Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic impli...Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic implications of chronic long-bone osteomyelitis in sickle-cell subjects aged 0 to 5 years at Zinder National Hospital. Methodology: This is a descriptive study with retrospective data collection of sickle cell subjects hospitalized and treated for chronic osteomyelitis from November 2023 to October 2024 at Zinder National Hospital. Results: Of the 16 patients included, male sex predominated in 56.25% (9/16). The mean age of patients was 32.69 months, ranging from 12 to 54 months. Involvement was multifocal in 75% (12/16) and bilateral in 37.5% (6/16). Bone involvement was predominantly in the pelvic limbs (87.5%). Among the bones affected, the femur was the most frequent site of involvement. All patients presented clinical symptoms such as pain, fever and swelling. Hyperleukocytosis was present in all subjects. Abscesses were present in 93.75% of cases, and sequestration was observed in 37.5% of patients. All cases were managed medico-surgically. Complications were noted in 25% (4/16), and involved residual bone deformities. Cure was confirmed in 43.75% (7/16). Conclusion: Chronic osteomyelitis in sickle-cell patients is a serious complication of acute osteomyelitis. Early management of acute osteomyelitis helps to avoid.展开更多
Osteomyelitis is a state of inflammation caused by pathogens with progressive bone destruction.In critical conditions,osteomyelitis can result in limb necrosis,dysfunction,and permanent disability.Traditional treatmen...Osteomyelitis is a state of inflammation caused by pathogens with progressive bone destruction.In critical conditions,osteomyelitis can result in limb necrosis,dysfunction,and permanent disability.Traditional treatments for osteomyelitis usually include antibiotics and surgical debridement.However,overuse of antibiotics can result in bacterial resistance and serious side effects.In this paper,a microwave(MW)-responsive composite MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was constructed from flaky nanoflower molybdenum disulfide(MoS_(2)),rod-shaped bismuth sulfide(Bi_(2)S_(3)),and bulk barium titanate(BaTiO_(3))for the therapy of bacteriainfected osteomyelitis.Under MW irradiation,MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) could generate MW heat and reactive oxygen species(ROS),and its MW thermal response mechanism was investigated by MW vector analysis,which showed that the MW thermal response performance of MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was devoted to the reflection loss,dielectric loss,and suitable impedance matching and attenuation constants induced by the interfacial polarization,dipole polarization,and ferroelectrode polarization.Under MW irradiation,due to strong electromagnetic field enhancement parameters and low oxygen adsorption energy,MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) could form a heterogeneous interface to accelerate charge transfer,resulting in ROS.The antibacterial mechanism of MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was investigated by bacterial transcriptome RNA sequencing analysis,which indicated that MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) had excellent antibacterial properties.展开更多
BACKGROUND Chronic recurrent multifocal osteomyelitis(CRMO)is a rare autoinflammatory bone disorder primarily affecting children and adolescents.Spinal involvement in CRMO is common and can lead to significant clinica...BACKGROUND Chronic recurrent multifocal osteomyelitis(CRMO)is a rare autoinflammatory bone disorder primarily affecting children and adolescents.Spinal involvement in CRMO is common and can lead to significant clinical features and complications,including severe chronic back pain and spinal deformities with possible spinal cord compression.AIM To summarize the information about vertebral involvement in CRMO patients,including the clinical features,diagnostic approaches,and treatment outcomes.METHODS Sixty-three manuscripts(2005-2025)were found in PubMed,including case reports,retrospective cohort studies,randomized controlled trials,and imaging studies.The focus was on spinal involvement features,diagnostic imaging,treatment strategies,and long-term outcomes in pediatric CRMO patients.RESULTS Spinal involvement in CRMO ranges from 28%to 81%among patients with CRMO.Patients typically present with localized back pain,back stiffness,and,in more severe cases,spinal deformities such as kyphosis or scoliosis.Multifocal lesions are frequently observed,with the thoracic spine being the most commonly affected area.Whole-body magnetic resonance imaging(WBMRI)has emerged as the gold standard for effectively revealing multifocal bone lesions and spinal involvement.However,a bone biopsy is often needed to rule out infection or malignancy.Bisphosphonate treatment showed a high response rate(90.9%),while tumor necrosis factor-alpha(TNF-α)inhibitors were less effective(66.7%).Long-term follow-up is crucial,as relapses and progression of spinal deformities can occur even with treatment.CONCLUSION Spinal involvement in CRMO often leads to chronic pain,vertebral deformities,and rare spinal deformities.Early diagnosis using WBMRI,combined with treatment with bisphosphonates and TNF-αinhibitors,could improve outcomes.展开更多
