathol., 1974 Aug;38(2):259-63.

PMID: 4528442

Matched MeSH terms: Osteomyelitis/diagnosis

Fulltext Primary bone lymphoma: report of a case with multifocal skeletal involvement

Rahmat K, Wastie M, Abdullah B

Biomed Imaging Interv J, 2007 Oct;3(4):e52.

PMID: 21614300 MyJurnal DOI: 10.2349/biij.3.4.e52

Primary bone lymphoma is an uncommon tumour accounting for approximately 4-5% of extra nodal lymphoma and less than 1% of all Non-Hodgkin's lymphoma. The radiographic appearance of primary bone lymphoma is variable. As lesions frequently resemble other disease processes namely chronic osteomyelitis and metastases, further imaging evaluation and histopathological examination allow early identification for appropriate treatment. The authors present a case of anaplastic large cell lymphoma of bone presenting with multifocal osseus involvement.

Matched MeSH terms: Osteomyelitis

Fulltext Acute haematogenous osteomyelitis: an unusual complication following a closed fracture of the femur in a child

Baharuddin M, Sharaf I

Med J Malaysia, 2001 Dec;56 Suppl D:54-6.

PMID: 14569768

We report a rare case of an acute haematogenous osteomyelitis of the femur in a five-year-old boy following a closed fracture of the femur. Because of its rare occurrence, the diagnosis of osteomyelitis was missed initially. He presented with a groin abscess seven weeks after injury. He was treated with external fixation, repeated debridements and intravenous antibiotics. Culture grew Staphylococcus aureus. The latest follow-up one-year after the injury showed resolution of the infection and union of the fracture. The range of knee movement is limited from 0-90 degrees due to quadriceps contracture.

Matched MeSH terms: Osteomyelitis/etiology*; Osteomyelitis/microbiology; Osteomyelitis/radiography

Multifocal osteoarticular tuberculosis in a systemic lupus erythematosus (SLE) patient: a rarity or an underdiagnosed condition?

Lim SL, Ong PS, Khor CG

Mod Rheumatol Case Rep, 2020 07;4(2):237-242.

PMID: 33086999 DOI: 10.1080/24725625.2020.1754567

Tuberculosis (TB) and its association with rheumatic diseases have been widely recognised. Occurrence of multifocal skeletal involvement constitutes <5% of all skeletal TB cases. We present a Malay patient with multifocal osteoarticular TB (OATB). A 35 year-old SLE woman with background usage of corticosteroid therapy and Azathioprine presented with lupus nephritis flare. Renal biopsy revealed diffuse proliferative lupus nephritis and intravenous (IV) Cyclophosphamide 0.5 g/m2 (850 mg) was initiated. One week later, patient complained dorsum of left hand and right knee swelling. On physical examination, patient was afebrile and the left hand swelling was cystic in consistency while right knee was warm and tender. Erythrocyte Sedimentation Rate (ESR) was 50 mm/hr and C-Reactive Protein (CRP) was 9.4 mg/L. Her Mantoux test was positive with 20 mm induration. Wrist radiograph and chest radiograph was normal. Musculoskeletal ultrasound showed 4th extensor compartment tenosynovitis with Doppler signal and right knee effusion with synovial proliferation. Extensor tenosynovectomy and right knee aspiration was performed. Left hand excised tissue and right knee synovial fluid for acid-fast bacilli (AFB) stain, TB PCR, bacterial and fungal cultures were negative. Urgent histopathological examination of the excised tissue showed necrotising granulomatous inflammation. Patient was empirically started on TB treatment and subsequent mycobacterial culture confirmed the diagnosis of TB. The joints swelling resolved after one month of TB treatment. Multifocal OATB is an infrequent form of extrapulmonary TB and diagnosing OATB requires high index of suspicion particularly in SLE patient on immunosuppression. Prompt investigations are essential to the diagnosis of this rare condition for early initiation of anti-tuberculous therapy.

Matched MeSH terms: Osteomyelitis/diagnosis*; Osteomyelitis/drug therapy; Osteomyelitis/etiology*

Fulltext Cryptococcal osteomyelitis of the femur: a case report and review of literature

Zainal AI, Wong SL, Pan KL, Wong OL, Tzar MN

Trop Biomed, 2011 Aug;28(2):444-9.

