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Inskip SA, Taylor GM, Zakrzewski SR, Mays SA, Pike AWG, Llewellyn G, Williams CM, Lee OYC, Wu HHT, Minnikin DE, Besra GS, Stewart GR. Osteological, biomolecular and geochemical examination of an early anglo-saxon case of lepromatous leprosy. PLoS One 2015; 10:e0124282. [PMID: 25970602 PMCID: PMC4430215 DOI: 10.1371/journal.pone.0124282] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 03/12/2015] [Indexed: 11/19/2022] Open
Abstract
We have examined a 5th to 6th century inhumation from Great Chesterford, Essex, UK. The incomplete remains are those of a young male, aged around 21-35 years at death. The remains show osteological evidence of lepromatous leprosy (LL) and this was confirmed by lipid biomarker analysis and ancient DNA (aDNA) analysis, which provided evidence for both multi-copy and single copy loci from the Mycobacterium leprae genome. Genotyping showed the strain belonged to the 3I lineage, but the Great Chesterford isolate appeared to be ancestral to 3I strains found in later medieval cases in southern Britain and also continental Europe. While a number of contemporaneous cases exist, at present, this case of leprosy is the earliest radiocarbon dated case in Britain confirmed by both aDNA and lipid biomarkers. Importantly, Strontium and Oxygen isotope analysis suggest that the individual is likely to have originated from outside Britain. This potentially sheds light on the origins of the strain in Britain and its subsequent spread to other parts of the world, including the Americas where the 3I lineage of M. leprae is still found in some southern states of America.
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Affiliation(s)
- Sarah A. Inskip
- Faculteit Archaeologie, Universiteit Leiden, 2311 BE, Leiden, The Netherlands
| | - G. Michael Taylor
- Department of Microbial and Cellular Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, GU2 7TE, United Kingdom
| | - Sonia R. Zakrzewski
- Department of Archaeology, University of Southampton, Avenue Campus, Highfield, Southampton, SO17 1BF, United Kingdom
| | - Simon A. Mays
- Ancient Monuments Laboratory, English Heritage Centre for Archaeology, Fort Cumberland, Fort Cumberland Road, Eastney, Portsmouth PO4 9LD, United Kingdom
| | - Alistair W. G. Pike
- Department of Archaeology, University of Southampton, Avenue Campus, Highfield, Southampton, SO17 1BF, United Kingdom
| | - Gareth Llewellyn
- EPSRC National Mass Spectrometry Facility, Institute of Mass Spectrometry, College of Medicine, Swansea University, Swansea, SA2 8PP, United Kingdom
| | - Christopher M. Williams
- EPSRC National Mass Spectrometry Facility, Institute of Mass Spectrometry, College of Medicine, Swansea University, Swansea, SA2 8PP, United Kingdom
| | - Oona Y-C Lee
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Houdini H. T. Wu
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - David E. Minnikin
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Gurdyal S. Besra
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, United Kingdom
| | - Graham R. Stewart
- Department of Microbial and Cellular Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, GU2 7TE, United Kingdom
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Pabla R, Tibrewal S, Ramachandran M, Barry M. Primary subacute osteomyelitis of the talus in children: a case series and review. Acta Orthop Belg 2011; 77:294-298. [PMID: 21845995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Subacute haematogenous osteomyelitis of the talus in children is a rare condition. All previously reported cases have been managed by hospital admission with surgical debridement and antibiotics or by intravenous antibiotic therapy followed by oral antibiotics. This case series documents the management of the condition at our institution and reviews the current published literature. We conclude that with appropriate patient selection, primary subacute haematogenous osteomyelitis of the paediatric talus can be managed on an out-patient basis with oral antibiotic therapy.