We review the representatives literatures on chronic osteomyelitis,sum up the new insights in recent years into diagnostic options and treatment regimens,analyze the advantages and disadvantages of various diagnostic ...We review the representatives literatures on chronic osteomyelitis,sum up the new insights in recent years into diagnostic options and treatment regimens,analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies,and propose areas of interest to make current diagnostic and treatment strategies more specific.展开更多
Osteomyelitis is a significant cause of morbidity in children throughout the world. Multiple imaging modalities can be used to evaluate for suspected osteomyelitis, however magnetic resonance imaging(MRI) has distinct...Osteomyelitis is a significant cause of morbidity in children throughout the world. Multiple imaging modalities can be used to evaluate for suspected osteomyelitis, however magnetic resonance imaging(MRI) has distinct advantages over other modalities given its ability to detect early changes related to osteomyelitis, evaluate the true extent of disease, depict extraosseous spread of infection, and help guide surgical manage-ment. MRI has assumed a greater role in the evaluation of osteomyelitis with the increase in musculoskeletal infections caused by methicillin-resistant Staphylococ-cus aureus which have unique imaging features that are well-demonstrated with MRI. This review focuses primarily on the use of MRI in the evaluation of osteo-myelitis in children and will include a discussion of the clinically important and characteristic findings on MRI of acute bacterial osteomyelitis and related conditions.展开更多
Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 1...Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 10%-15% of moderate and in 50% of severe infectious process. An early and accurate diagnosis is required to ensure a targeted treatment and reduce the risk of major amputation. The aim of this review is to report a complete overview about the management of diabetic foot osteomyelitis. Epidemiology, clinical aspects, diagnosis and treatment are widely described according to scientific reccomendations and our experience.展开更多
Objective: To describe the demographics and outcome of patients with candidal vertebral osteomyelitis (CVO). CVO is a rare and frequently misdiagnosed condition. It may lead to destruction of the vertebral bodies, spi...Objective: To describe the demographics and outcome of patients with candidal vertebral osteomyelitis (CVO). CVO is a rare and frequently misdiagnosed condition. It may lead to destruction of the vertebral bodies, spinal cord compression and neurological deficits. Methods: The medical records of all patients diagnosed with CVO at our institution between 01/01/1990-12/31/2009 were reviewed. The cumulative probability of treatment success was assessed by the Kaplan-Meier survival method. Patients were followed until death, failure, or loss of follow-up. Results: Nine patients developed CVO during the 20 year study period. The cervical spine was involved in 5 cases. Seven patients presented with mechanical-type pain, while 2 patients had an elevated temperature at diagnosis. A contiguous infection between the upper airways and the cervical spine was present in 4 patients. One patient presented with concomitant candidemia. Candida albicans, Candida parapsilosis, and Candida glabrata were cultured in 3 of 9 cases respectively. Eight of 9 were treated with azole-based therapy. Patients were followed for an average of 20 months (range 1 - 75 months). The cumulative incidence of success was 66% ± 19% at 1 year and 55% ± 20% at 2 years of follow-up. Conclusions: CVO presents insidiously and is associated with a long duration of symptoms. It most frequently affects the cervical spine and is associated with a poor outcome.展开更多
Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early ...Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early treatment is necessary to prevent complications,and the standard of care is progressing to a shorter duration of intravenous(Ⅳ) antibiotics and transitioning to oral therapy for the rest of the treatment course.We systematically reviewed the current literature on pediatric patients with acute osteomyelitis to determine when and how to transition to oral antibiotics from a short Ⅳ course.Studies have shown that switching to oral after a short course(i.e.,3-7 d) of Ⅳ therapy has similar cure rates to continuing long-term Ⅳ therapy.Prolonged Ⅳ use is also associated with increased risk of complications.Parameters that help guide clinicians on making the switch include a downward trend in fever,improvement in local tenderness,and a normalization in C-reactive protein concentration.Based on the available literature,we recommend transitioning antibiotics to oral after 3-7 d of Ⅳ therapy for pediatric patients(except neonates) with acute uncomplicated osteomyelitis if there are signs of clinical improvement,and such regimen should be continued for a total antibiotic duration of four to six weeks.展开更多
Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.Howeve...Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.展开更多