PMID: 22041767 MyJurnal

Fungal osteomyelitis is a rare opportunistic infection. It exhibits some clinical and radiological similarities to several other bone pathologies. A diagnostic delay may result in significant increase in morbidity. We report a case of a 37-year-old man with underlying hypogammaglobulinaemia presented with isolated cryptococcal osteomyelitis of the femur.

Matched MeSH terms: Osteomyelitis/diagnosis*; Osteomyelitis/microbiology; Osteomyelitis/pathology*

Outcomes of Free Muscle Flaps versus Free Fasciocutaneous Flaps for Lower Limb Reconstruction following Trauma: A Systematic Review and Meta-Analysis

Dow T, ElAbd R, McGuire C, Corkum J, Youha SA, Samargandi O, et al.

J Reconstr Microsurg, 2023 Sep;39(7):526-539.

PMID: 36577497 DOI: 10.1055/a-2003-8789

BACKGROUND: Free flap reconstruction of the lower limb following trauma often suffers higher complication rates than other areas of the body. The choice of muscle or fasciocutaneous free flap is an area of active debate.

METHODS: A systematic review of EMBASE, MEDLINE, PubMed, and Cochrane Register from inception to April 1, 2022 was performed. Articles were assessed using the methodological index for non-randomized studies instrument. The primary outcome was to assess and compare the major surgical outcomes of partial or total flap failure, reoperation, and amputation rates.

RESULTS: Seventeen studies were included. All studies were retrospective in nature, of level three evidence, and published between 1986 and 2021. The most common muscle and fasciocutaneous free flaps used were latissimus dorsi flap (38.1%) and anterolateral thigh (ALT) flap (64.8%), respectively. Meta-analysis found no significance difference in rates of total flap failure, takeback operations, or limb salvage, whereas partial flap failure rate was significantly lower for fasciocutaneous flaps. The majority of studies found no significant difference in complication rates, osteomyelitis, time to fracture union, or time to functional recovery. Most, 82.4% (14/17), of the included studies were of high methodological quality.

CONCLUSION: The rate of total flap failure, reoperation, or limb salvage is not significantly different between muscle and fasciocutaneous free flaps after lower limb reconstruction following trauma. Partial flap failure rates appear to be lower with fasciocutaneous free flaps. Outcomes traditionally thought to be managed better with muscle free flaps, such as osteomyelitis and rates of fracture union, were comparable.

Matched MeSH terms: Osteomyelitis*

Subacute osteomyelitis masquerading as primary bone sarcoma: report of six cases

Dhanoa A, Singh VA

Surg Infect (Larchmt), 2010 Oct;11(5):475-8.

PMID: 20858161 DOI: 10.1089/sur.2009.011

We report a series of six immunocompetent patients who were believed initially to have primary bone sarcomas, but turned out to have subacute osteomyelitis.

Matched MeSH terms: Osteomyelitis/diagnosis*; Osteomyelitis/drug therapy; Osteomyelitis/pathology*

Fulltext Botulinum toxin type A for rehabilitation after a spinal cord injury: a case report

Naicker AS, Roohi SA, Chan JL

J Orthop Surg (Hong Kong), 2009 Apr;17(1):96-9.

PMID: 19398803 DOI: 10.1177/230949900901700121

A 56-year-old man became quadriplegic, bed bound, and carer-dependent secondary to cervical osteomyelitis. Three years later, he presented with generalised spasticity, crouched posture, and a large sacral pressure sore. The severe spasticity in his hips and knees prevented ischial sitting. Injections of botulinum toxin type A to both hamstrings and gastrosoleuii controlled the flexor spasticity of his lower limbs and facilitated rehabilitation and wound healing through proper positioning, wound care, stretching, and weight-bearing exercises. A few weeks later, the patient could better position himself in bed (prone lying) and on his wheelchair (ischial sitting). His spasm-related pain lessened and his mobility and activities of daily living improved. The sacral pressure sore healed completely a few months later. The patient could sleep better, feed with set-up and adaptive aids, groom, dress, and transfer himself with minimal assistance. The effects of botulinum toxin extended beyond just spasticity reduction. His upper extremity function, mobility, and social well-being were all improved through better positioning.

Matched MeSH terms: Osteomyelitis/complications; Osteomyelitis/pathology; Osteomyelitis/therapy

Fulltext A rare presentation of isolated carpal bone tuberculous osteomyelitis mimicking gouty arthritis

Abdul Hamid MF, Rajandiran SR, Yu-Lin AB, Sapuan J

Int J Mycobacteriol, 2020 8 31;9(3):325-328.

