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Morphine Alters M. bovis Infected Microglia’s Ability to Activate γδ T Lymphocytes. J Neuroimmune Pharmacol 2011; 6:578-84. [DOI: 10.1007/s11481-011-9308-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2011] [Accepted: 08/15/2011] [Indexed: 11/25/2022]
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2
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Kalouche I, Ghanem I, Kharrat K, Dagher F. Osteomyelitis of the rib due to Streptococcus pneumoniae: a very rare condition in children. J Pediatr Orthop B 2005; 14:55-60. [PMID: 15577309 DOI: 10.1097/01202412-200501000-00010] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
Rib osteomyelitis is a rare disease. We present a previously unreported case of Streptococcus pneumoniae osteomyelitis of the rib. A 4-month-old-infant presented with fever, irritability and abdominal tenderness. Pericostal collection was discovered incidentally on ultrasound; it was first drained by needle aspiration and appropriate antibiotic therapy was given, with resolution of fever in 24 h, but recurrence of symptoms 4 days later, with swelling over the affected rib. Surgical drainage with resection of the infected portion of the rib were done followed by a prolonged course of intravenous and then oral antibiotics, without any recurrence at 6 months follow-up. A review of the pertinent literature was made. This case demonstrates that the spectrum of pathogens potentially responsible for rib osteomyelitis may be broader than previously reported. The management and outcome are similar to rib osteomyelitis due to any other bacteria.
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Affiliation(s)
- Ibrahim Kalouche
- Department of Orthopaedic Surgery, Hôtel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon
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3
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Abstract
Tuberculosis (TB) of the ribs is extremely rare and its diagnosis is often delayed due to the late appearance of radiologic signs. Although antituberculous drugs are the mainstay of treatment, surgery has a definite therapeutic role in recalcitrant or recurrent cases. A 5-year-old boy with scrofuloderma of the chest wall due to underlying TB of the rib, who responded partially to antituberculous treatment is reported. Surgical resection of the affected rib led to complete resolution. Early diagnosis of TB of this rare site and the role of surgical intervention in such cases is emphasized.
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Affiliation(s)
- Sukhjot Kaur
- Department of Dermatology, Government Medical College and Hospital, Chandigarh, India
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4
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Abstract
Skeletal infections in injection drug users have an insidious onset, present with indolent symptoms, and often occur in unusual locations. Unless physicians are familiar with the disease entities unique to the injection drug user, the diagnosis is frequently delayed. Systemic signs of infection are often lacking. The organisms causing the infection represent a wide spectrum; hence, empiric therapy is not generally recommended. Plain-film radiographs are of little help for early diagnosis. Imaging studies, especially radionucleotide studies and CT or MR imaging scans, can help localize the site of infection. For etiologic diagnosis of these infections, bone biopsy or needle aspiration of the involved bone or joint is required. The choice of antibiotic agent should be based on culture results and the antimicrobial susceptibility of the causative organism. Treatment may also involve surgical drainage or débridement of affected structures. Failure to manage acute bone and joint infection aggressively inevitably leads to chronic, often incurable, infection. Successful therapy requires a team approach including the internist and consultants from orthopedic surgery, infectious diseases, and substance abuse counselors.
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Affiliation(s)
- Vivek Kak
- Division of Infectious Diseases, Department of Internal Medicine, B-320, Life Sciences Building, Michigan State University, East Lansing, MI-48824, USA.
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5
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Ventura G, Cauda R, Paliotta VF, Colosimo C, Lucia MB. Pott's disease of the cervico-occipital junction in an AIDS patient. TUBERCLE AND LUNG DISEASE : THE OFFICIAL JOURNAL OF THE INTERNATIONAL UNION AGAINST TUBERCULOSIS AND LUNG DISEASE 1996; 77:188-90. [PMID: 8762857 DOI: 10.1016/s0962-8479(96)90037-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Pott's disease of the cervical spine is relatively rare despite the fact that tuberculous spondylitis is still the most common manifestation of bone and joint infection. We describe a case, the first to our knowledge, of sub-occipital Pott's disease associated with a retropharyngeal abscess in an acquired immune deficiency syndrome (AIDS) patient. Neurological signs were the main clinical findings. The patient was successfully treated with anti-tuberculosis drugs combined with external stabilization of the spine.