BACKGROUND Calcium pyrophosphate dihydrate deposition disease(CPPD),or pseudogout,is an inflammatory arthritis common among elderly patients,but rarely seen in patients under the age of 40.In the rare cases presented ...BACKGROUND Calcium pyrophosphate dihydrate deposition disease(CPPD),or pseudogout,is an inflammatory arthritis common among elderly patients,but rarely seen in patients under the age of 40.In the rare cases presented of young patients with CPPD,genetic predisposition or related metabolic conditions were almost always identified.CASE SUMMARY The authors report the case of a 9-year-old boy with no past medical history who presented with acute knee pain and swelling after a cat scratch injury 5 d prior.Synovial fluid analysis identified calcium pyrophosphate dihydrate crystals.Further MRI analysis identified osteomyelitis and a small soft tissue abscess.CONCLUSION This case presents the extremely rare diagnostic finding of calcium pyrophosphate dihydrate crystals in a previously healthy pediatric patient.The presence of osteomyelitis presents a unique insight into the pathogenesis of these crystals in pediatric patients.More research needs to be done on the role of CPPD in pediatric arthritis and joint infection.展开更多
Mucormycosis, a rapidly invasive form of fungal infection caused by Mucorales fungi, has high morbidity and mortality rates. Rhino-orbital-cerebral mucormycosis is the most common form of mucormycosis. With the corona...Mucormycosis, a rapidly invasive form of fungal infection caused by Mucorales fungi, has high morbidity and mortality rates. Rhino-orbital-cerebral mucormycosis is the most common form of mucormycosis. With the coronavirus disease 2019(COVID-19) outbreak, a causal correlation between mucormycosis and COVID-19 has been suspected, contributing to the abrupt increase in opportunistic fungal infection cases. We present a case of a Southeast Asian woman in her 60s with complaints of pus discharge in the palatal region with maxillary teeth mobility for 3 months. Physical examination revealed multiple nonvital upper teeth with severe mobility. Incisional biopsy of the maxilla and multidetector computed tomography of the head and neck confirmed the diagnosis of osteomyelitis of the maxilla secondary to mucormycosis. Surgical treatment was performed, and amphotericin B and posaconazole were administered. No operative complications or further bone destruction were observed at 8 months postoperatively.展开更多
This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultr...This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultrasond during four to fourteen days after onset.The mean length and anteroposterior distance of the subperiosteal abscesses were 86.4 mm and 10.7 mm,respectively.Of 24 cases of subperiosteal atscesses,aspiration performed under ultrasound guidance revealed purulent fluid in al and 23 were verified surgically.The results obtained indicate that ultrasound can be used it diagnosis of actue hematogerous osteomyelitis in the early stage.the earliest case was diagrosed by ultrasound 4 days afttr onset.By use of ultrasound, differentiation diagnosis of acute hematogenous osteomyelitis from other diseases such as cellulitis,soff tissue abscess,acutt septic arthritis and maignant bone tumors is also discussed.展开更多
<strong>Introduction<b style="white-space:normal;"><span style="font-family:Verdana;">:</span></b></strong><span style="font-family:Verdana;">...<strong>Introduction<b style="white-space:normal;"><span style="font-family:Verdana;">:</span></b></strong><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sickle Cell Disease (SCD) is the most prevalent genetic disease in the world predominantly in the African population with Sickle Cell Anaemia (SCA) being its dominant form. One of the most frequent complication</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of SCD is osteomyelitis. SCA is due to a</span><span style="font-family:""> </span><span style="font-family:Verdana;">point mutation in the beta</span><span style="font-family:""> </span><span style="font-family:Verdana;">globin chain of haemoglobin. This is responsible for the sickled shape of RBCs under low oxygen tension conditions leading to obstruction in the microcirculation. This leads to vaso-occlusive crises (VOC) which has a similar clinical presentation to that of osteomyelitis, another complication of SCD.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Case Presentation</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We present the case of a three-year-old girl with SCA who presented with an inability to bear weight in a febrile context. A diagnosis of VOC was initially made, which was later on changed to both a left chronic tibial and right distal femoral osteomyelitis following a series of biological, and imaging investigations. Surgical debridement and drainage were performed, resulting 9 weeks later </span><span style="font-family:Verdana;">in the</span><span style="font-family:Verdana;"> involution of fever and leg pain.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Osteomyelitis when associated with SCD is a dreadful and deathly disease in low income countries as it also presents like VOC therefore higher suspicion index is recommended. It is therefore important to take this into consideration at an early stage in patients with homozygous sickle cell disease so as to rapidly initiate multidisciplinary care. Appropriate investigations, appropriate antibiotic therapy, and timely surgical intervention</span><span style="font-family:""> </span><span style="font-family:Verdana;">would help to greatly reduce morbidity and mortality.</span>展开更多
BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases ...BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.展开更多
Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in...Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in limb amputation via transtibial or transfemoral amputation, which can increase morbidity and mortality. This case report involves a 29-year-old male who sustained bilateral calcaneal fracture after a fall, who developed osteomyelitis of the right calcaneus after being treated with internal/external fixation and antibiotic therapy. In order to preserve the limb total calcaneal replacement with 3D printed implant was done.展开更多
