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Meroni G, Tsikopoulos A, Tsikopoulos K, Allemanno F, Martino PA, Soares Filipe JF. A Journey into Animal Models of Human Osteomyelitis: A Review. Microorganisms 2022; 10:microorganisms10061135. [PMID: 35744653 PMCID: PMC9228829 DOI: 10.3390/microorganisms10061135] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 05/28/2022] [Accepted: 05/30/2022] [Indexed: 12/24/2022] Open
Abstract
Osteomyelitis is an infection of the bone characterized by progressive inflammatory destruction and apposition of new bone that can spread via the hematogenous route (hematogenous osteomyelitis (HO)), contiguous spread (contiguous osteomyelitis (CO)), and direct inoculation (osteomyelitis associated with peripheral vascular insufficiency (PVI)). Given the significant financial burden posed by osteomyelitis patient management, the development of new preventive and treatment methods is warranted. To achieve this objective, implementing animal models (AMs) of infection such as rats, mice, rabbits, avians, dogs, sheep, goats, and pigs might be of the essence. This review provides a literature analysis of the AMs developed and used to study osteomyelitis. Historical relevance and clinical applicability were taken into account to choose the best AMs, and some study methods are briefly described. Furthermore, the most significant strengths and limitations of each species as AM are discussed, as no single model incorporates all features of osteomyelitis. HO’s clinical manifestation results in extreme variability between patients due to multiple variables (e.g., age, sex, route of infection, anatomical location, and concomitant diseases) that could alter clinical studies. However, these variables can be controlled and tested through different animal models.
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Affiliation(s)
- Gabriele Meroni
- One Health Unit, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Pascal 36, 20133 Milan, Italy; (F.A.); (P.A.M.)
- Correspondence: ; Tel.: +39-3428-262-125
| | - Alexios Tsikopoulos
- Department of Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece;
| | | | - Francesca Allemanno
- One Health Unit, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Pascal 36, 20133 Milan, Italy; (F.A.); (P.A.M.)
| | - Piera Anna Martino
- One Health Unit, Department of Biomedical, Surgical, and Dental Sciences, University of Milan, Via Pascal 36, 20133 Milan, Italy; (F.A.); (P.A.M.)
| | - Joel Fernando Soares Filipe
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Via dell’Università 6, 26900 Lodi, Italy;
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Yuen WLP, Loo WL. Multifocal tuberculous osteomyelitis mimicking widespread bony metastases: review of literature and case report. Spinal Cord Ser Cases 2022; 8:23. [PMID: 35181667 PMCID: PMC8857216 DOI: 10.1038/s41394-022-00496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Mycobacterium tuberculosis infections remain a significant cause of morbidity and mortality worldwide. Extrapulmonary infections are less common, and skeletal tuberculosis accounts for about 5-20% of all cases. Skeletal tuberculosis cases often pose diagnostic challenges due to its insidious onset, non-specific clinical presentation and radiographic findings similar to other diseases. Multifocal skeletal tuberculosis is an extremely rare clinical entity, and is defined as an infection that affects two or more non-contiguous bony structures. This clinical entity can mimic bony metastasis and may lead to delays in diagnosis and treatment. CASE PRESENTATION We present a case of multifocal skeletal tuberculous infection mimicking widespread bony metastasis, occurring in an immunocompetent 28-year-old male, and discuss the diagnostic challenges faced and management strategies. The patient successfully underwent instrumentation and stabilization of a pathological T11 vertebra fracture and treatment of tuberculosis infection. DISCUSSION While TB infections remain less common in developed countries, they can still cause significant morbidity. Multifocal skeletal tuberculous infections can resemble spinal or bony metastasis on various imaging modalities. Care must be taken when interpreting such imaging results, with histopathology and mycobacterial cultures remaining the gold standard to determine the presence of active TB infections.
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Affiliation(s)
- Wen Loong Paul Yuen
- Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei Street 3, Singapore, 5298892, Singapore.