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Affiliation(s)
- G Ventura
- Department of Infectious Diseases, Catholic University, Rome, Italy
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6
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McAdams HP, Erasmus J, Winter JA. RADIOLOGIC MANIFESTATIONS OF PULMONARY TUBERCULOSIS. Radiol Clin North Am 1995. [DOI: 10.1016/s0033-8389(22)00611-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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8
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Haas DW, Des Prez RM. Tuberculosis and acquired immunodeficiency syndrome: a historical perspective on recent developments. Am J Med 1994; 96:439-50. [PMID: 8192176 DOI: 10.1016/0002-9343(94)90171-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The incidence of tuberculosis has increased in recent years, at least in part as a result of the ongoing worldwide epidemic of acquired immunodeficiency syndrome (AIDS). In addition, the occurrence of outbreaks caused by multidrug-resistant Mycobacterium tuberculosis organisms has greatly heightened concern. In retrospect, a number of seminal studies that have appeared during the past decade have helped to define changing concepts concerning the epidemiology, pathogenesis, approaches to preventive care, diagnosis, and treatment of tuberculosis in HIV-infected persons. Such reports have shown that the variable clinical manifestations of tuberculosis in patients with AIDS are greatly influenced by the degree of HIV-induced immunosuppression. Explosive outbreaks of tuberculosis occurring in closed environments have emphasized that patients with AIDS and pulmonary tuberculosis may be highly contagious, especially when diagnosis and implementation of appropriate infection control measures are delayed. The extent to which homelessness and illicit drug use complicate management of tuberculosis have been examined, and the high risk of persons who are both tuberculin-positive and HIV-positive ultimately developing active tuberculosis, unless chemoprophylaxis is completed, has been clearly shown. The utility of sputum smears, bronchoscopy, and newer technologies such as polymerase chain reaction for diagnosis has been examined. The risk of relapse appears to be low when patients with AIDS with drug-sensitive tuberculosis complete appropriate multiple-drug therapy. Recent reports have addressed important hospital infection control, tuberculin testing, and chemoprophylaxis issues. This paper describes this evolution of understanding, focusing on reports that we believe have been conceptually important.
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Affiliation(s)
- D W Haas
- Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee
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Bargalló N, Nicolau C, Luburich P, Ayuso C, Cardenal C, Gimeno F. Intestinal tuberculosis in AIDS. GASTROINTESTINAL RADIOLOGY 1992; 17:115-8. [PMID: 1551503 DOI: 10.1007/bf01888523] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The radiological appearance of intestinal tuberculosis (IT) in six patients with AIDS is presented. Involvement of the ileocecal segment (five cases), cecum (four cases), and duodenum (one case) was seen on computed tomographic (CT) or barium studies. There were no significant differences in radiological manifestations of IT among patients with or without AIDS, but all six patients had an advanced stage of their disease at the time of diagnosis.
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Affiliation(s)
- N Bargalló
- Department of Radiology, Hospital Clìnic i Provincial, Barcelona, Spain
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10
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Affiliation(s)
- R FitzGerald
- Department of Radiology, New Cross Hospital, Wolverhampton, UK
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11
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Brancós MA, Peris P, Miró JM, Monegal A, Gatell JM, Mallolas J, Mensa J, García S, Muñoz-Gomez J. Septic arthritis in heroin addicts. Semin Arthritis Rheum 1991; 21:81-7. [PMID: 1749942 DOI: 10.1016/0049-0172(91)90041-w] [Citation(s) in RCA: 69] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Over a 6-year period (1982 to 1988), 36 episodes of septic arthritis were diagnosed in 35 heroin addicts from Barcelona, Spain. Thirty (86%) were men and five (14%) were women, with a mean age of 24 years (range, 14 to 39). Twenty-nine episodes (80%) were monoarticular and seven (20%) were oligoarticular. The sacroiliac (16 cases), sternoclavicular (8), hip (5), and shoulder (4) joints were most frequently infected. Staphylococcus aureus and Pseudomonas aeruginosa were the etiological agents in 75% and 11% of episodes, respectively. Response to antibiotic treatment was good in 32 cases (90%), eight patients needed surgical drainage, and none died. We conclude that septic arthritis in heroin addicts localizes predominantly in axial joints. In our geographic area, infection with S aureus is more frequent than with gram-negative rods such as P aeruginosa or Serratia marcescens, which are most frequently found in reports from the United States.