BACKGROUND Mycobacterium houstonense(M.houstonense)belongs to the nontuberculous mycobacterium group.Infection caused by M.houstonense is prone to recurrence.CASE SUMMARY We present a patient who was diagnosed with os...BACKGROUND Mycobacterium houstonense(M.houstonense)belongs to the nontuberculous mycobacterium group.Infection caused by M.houstonense is prone to recurrence.CASE SUMMARY We present a patient who was diagnosed with osteomyelitis caused by M.houstonense and treated with a combination of cefoxitin,and amikacin combined with linezolid.CONCLUSION The emergence of metagenomic next-generation sequencing(NGS)has brought new hope for the diagnosis and treatment of listeria meningitis.NGS can analyze a large number of nucleic acid sequences in a short time and quickly determine the pathogen species in the sample.Compared with traditional cerebrospinal fluid culture,NGS can greatly shorten the diagnosis time and provide strong support for the timely treatment of patients.Regarding treatment,NGS can also play an important role.Rapid and accurate diagnosis can enable patients to start targeted treatment as soon as possible and improve the treatment effect.At the same time,by monitoring the changes in pathogen resistance,the treatment plan can be adjusted in time to avoid treatment failure.展开更多
Osteomyelitis is a debilitating bone infection primarily caused by Staphylococcus aureus.Despite advancements in surgery and chemotherapy,the treatment of osteomyelitis remains unsatisfactory,characterized by antibiot...Osteomyelitis is a debilitating bone infection primarily caused by Staphylococcus aureus.Despite advancements in surgery and chemotherapy,the treatment of osteomyelitis remains unsatisfactory,characterized by antibiotic resistance and recurrent relapses.Numerous studies have confirmed that non-coding RNAs could play an emerging role in regulating gene expression,as well as in the differentiation of osteoblasts and osteoclasts,along with bone formation.In this context,we provide an overview of current knowledge regarding the roles of non-coding RNAs in osteomyelitis and explore the potential therapeutic applications of these molecules in disease management,aiming to uncover novel diagnostic and treatment approaches.展开更多
We report here a 17-year-old boy with a complicated presentation of undifferentiated juvenile idiopathic arthritis, vision-threatening uveitis and chronic recurrent multifocal osteomyelitis (CRMO) in the pelvis. His s...We report here a 17-year-old boy with a complicated presentation of undifferentiated juvenile idiopathic arthritis, vision-threatening uveitis and chronic recurrent multifocal osteomyelitis (CRMO) in the pelvis. His severe iritis needed subtenon injections and only responded to infliximab after failing multiple biologics. Unfortunately he later developed infliximab-associated psoriasis. A combination of infliximab and ustekinumab induced remission of his arthritis, osteomyelitis, uveitis and psoriasis without experiencing severe infections.展开更多
Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatm...Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatment is early recognition and antibiotics.The course can sometimes be indolent leading to delayed presentations.Once suspected,comprehensive workup and initiation of management should be employed.In rare circumstances,surgical evacuation or deformity correction is indicated.Continued antibiotic treatment should be considered post-operatively.Methods:Emerging treatment solutions are being developed to help target osteomyelitis in a more effective manner.In this review,we highlight the epidemiology and pathophysiology of spinal osteomyelitis.We overview the diagnostic workup and treatment options.Finally,we present new options that are currently being investigated and are on the near horizon.Conclusion:This review offers a user friendly resource for clinicians and researchers regarding osteomyelitis of the spine and will serve as a catalyst for further discovery.展开更多
文摘Objective: Chronic osteomyelitis represents a frequent complication in young children, especially those with sickle cell disease. The aim of this study was to describe the epidemiological aspects and therapeutic implications of chronic long-bone osteomyelitis in sickle-cell subjects aged 0 to 5 years at Zinder National Hospital. Methodology: This is a descriptive study with retrospective data collection of sickle cell subjects hospitalized and treated for chronic osteomyelitis from November 2023 to October 2024 at Zinder National Hospital. Results: Of the 16 patients included, male sex predominated in 56.25% (9/16). The mean age of patients was 32.69 months, ranging from 12 to 54 months. Involvement was multifocal in 75% (12/16) and bilateral in 37.5% (6/16). Bone involvement was predominantly in the pelvic limbs (87.5%). Among the bones affected, the femur was the most frequent site of involvement. All patients presented clinical symptoms such as pain, fever and swelling. Hyperleukocytosis was present in all subjects. Abscesses were present in 93.75% of cases, and sequestration was observed in 37.5% of patients. All cases were managed medico-surgically. Complications were noted in 25% (4/16), and involved residual bone deformities. Cure was confirmed in 43.75% (7/16). Conclusion: Chronic osteomyelitis in sickle-cell patients is a serious complication of acute osteomyelitis. Early management of acute osteomyelitis helps to avoid.