| | - Wee Lim Loo
- grid.413815.a0000 0004 0469 9373Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei Street 3, Singapore, 5298892 Singapore
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Nataprawira HM, Ediwan NA, Diana IA, Dwiyana RF, Febrina D. Multifocal Osteomyelitic Tuberculosis at Rare Locations with Metastatic Tuberculosis Abscess. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:503-507. [PMID: 30975973 PMCID: PMC6474155 DOI: 10.12659/ajcr.913615] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Patient: Female, 9 Final Diagnosis: Multifocal osteomyelitic tuberculosis at rare locations with metastatic tuberculosis abscess Symptoms: Lumps at the left elbow joint • lateral side the left hand • lateral side of the left feet Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology
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Affiliation(s)
- Heda Melinda Nataprawira
- Department of Child Health, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Natasha A Ediwan
- Department of Child Health, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Inne Arline Diana
- Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Reiva Farah Dwiyana
- Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dia Febrina
- Department of Dermato-Venerology, Universitas Padjadjaran - Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
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Chesov D, Botnaru V. Imaging for diagnosis and management of tuberculosis. Tuberculosis (Edinb) 2018. [DOI: 10.1183/2312508x.10021217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Mortazavi MM, Khan MA, Quadri SA, Suriya SS, Fahimdanesh KM, Fard SA, Hassanzadeh T, Taqi MA, Grossman H, Tubbs RS. Cranial Osteomyelitis: A Comprehensive Review of Modern Therapies. World Neurosurg 2018; 111:142-153. [DOI: 10.1016/j.wneu.2017.12.066] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 12/07/2017] [Accepted: 12/09/2017] [Indexed: 11/28/2022]
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Lin HF, Liao KF, Chang CM, Lin CL, Lai SW. Statin use correlates with reduced risk of chronic osteomyelitis: a nationwide case-control study in Taiwan. Curr Med Res Opin 2017; 33:2235-2240. [PMID: 28699801 DOI: 10.1080/03007995.2017.1354831] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND/OBJECTIVE Potential association between prior statin use and chronic osteomyelitis is examined. METHODS A nationwide case-control study was conducted based on data taken from the Taiwan National Health Insurance program. The case group includes 2338 subjects aged 20-84 years newly diagnosed for chronic osteomyelitis from 2000 to 2013; the control group included 2338 randomly selected subjects without chronic osteomyelitis matched for sex, age, and index year. Statin use was respectively defined as "current", "recent" or "past" if the most recent statin prescription was filled <3 months, 3-6 months or ≥6 months prior to the chronic osteomyelitis diagnosis. Relative risk of chronic osteomyelitis associated with statin use was measured by the odds ratio (OR) with 95% confidence interval (CI) using the conditional logistic regression model. RESULTS After controlling for potential confounders, the adjusted ORs of chronic osteomyelitis were 0.57 for subjects with current statin use (95% CI 0.45, 0.72), 0.80 for subjects with recent statin use (95% CI 0.48, 1.33), and 1.00 for subjects with past statin use (95% CI 0.83, 1.20), compared patients with no prior statin use. In further analysis, the adjusted ORs of chronic osteomyelitis were 0.70 for subjects with cumulative statin use <12 months (95% CI 0.47, 1.07), and 0.56 for subjects with cumulative statins use ≥12 months (95% CI 0.41, 0.77), compared with those with no prior statin use. CONCLUSIONS Current statin use is associated with reduced concurrent diagnosis of chronic osteomyelitis, particularly for a cumulative statin use ≥12 months.
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Affiliation(s)
- Hsien-Feng Lin
- a School of Chinese Medicine , China Medical University , Taichung , Taiwan
- b Department of Family Medicine , China Medical University Hospital , Taichung , Taiwan
| | - Kuan-Fu Liao
- c Department of Internal Medicine , Taichung Tzu Chi General Hospital , Taichung , Taiwan
- d College of Medicine , Tzu Chi University , Hualien , Taiwan
- e Graduate Institute of Integrated Medicine, China Medical University , Taichung , Taiwan
| | - Ching-Mei Chang
- f Department of Nursing , Tungs' Taichung Metro Habor Hospital , Taichung , Taiwan
| | - Cheng-Li Lin
- g College of Medicine , China Medical University , Taichung , Taiwan
- h Management Office for Health Data, China Medical University Hospital , Taichung , Taiwan
| | - Shih-Wei Lai
- b Department of Family Medicine , China Medical University Hospital , Taichung , Taiwan
- g College of Medicine , China Medical University , Taichung , Taiwan
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Abstract
PURPOSE OF REVIEW The term osteomyelitis covers a wide range of inflammatory bone disorders caused by microbial invasion or due to autoinflammatory processes, but furthermore osteomyelitis also occurs at different ages and at preferred localizations in the human skeleton. This article aims to give an overview of the current literature focussing on pathognomonic aspects of osteomyelitis because of microbial invasion. RECENT FINDINGS Outlining the chronological sequence of osteomyelitis originating from the invasion of microbes finally leading to destruction of bone tissue, the formation and proliferation of biofilm structures play a key role in the development of inflammatory bone disorders. The components of the biofilm on the one hand mediate an immune response leading to an increase of local cytokines and induction of osteoclastogenesis but on the other hand also directly interact with the osteoblasts. As a result, the bone-remodelling process is immensely diminished by induction of proapoptotic pathways, decreased proliferation and differentiation of osteoblasts and an additional promotion of osteoclastogenesis. SUMMARY Although microbial invasion is responsible to be the cause for inflammatory bone disorders, except for an autoinflammatory origin, the underlying and detailed mechanisms in the pathogenesis of osteomyelitis are not yet fully understood, but represent an absolute precondition for the development of effective causal treatment strategies in the future.
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Abstract
Focal lesions in bone are very common and many of these lesions are not bone tumors. These bone tumor mimickers can include numerous normal anatomic variants and non-neoplastic processes. Many of these tumor mimickers can be left alone, while others can be due to a significant disease process. It is important for the radiologist and clinician to be aware of these bone tumor mimickers and understand the characteristic features which allow discrimination between them and true neoplasms in order to avoid unnecessary additional workup. Knowing which lesions to leave alone or which ones require workup can prevent misdiagnosis and reduce patient anxiety.
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Affiliation(s)
- Jennifer Ni Mhuircheartaigh
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
| | - Yu-Ching Lin
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States ; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Keelung Chang Gung University, Taoyuan, Taiwan
| | - Jim S Wu
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States
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