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Brochet T, Tonnelier M, Justinien E, Lecapitaine AL, Bouras A. A case of community-acquired spondylodiscitis caused by Achromobacter xylosoxidans. IDCases 2024; 36:e01980. [PMID: 38737915 PMCID: PMC11088332 DOI: 10.1016/j.idcr.2024.e01980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/25/2024] [Accepted: 04/29/2024] [Indexed: 05/14/2024] Open
Abstract
Achromobacter xylosoxidans is a Gram-negative, aerobic, non-fermenting bacillus mainly responsible for nosocomial infections. We report the first case of community-acquired spondylodiscitis caused by Achromobacter xylosoxidans in a 61-year-old woman, immunocompromised with necrotizing dermohypodermitis of the right lower limb successfully treated with ertapenem and ciprofloxacin.
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Affiliation(s)
- T. Brochet
- Infectious Diseases Department, CH Compiègne, Noyon, France
| | - M. Tonnelier
- Infectious Diseases Department, CH Compiègne, Noyon, France
| | - E. Justinien
- Endocrinology Department, CH Compiègne, Noyon, France
| | | | - A. Bouras
- Infectious Diseases Department, CH Compiègne, Noyon, France
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Grau-van Laak C, Ruiz-García C, Lassaletta L, Morales-Puebla JM. Chronic otorrhea and osteomyelitis of the external auditory canal by Achromobacter xylosoxidans: an uncommon diagnosis. Eur Arch Otorhinolaryngol 2024; 281:2031-2035. [PMID: 38367073 PMCID: PMC10942891 DOI: 10.1007/s00405-024-08465-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/08/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE Achromobacter xylosoxidans is an emerging pathogen mainly associated with resistant nosocomial infections. This bacteria had been isolated in the ear together with other pathogens in cultures from patients with chronic otitis media, but it had never been reported as a cause of osteomyelitis of the external auditory canal. CASE PRESENTATION We present a unique case of a healthy 81-year-old woman who presented with left chronic otorrhea refractory to topical and oral antibiotic treatment. Otomicroscopy revealed an erythematous and exudative external auditory canal (EAC) with scant otorrhea. The tympanic membrane was intact, but an area of bone remodeling with a small cavity anterior and inferior to the bony tympanic frame was observed. Otic culture isolated multi-drug-resistant A. xylosoxidans, only sensitive to meropenem and cotrimoxazole. Temporal bone computed tomography showed an excavation of the floor of the EAC compatible with osteomyelitis. Targeted antibiotherapy for 12 weeks was conducted, with subsequent resolution of symptoms and no progression of the bone erosion. CONCLUSIONS Atypical pathogens such as A. xylosoxidans can be the cause of chronic otitis externa. Early diagnosis and specific antibiotherapy can prevent the development of further complications, such as osteomyelitis. In these cases, otic cultures play an essential role to identify the causal germ. This is the first case of EAC osteomyelitis due to A. xylosoxidans reported to date.
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Affiliation(s)
- Coloma Grau-van Laak
- PhD Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain.
- Department of Otolaryngology, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.
- IdiPAZ Research Institute, Madrid, Spain.