基金supported by NSFC-Guangdong Province Joint Program(Key program No U21A2084)the China National Funds for Distinguished Young Scientists(No.51925104)+8 种基金the National Natural Science Foundation of China(No.52173251)the National Natural Science Foundation of China(No.52401307)the Central Guidance on Local Science and Technology Development Fund of Hebei Province(No.226Z1303 G)Yanzhao Young Sci-entist Project(No.C2023202018)Beijing Natural Science Foun-dation(No.7232338)the Key project of Beijing Natural Science Foundation Joint Fund(No.L242040)the State Key Laboratory of Advanced Technology for Materials Synthesis and Processing(Wuhan University of Technology)(No.2024-KF-7)the National Natural Science Foundation of China(No.52471256)the Shen-zhen Science and Technology Innovation Committee Project(No.SGDX20220530111405038).
文摘Osteomyelitis is a state of inflammation caused by pathogens with progressive bone destruction.In critical conditions,osteomyelitis can result in limb necrosis,dysfunction,and permanent disability.Traditional treatments for osteomyelitis usually include antibiotics and surgical debridement.However,overuse of antibiotics can result in bacterial resistance and serious side effects.In this paper,a microwave(MW)-responsive composite MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was constructed from flaky nanoflower molybdenum disulfide(MoS_(2)),rod-shaped bismuth sulfide(Bi_(2)S_(3)),and bulk barium titanate(BaTiO_(3))for the therapy of bacteriainfected osteomyelitis.Under MW irradiation,MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) could generate MW heat and reactive oxygen species(ROS),and its MW thermal response mechanism was investigated by MW vector analysis,which showed that the MW thermal response performance of MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was devoted to the reflection loss,dielectric loss,and suitable impedance matching and attenuation constants induced by the interfacial polarization,dipole polarization,and ferroelectrode polarization.Under MW irradiation,due to strong electromagnetic field enhancement parameters and low oxygen adsorption energy,MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) could form a heterogeneous interface to accelerate charge transfer,resulting in ROS.The antibacterial mechanism of MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) was investigated by bacterial transcriptome RNA sequencing analysis,which indicated that MoS_(2)/Bi_(2)S_(3)/BaTiO_(3) had excellent antibacterial properties.
文摘BACKGROUND Chronic recurrent multifocal osteomyelitis(CRMO)is a rare autoinflammatory bone disorder primarily affecting children and adolescents.Spinal involvement in CRMO is common and can lead to significant clinical features and complications,including severe chronic back pain and spinal deformities with possible spinal cord compression.AIM To summarize the information about vertebral involvement in CRMO patients,including the clinical features,diagnostic approaches,and treatment outcomes.METHODS Sixty-three manuscripts(2005-2025)were found in PubMed,including case reports,retrospective cohort studies,randomized controlled trials,and imaging studies.The focus was on spinal involvement features,diagnostic imaging,treatment strategies,and long-term outcomes in pediatric CRMO patients.RESULTS Spinal involvement in CRMO ranges from 28%to 81%among patients with CRMO.Patients typically present with localized back pain,back stiffness,and,in more severe cases,spinal deformities such as kyphosis or scoliosis.Multifocal lesions are frequently observed,with the thoracic spine being the most commonly affected area.Whole-body magnetic resonance imaging(WBMRI)has emerged as the gold standard for effectively revealing multifocal bone lesions and spinal involvement.However,a bone biopsy is often needed to rule out infection or malignancy.Bisphosphonate treatment showed a high response rate(90.9%),while tumor necrosis factor-alpha(TNF-α)inhibitors were less effective(66.7%).Long-term follow-up is crucial,as relapses and progression of spinal deformities can occur even with treatment.CONCLUSION Spinal involvement in CRMO often leads to chronic pain,vertebral deformities,and rare spinal deformities.Early diagnosis using WBMRI,combined with treatment with bisphosphonates and TNF-αinhibitors,could improve outcomes.