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Affiliation(s)
- M A Brancós
- Servicio de Reumatologia, Hospital Clinic i Provincial, Barcelona, Spain
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12
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Root-Bernstein RS. Non-HIV immunosuppressive factors in AIDS: a multifactorial, synergistic theory of AIDS aetiology. RESEARCH IN IMMUNOLOGY 1990; 141:815-38. [PMID: 2100016 DOI: 10.1016/0923-2494(90)90183-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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13
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Affiliation(s)
- M D Stein
- Division of General Internal Medicine, Brown University, Rhode Island Hospital, Providence 02903
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Root-Bernstein R. Non-HIV immunosuppressive factors in AIDS: A multifactorial, synergistic theory of aids aetiology. ACTA ACUST UNITED AC 1990. [DOI: 10.1016/0923-2494(90)90040-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miro JM, Brancos MA, Abello R, Lomena F, Bisbe J, Ribalta T, Rotes-Querol J. Costochondral involvement in systemic candidiasis in heroin addicts: clinical, scintigraphic, and histologic features in 26 patients. ARTHRITIS AND RHEUMATISM 1988; 31:793-7. [PMID: 3289549 DOI: 10.1002/art.1780310616] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We studied the clinical, scintigraphic, and histopathologic characteristics of 26 intravenous drug abusers with costochondral involvement secondary to systemic infection with Candida albicans. The clinical findings were of a mass appearing in the anterior region of the thorax. In general, signs of inflammation were absent. Histopathologic study of this costochondral mass in 12 patients showed perichondritis in 100% and myositis in 87%, with secondary involvement of cartilage in 43% and of bone in 75%. Results of bone scintigrams using 99mTc-methylene diphosphonate were positive in only 7 of 15 patients (47%), with a correlation between positive uptake and osteitis. Gallium scintigraphy findings were positive in 9 of 10 patients (90%). The greater sensitivity of 67Ga was probably because the invariably present pericartilaginous inflammatory mass was not always accompanied by secondary cartilage and bone involvement.
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Affiliation(s)
- J M Miro
- Infectious Diseases Unit, Hospital Clinic i Provincial, Barcelona, Spain
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Duncanson FP, Hewlett D, Maayan S, Estepan H, Perla EN, McLean T, Rodriguez A, Miller SN, Lenox T, Wormser GP. Mycobacterium tuberculosis infection in the acquired immunodeficiency syndrome. A review of 14 patients. TUBERCLE 1986; 67:295-302. [PMID: 3660457 DOI: 10.1016/0041-3879(86)90019-x] [Citation(s) in RCA: 33] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The clinical findings in 13 drug abusers and one homosexual man with tuberculosis and the acquired immunodeficiency syndrome (AIDS) from New York City are described. Tuberculosis preceded the diagnosis of AIDS in nine of the 14 patients by a mean of 7 months and occurred within the same month in the remaining five. The presence of thrush, generalised lymphadenopathy, lymphopenia, cutaneous anergy and chest radiographs showing hilar adenopathy and/or lower lobe infiltrates was common among the patients in whom tuberculosis preceded AIDS. Eight of our patients had extra-pulmonary tuberculosis, six had disseminated tuberculosis and five had tuberculous lymphadenitis. Cultures of tissue biopsies may be positive for Mycobacterium tuberculosis despite the absence of acid fast bacilli or granulomas on microscopic examination. Tuberculosis generally responded to chemotherapy, but the majority of patients died from opportunist infections.
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Affiliation(s)
- F P Duncanson
- Department of Medicine of Lincoln Hospital, New York City, New York
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Firooznia H, Golimbu C, Rafii M, Lichtman EA. Radiology of musculoskeletal complications of drug addiction. Semin Roentgenol 1983; 18:198-206. [PMID: 6351258 DOI: 10.1016/0037-198x(83)90023-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abstract
The radiological appearances of seven cases of rib tuberculosis are discussed. The combination of rib destruction and an extrapleural soft tissue opacity in an Asian immigrant makes tuberculosis a highly likely diagnosis. The presence of an associated fluctuant chest wall swelling, enables a diagnosis of tuberculosis to be made with confidence even in Caucasians.
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