PMID: 32862171 DOI: 10.4103/ijmy.ijmy_97_20

Tuberculosis (TB) is the most prevalent infectious disease in Southeast Asia. It causes both pulmonary and extrapulmonary diseases. TB of the wrist is rare and presents as osteomyelitis or tenosynovitis. We report a middle-aged male with carpal bone tuberculous osteomyelitis. He presented with left wrist pain initially treated as gouty arthritis. Within 2 weeks, he developed seropurulent discharge with osteomyelitic changes on imaging. He underwent debridement, and intraoperatively, there was destruction of most carpal bones. Histopathological examination revealed chronic granulomatous inflammation with abscess formation. Anti-TB medication was initiated, and he made a complete recovery with almost full range of wrist movement after 9 months of treatment. This case serves as a reminder that TB is a great mimicker, and a high index of suspicion is required to make a diagnosis of TB of the wrist. Early initiation of anti-TB is pivotal to prevent complications and deterioration of joint functions.

Matched MeSH terms: Osteomyelitis/diagnosis; Osteomyelitis/microbiology*; Osteomyelitis/surgery

Fulltext Allergic reaction following insertion of Vancomycin loaded in bone cement

Goh, K.L., Nazri, M.Y., Ong, C.L.

International Medical Journal Malaysia, 2014;13(1):61-64.

MyJurnal

Vancomycin bead is an important ancillary treatment for osteomyelitis caused by methicillin-resistant Staphylococcus aureus (MRSA). However, red-man syndrome, which can be a life-threatening complication of vancomycin, may occur from the use of vancomycin beads albeit rarely. We report our first case of red-man syndrome caused by vancomycin bead's insertion for chronic osteomyelitis. Symptomatic treatment was not
effective and removal of the vancomycin beads seems to be the best treatment for this condition.

Matched MeSH terms: Osteomyelitis

Fulltext Ischial Tuberosity Tuberculosis : An Unusual Location andPresented as Chronic Gluteal Abscess

Krishnan, H., Yoon, T.R., Park, K.S.

Malays Orthop J, 2010;4(1):42-45.

MyJurnal

This case report describes an unusual case of extrapulmonary tuberculosis of the ischial tuberosity presenting with chronic gluteal pain of 4 years duration. The patient presented when the pain became intolerable; at that time, the ischial tuberosity was debrided and curetted while incision and drainage were used to treat the gluteal abscess. Antituberculosis chemotherapy was administered (for a period of one year) following histopathological confirmation of tuberculosis. At four yearspostoperatively, the patient has no pain and is symptom free. Furthermore, radiographs shows that the right ischial tuberosity osteomyelitis has healed. Prompt diagnosis and treatment resulted in a good clinical outcome in this patient.

Matched MeSH terms: Osteomyelitis

Fulltext Ciprofloxacin-resistant Salmonella enterica serotype typhi in a patient with osteomyelitis of the rib

Wilson G, Prabhu N, Easow JM, Mukhopadhyay C

Med J Malaysia, 2005 Dec;60(5):667-9.

PMID: 16515126

Salmonella osteomyelitis of the rib is a rare clinical entity. In our case, a muhidrug resistant Salmonella enterica serotype Typhi was isolated from an immuno-competent patient with osteomyclitis of the ribs, who was treated earlier with ciprotloxacin for typhoid fever. The patient was successfully treated for osteomyclitis with intravenous ceftriaxone.

Matched MeSH terms: Osteomyelitis/drug therapy*; Osteomyelitis/microbiology*

Fulltext Outcome of infection following internal fixation of closed fractures

Nazri MY, Halim YA

Med J Malaysia, 2004 Dec;59(5):665-9.

PMID: 15889570

A retrospective study was done in 30 patients with infected closed fractures treated initially by open reduction and internal fixation. Nineteen fractures involved the femur, 8 the tibia, 2 the radius and 1 the ulna. Twenty-five were diaphyseal and 5 metaphyseal. Twenty-two fractures had initially been treated with plating and 8 with intramedullary nailing. Thirteen patients presented in the acute phase and 17 in the subacute phase of infection. Twenty-two patients presented with low grade infection and 8 with florid infection. The commonest organism isolated was Staphylococcus aureus (80%), of which fifty four percent was resistant to Methicillin (MRSA). This study showed that 77% of infected fractures with a stable implant united even in the presence of infection.

Matched MeSH terms: Osteomyelitis/etiology*; Osteomyelitis/therapy*

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