基金Supported by the National Natural Science Foundation of China(NO.81460339)Innovative Research Project For Graduate Students in Hainan Province(No.Hys2018-284)
文摘We review the representatives literatures on chronic osteomyelitis,sum up the new insights in recent years into diagnostic options and treatment regimens,analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies,and propose areas of interest to make current diagnostic and treatment strategies more specific.
文摘Osteomyelitis is a significant cause of morbidity in children throughout the world. Multiple imaging modalities can be used to evaluate for suspected osteomyelitis, however magnetic resonance imaging(MRI) has distinct advantages over other modalities given its ability to detect early changes related to osteomyelitis, evaluate the true extent of disease, depict extraosseous spread of infection, and help guide surgical manage-ment. MRI has assumed a greater role in the evaluation of osteomyelitis with the increase in musculoskeletal infections caused by methicillin-resistant Staphylococ-cus aureus which have unique imaging features that are well-demonstrated with MRI. This review focuses primarily on the use of MRI in the evaluation of osteo-myelitis in children and will include a discussion of the clinically important and characteristic findings on MRI of acute bacterial osteomyelitis and related conditions.
文摘Foot infection is a well recognized risk factor for major amputation in diabetic patients. The osteomyelitis is one of the most common expression of diabetic foot infection, being present approximately in present in 10%-15% of moderate and in 50% of severe infectious process. An early and accurate diagnosis is required to ensure a targeted treatment and reduce the risk of major amputation. The aim of this review is to report a complete overview about the management of diabetic foot osteomyelitis. Epidemiology, clinical aspects, diagnosis and treatment are widely described according to scientific reccomendations and our experience.
文摘Objective: To describe the demographics and outcome of patients with candidal vertebral osteomyelitis (CVO). CVO is a rare and frequently misdiagnosed condition. It may lead to destruction of the vertebral bodies, spinal cord compression and neurological deficits. Methods: The medical records of all patients diagnosed with CVO at our institution between 01/01/1990-12/31/2009 were reviewed. The cumulative probability of treatment success was assessed by the Kaplan-Meier survival method. Patients were followed until death, failure, or loss of follow-up. Results: Nine patients developed CVO during the 20 year study period. The cervical spine was involved in 5 cases. Seven patients presented with mechanical-type pain, while 2 patients had an elevated temperature at diagnosis. A contiguous infection between the upper airways and the cervical spine was present in 4 patients. One patient presented with concomitant candidemia. Candida albicans, Candida parapsilosis, and Candida glabrata were cultured in 3 of 9 cases respectively. Eight of 9 were treated with azole-based therapy. Patients were followed for an average of 20 months (range 1 - 75 months). The cumulative incidence of success was 66% ± 19% at 1 year and 55% ± 20% at 2 years of follow-up. Conclusions: CVO presents insidiously and is associated with a long duration of symptoms. It most frequently affects the cervical spine and is associated with a poor outcome.
文摘Osteomyelitis is a bone infection that requires prolonged antibiotic treatment and potential surgical intervention.If left untreated,acute osteomyelitis can lead to chronic osteomyelitis and overwhelming sepsis.Early treatment is necessary to prevent complications,and the standard of care is progressing to a shorter duration of intravenous(Ⅳ) antibiotics and transitioning to oral therapy for the rest of the treatment course.We systematically reviewed the current literature on pediatric patients with acute osteomyelitis to determine when and how to transition to oral antibiotics from a short Ⅳ course.Studies have shown that switching to oral after a short course(i.e.,3-7 d) of Ⅳ therapy has similar cure rates to continuing long-term Ⅳ therapy.Prolonged Ⅳ use is also associated with increased risk of complications.Parameters that help guide clinicians on making the switch include a downward trend in fever,improvement in local tenderness,and a normalization in C-reactive protein concentration.Based on the available literature,we recommend transitioning antibiotics to oral after 3-7 d of Ⅳ therapy for pediatric patients(except neonates) with acute uncomplicated osteomyelitis if there are signs of clinical improvement,and such regimen should be continued for a total antibiotic duration of four to six weeks.
基金Supported by the Science project of Hunan Provincial Health Commission,No.202204073347.
文摘Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.