| | - Carmen Ruiz-García
- PhD Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain
- Department of Otolaryngology, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
| | - Luis Lassaletta
- PhD Program in Medicine and Surgery, Autonomous University of Madrid, Madrid, Spain
- Department of Otolaryngology, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
| | - J Manuel Morales-Puebla
- Department of Otolaryngology, La Paz University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain
- IdiPAZ Research Institute, Madrid, Spain
- Biomedical Research Networking Centre on Rare Diseases (CIBERER), Institute of Health Carlos III, Madrid, Spain
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3
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Erroi F, Rotondo C, Sciacca S, Trotta A, Cantatore FP, Corrado A. Serious spondylodiscitis, septic sacroiliitis and multiple abscesses after ozone therapy for low back pain: A case report on good response to combined treatment with empiric antibiotic and neridronate. Int J Rheum Dis 2023. [PMID: 36814395 DOI: 10.1111/1756-185x.14632] [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: 12/21/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
Ozone therapy is a minimally invasive technique now widely used for the treatment of pain due to herniated discs. In literature there are conflicting results concerning its real effectiveness and few data about its possible complications. In this case report we present a case of spondylodiscitis, septic arthritis and gluteal abscess following the execution of 4 sessions of ozone therapy. Given the impossibility of isolating the etiological agent, an empirical antibiotic therapy with an overall duration of 6 weeks was set up, initially with daptomycin and ceftriazone, to which was added after 2 days metronidazole, administered intravenously; after 20 days the cephalosporin was replaced with oral amoxicillin/clavulanate. Neridronate was added to treat bone edema and to avoid bone erosion. The patient showed improvement of both clinical conditions and inflammation indexes, and was discharged after 4 weeks without further complications at follow-up. Few cases are reported in the literature about spondylodiscitis secondary to ozone treatment, and just 1 case is described about the use of neridronate as additive drug to antibiotic treatment in spondylodiscitis to avoid bone disruption and surgery complications.
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Affiliation(s)
- Francesca Erroi
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
| | - Cinzia Rotondo
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
| | - Stefania Sciacca
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
| | - Antonello Trotta
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
| | - Francesco Paolo Cantatore
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
| | - Addolorata Corrado
- Rheumatology Unit, Department of Medical and Surgical Sciences, University of Foggia - Policlinico Riuniti di Foggia, Foggia, Italy
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Hidalgo-Tallón FJ, Torres-Morera LM, Baeza-Noci J, Carrillo-Izquierdo MD, Pinto-Bonilla R. Updated Review on Ozone Therapy in Pain Medicine. Front Physiol 2022; 13:840623. [PMID: 35283802 PMCID: PMC8904924 DOI: 10.3389/fphys.2022.840623] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 01/24/2022] [Indexed: 12/02/2022] Open
Abstract
The use of medical ozone in the treatment of chronic pain is progressively expanding in Spain and today it is used both in public and private medical centers. However, there is a great lack of knowledge about this technology not only in primary care but also in medical specialties. Although its biochemical bases are well determined and there are various systematic reviews and meta-analyses in the literature that justify its use in pain medicine, some professionals still are prejudiced against it. The evidence level of using medical ozone according SIGN (Scotish Intercollegiate Guideline Network) criteria is similar or superior to most of the techniques used in a Pain Unit. In this paper, we have done a review on ozone therapy in pain medicine, compiling the evidence published about it.
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Affiliation(s)
| | - Luis Miguel Torres-Morera
- Department of Anesthesia, Resuscitation, and Pain Treatment Service, Hospital Puerta del Mar, Cadiz, Spain
| | - Jose Baeza-Noci
- Department of Embryology and Human Anatomy, School of Medicine, University of Valencia, Valencia, Spain
| | | | - Rosa Pinto-Bonilla
- Department of Embryology and Human Anatomy, School of Medicine, University of Valencia, Valencia, Spain