文摘BACKGROUND Calcium pyrophosphate dihydrate deposition disease(CPPD),or pseudogout,is an inflammatory arthritis common among elderly patients,but rarely seen in patients under the age of 40.In the rare cases presented of young patients with CPPD,genetic predisposition or related metabolic conditions were almost always identified.CASE SUMMARY The authors report the case of a 9-year-old boy with no past medical history who presented with acute knee pain and swelling after a cat scratch injury 5 d prior.Synovial fluid analysis identified calcium pyrophosphate dihydrate crystals.Further MRI analysis identified osteomyelitis and a small soft tissue abscess.CONCLUSION This case presents the extremely rare diagnostic finding of calcium pyrophosphate dihydrate crystals in a previously healthy pediatric patient.The presence of osteomyelitis presents a unique insight into the pathogenesis of these crystals in pediatric patients.More research needs to be done on the role of CPPD in pediatric arthritis and joint infection.
文摘Mucormycosis, a rapidly invasive form of fungal infection caused by Mucorales fungi, has high morbidity and mortality rates. Rhino-orbital-cerebral mucormycosis is the most common form of mucormycosis. With the coronavirus disease 2019(COVID-19) outbreak, a causal correlation between mucormycosis and COVID-19 has been suspected, contributing to the abrupt increase in opportunistic fungal infection cases. We present a case of a Southeast Asian woman in her 60s with complaints of pus discharge in the palatal region with maxillary teeth mobility for 3 months. Physical examination revealed multiple nonvital upper teeth with severe mobility. Incisional biopsy of the maxilla and multidetector computed tomography of the head and neck confirmed the diagnosis of osteomyelitis of the maxilla secondary to mucormycosis. Surgical treatment was performed, and amphotericin B and posaconazole were administered. No operative complications or further bone destruction were observed at 8 months postoperatively.
文摘This article presents sonographic diagnosis of acute hematogenous osteomyelitis in early stage.24 clildren with clinically suspected acute hematogtnous osteomyelits were detected to have subptrosteal abscesses by ultrasond during four to fourteen days after onset.The mean length and anteroposterior distance of the subperiosteal abscesses were 86.4 mm and 10.7 mm,respectively.Of 24 cases of subperiosteal atscesses,aspiration performed under ultrasound guidance revealed purulent fluid in al and 23 were verified surgically.The results obtained indicate that ultrasound can be used it diagnosis of actue hematogerous osteomyelitis in the early stage.the earliest case was diagrosed by ultrasound 4 days afttr onset.By use of ultrasound, differentiation diagnosis of acute hematogenous osteomyelitis from other diseases such as cellulitis,soff tissue abscess,acutt septic arthritis and maignant bone tumors is also discussed.
文摘<strong>Introduction<b style="white-space:normal;"><span style="font-family:Verdana;">:</span></b></strong><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">Sickle Cell Disease (SCD) is the most prevalent genetic disease in the world predominantly in the African population with Sickle Cell Anaemia (SCA) being its dominant form. One of the most frequent complication</span><span style="font-family:Verdana;">s</span><span style="font-family:Verdana;"> of SCD is osteomyelitis. SCA is due to a</span><span style="font-family:""> </span><span style="font-family:Verdana;">point mutation in the beta</span><span style="font-family:""> </span><span style="font-family:Verdana;">globin chain of haemoglobin. This is responsible for the sickled shape of RBCs under low oxygen tension conditions leading to obstruction in the microcirculation. This leads to vaso-occlusive crises (VOC) which has a similar clinical presentation to that of osteomyelitis, another complication of SCD.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Case Presentation</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">We present the case of a three-year-old girl with SCA who presented with an inability to bear weight in a febrile context. A diagnosis of VOC was initially made, which was later on changed to both a left chronic tibial and right distal femoral osteomyelitis following a series of biological, and imaging investigations. Surgical debridement and drainage were performed, resulting 9 weeks later </span><span style="font-family:Verdana;">in the</span><span style="font-family:Verdana;"> involution of fever and leg pain.</span><span style="font-family:""> </span><b><span style="font-family:Verdana;">Conclusion</span></b><b><span style="font-family:Verdana;">: </span></b><span style="font-family:Verdana;">Osteomyelitis when associated with SCD is a dreadful and deathly disease in low income countries as it also presents like VOC therefore higher suspicion index is recommended. It is therefore important to take this into consideration at an early stage in patients with homozygous sickle cell disease so as to rapidly initiate multidisciplinary care. Appropriate investigations, appropriate antibiotic therapy, and timely surgical intervention</span><span style="font-family:""> </span><span style="font-family:Verdana;">would help to greatly reduce morbidity and mortality.</span>
文摘BACKGROUND Urinary tract infection(UTI)is one of the most common bacterial infections.Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia;however,bacteremia resolves in most cases without complication.Rarely,complications due to bacteremia occur.One of these is osteomyelitis.It mainly affects the lumbar vertebral bodies,and rarely affects other site.CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs.Two months ago,she was admitted to the hospital for fever,flank pain,and urinary frequency and was diagnosed with bacteremic UTI.During hospitalization,she complained of pain in both legs;however,the pain resolved shortly after,and no abnormalities were observed on physical examination.Therefore,she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain.However,pain recurred after discharge and persisted;therefore,an imaging test was performed.Bone scan and magnetic resonance imaging suggested osseous infection in both femurs,tibiae and patellae.Surgical treatment was performed,and tissue-and bone cultures revealed Escherichia coli,a previously observed pathogen,which demonstrated same antibiotic sensitivities,as noted in previous UTI.She was diagnosed with disseminated osteomyelitis,as a complication of UTI,and was placed on an 8-wk antibiotic therapy.CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.
文摘Osteomyelitis of the calcaneus can be a limb threatening diagnosis, which is typically treated with antibiotic therapy with or without partial resection of the bone. Extensive infection of the bone commonly results in limb amputation via transtibial or transfemoral amputation, which can increase morbidity and mortality. This case report involves a 29-year-old male who sustained bilateral calcaneal fracture after a fall, who developed osteomyelitis of the right calcaneus after being treated with internal/external fixation and antibiotic therapy. In order to preserve the limb total calcaneal replacement with 3D printed implant was done.
基金Supported by The National Natural Science Foundation of China,No.82100631.
文摘BACKGROUND Mycobacterium houstonense(M.houstonense)belongs to the nontuberculous mycobacterium group.Infection caused by M.houstonense is prone to recurrence.CASE SUMMARY We present a patient who was diagnosed with osteomyelitis caused by M.houstonense and treated with a combination of cefoxitin,and amikacin combined with linezolid.CONCLUSION The emergence of metagenomic next-generation sequencing(NGS)has brought new hope for the diagnosis and treatment of listeria meningitis.NGS can analyze a large number of nucleic acid sequences in a short time and quickly determine the pathogen species in the sample.Compared with traditional cerebrospinal fluid culture,NGS can greatly shorten the diagnosis time and provide strong support for the timely treatment of patients.Regarding treatment,NGS can also play an important role.Rapid and accurate diagnosis can enable patients to start targeted treatment as soon as possible and improve the treatment effect.At the same time,by monitoring the changes in pathogen resistance,the treatment plan can be adjusted in time to avoid treatment failure.
基金supported by National Natural Science Foundation of China(32271177,82003981 to ZQ)President Fund of the 960th Hospital of Joint Logistics Support Force(2017ZX05 to C-LS).
文摘Osteomyelitis is a debilitating bone infection primarily caused by Staphylococcus aureus.Despite advancements in surgery and chemotherapy,the treatment of osteomyelitis remains unsatisfactory,characterized by antibiotic resistance and recurrent relapses.Numerous studies have confirmed that non-coding RNAs could play an emerging role in regulating gene expression,as well as in the differentiation of osteoblasts and osteoclasts,along with bone formation.In this context,we provide an overview of current knowledge regarding the roles of non-coding RNAs in osteomyelitis and explore the potential therapeutic applications of these molecules in disease management,aiming to uncover novel diagnostic and treatment approaches.
文摘We report here a 17-year-old boy with a complicated presentation of undifferentiated juvenile idiopathic arthritis, vision-threatening uveitis and chronic recurrent multifocal osteomyelitis (CRMO) in the pelvis. His severe iritis needed subtenon injections and only responded to infliximab after failing multiple biologics. Unfortunately he later developed infliximab-associated psoriasis. A combination of infliximab and ustekinumab induced remission of his arthritis, osteomyelitis, uveitis and psoriasis without experiencing severe infections.
文摘Background:Osteomyelitis of the spine is a serious condition that has been increasing with the intravenous drug pandemic and aging population.Multiple different organisms can cause osteomyelitis and mainstay of treatment is early recognition and antibiotics.The course can sometimes be indolent leading to delayed presentations.Once suspected,comprehensive workup and initiation of management should be employed.In rare circumstances,surgical evacuation or deformity correction is indicated.Continued antibiotic treatment should be considered post-operatively.Methods:Emerging treatment solutions are being developed to help target osteomyelitis in a more effective manner.In this review,we highlight the epidemiology and pathophysiology of spinal osteomyelitis.We overview the diagnostic workup and treatment options.Finally,we present new options that are currently being investigated and are on the near horizon.Conclusion:This review offers a user friendly resource for clinicians and researchers regarding osteomyelitis of the spine and will serve as a catalyst for further discovery.