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Andrés-Cano P, Vela T, Cano C, García G, Vera JC, Andrés-García JA. Cervical Spondylodiscitis After Oxygen-Ozone Therapy for Treatment of a Cervical Disc Herniation: a Case Report and Review of the Literature. HSS J 2016; 12:278-283. [PMID: 27703423 PMCID: PMC5026656 DOI: 10.1007/s11420-016-9500-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/02/2016] [Indexed: 02/07/2023]
Affiliation(s)
- Pablo Andrés-Cano
- Orthopaedic Surgery and Traumatology Department, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, s/n, 41013 Sevilla, Spain
| | - Tomás Vela
- Orthopaedic Surgery and Traumatology Department, Hospital Universitario Puerta del Mar, Cádiz, Cádiz Spain
| | - Claudio Cano
- Orthopaedic Surgery and Traumatology Department, Hospital Universitario Puerta del Mar, Cádiz, Cádiz Spain
| | - Gaspar García
- Orthopaedic Surgery and Traumatology Department, Hospital Universitario Puerta del Mar, Cádiz, Cádiz Spain
| | - Juan Carlos Vera
- Department of Neurosurgery, University of New Mexico, Albuquerque, NM USA
| | - Jose Antonio Andrés-García
- Orthopaedic Surgery and Traumatology Department, Hospital Universitario Puerta del Mar, Cádiz, Cádiz Spain
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Vanni D, Galzio R, Kazakova A, Pantalone A, Sparvieri A, Salini V, Magliani V. Intraforaminal ozone therapy and particular side effects: preliminary results and early warning. Acta Neurochir (Wien) 2016; 158:491-6. [PMID: 26293228 DOI: 10.1007/s00701-015-2545-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 08/07/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND The term "low back pain syndrome" represents a complex nosological entity. The therapeutic approach is often only symptomatic and not etiologic. METHODS Since 2013, 186 patients (97 males and 89 females, mean age 59.8 years) have undergone microsurgery for lumbar disc hernia or lumbar segmental stenosis. Among these patients, 23 had been previously treated with ozone therapy by the intraforaminal approach and 28 by intraforaminal steroid injections in other hospitals between 12 and 24 months before our clinical evaluation. These patients received 16 applications in an 8-week period (standard therapy). RESULTS During the surgery, many hard adhesions between the soft tissues and bony structures were unexpectedly discovered. In particular, it was noted that the root contracted and had firm adhesions to the dural sac and/or fragmented disc, which were difficult to resolve. These specific pathological patterns were observed only in the patients who received ozone injections by the intraforaminal approach. We did not find any pathological abnormalities in the patients who did not receive any injections or who received intraforaminal steroid injections. Thus, we could exclude that the tissue damage was due to the mechanical action of the needle. CONCLUSION It is important to assert that ozone therapy procedures can be associated with several major complications. Therefore, performing a revision of the guidelines and protocols for ozone therapy application is indispensable.
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Affiliation(s)
- Daniele Vanni
- Orthopaedic and Traumatology Department, Chieti and Vertebral Surgery Department, "G. d'Annunzio" University, Vestini Street, ASL 2 Lanciano Vasto, Chieti, Italy.
| | - Renato Galzio
- Operative Unit of Neurosurgery, San Salvatore Hospital, L'Aquila University, L'Aquila, Italy
| | - Anna Kazakova
- Vertebral Surgery Department, ASL 2 Lanciano Vasto, Chieti, Italy
| | - Andrea Pantalone
- Orthopaedic and Traumatology Department, Chieti and Vertebral Surgery Department, "G. d'Annunzio" University, Vestini Street, ASL 2 Lanciano Vasto, Chieti, Italy
| | - Antonio Sparvieri
- Department of Diagnostic Imaging, Floraspe Renzetti Hospital, Lanciano, Italy
| | - Vincenzo Salini
- Orthopaedic and Traumatology Department, Chieti and Vertebral Surgery Department, "G. d'Annunzio" University, Vestini Street, ASL 2 Lanciano Vasto, Chieti, Italy
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Levoy CS, Hall DJ, Berman D. Achromobacter xylosoxidans endocarditis and septic arthritis in an infant affected by generalized arterial calcification of infancy. JMM Case Rep 2015. [DOI: 10.1099/jmmcr.0.005006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Craig S. Levoy
- Department of Family Medicine, Bayfront Health, 700 Sixth Street South, St Petersburg, FL 33701, USA
| | - David J. Hall
- Division of General Pediatrics and Adolescent Medicine, Johns Hopkins University School of Medicine and All Children's Hospital Johns Hopkins Medicine, 601 Fifth Street South, St Petersburg, FL 33701, USA
| | - David Berman
- Division of Pediatric Infectious Diseases, All Children's Hospital Johns Hopkins Medicine, 601 Fifth Street South, St Petersburg, FL 33701, USA
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