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Affiliation(s)
- Ravinder Pabla
- Department of Trauma & Orthopaedics, Royal London Hospital, London, UK
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Abstract
We report the case of a 39-year-old woman with an uneventful medical history who presented an inflammatory left foot with no notion of trauma or fever. The plain x-ray and magnetic resonance imaging demonstrated talonavicular and subtalar osteoarthritis. A surgical biopsy with excision of inflammatory and necrotic tissue and removal of a fistular tract was performed. Histology revealed the presence of granulomas with caseous central necrosis suggesting tuberculosis of the bone. The diagnosis was confirmed when bacteriology samples grew Mycobacterium tuberculosis. Antituberculosis drugs were administered for twelve months. At 24 months, the patient presents a painful stiff rear foot after the development of secondary talonavicular degeneration. This case illustrates a particular clinical presentation of tuberculosis. This diagnosis should be considered in the presence of atypical bony lesions with a chronic course. Early diagnosis enables proper therapeutic management. Useful diagnostic imaging techniques include plain x-rays, computed tomography, and magnetic resonance imaging. Certain diagnosis is based on bacteriological and histological examinations.
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Affiliation(s)
- J-C Yombi
- Service de médecine interne, maladies infectieuses et tropicales, Cliniques universitaires Saint-Luc, avenue Hippocrate, 101200 Bruxelles, Belgium.
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Arias F, Mata-Essayag S, Landaeta ME, Capriles CHD, Pérez C, Núñez MJ, Carvajal A, Silva M. Candida albicans osteomyelitis: case report and literature review. Int J Infect Dis 2004; 8:307-14. [PMID: 15325600 DOI: 10.1016/j.ijid.2003.12.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Revised: 10/11/2003] [Accepted: 12/28/2003] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Osteomyelitis due to Candida species is an unusual but recognized entity. However, with the increasing occurrence of factors predisposing to candidemia and invasive candidiasis, candidal osteomyelitis is being diagnosed more frequently. An unusual case of Candida albicans osteomyelitis is reported here, along with a review of the published literature on previously reported cases of this disease. METHODS Report of the case and literature review. RESULTS In this case, Candida albicans was isolated from the talus; however, the diagnosis was made after several cultures were performed. Only one other case of Candida osteomyelitis located in foot bones was found in the review. CONCLUSIONS It is thought that this is the first case reported in Venezuela, and only the second in international literature.
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Affiliation(s)
- Félix Arias
- Servicio de Enfermedades Infecciosas del Adulto, Hospital Universitario de Caracas, Venezuela
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Anand A, Sood LK. Isolated tuberculosis of talus without ankle and subtalar joint involvement. Med J Malaysia 2002; 57:371-3. [PMID: 12440280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
This case has been reported because of its rarity and atypical clinical presentation. An 8-year-old boy presented with a gradually increasing swelling localised on the antero-medial aspect of the foot haemogram, erythrocyte sedimentation rate (ESR), Mantoux and X-ray chest were normal. An irregular lytic lesion of the talus was seen on the x-ray of the affected part. Ziehl Nelson staining of the aspirated fluid revealed acid-fast bacilli. Material obtained after curettage and bone grafting was sent for histopathological examination which confirmed the diagnosis of tuberculosis. Post operatively a below knee cast was given for 12 weeks and anti tubercular treatment was given for 20 months. At the end of the treatment patient had full and painless motion at the ankle and subtalar joint. The lytic lesion had healed on X-ray.
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Affiliation(s)
- A Anand
- Department of Orthopedics, Lady Hardinge Medical College and Associated Hospitals, New Delhi-110001, India
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Marcellin-Little DJ, Sellon RK, Kyles AE, Lemons CL, Kaufman L. Chronic localized osteomyelitis caused by atypical infection with Blastomyces dermatitidis in a dog. J Am Vet Med Assoc 1996; 209:1877-9. [PMID: 8944801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A 4-year-old male Golden Retriever was evaluated because of chronic non-weight-bearing lameness of the right hind limb associated with penetrating tarsal wounds. Arthritis of the tarsal joint and osteomyelitis of the talus were initially evident. Tarsal arthrodesis was performed 7 months after initial injury, but the lameness persisted. Ten months later, blastomycosis was diagnosed on the basis of results of histologic examination of bone biopsy specimens and serologic tests. No other site of involvement was detected. The limb was amputated, and Blastomyces dermatitidis was isolated from the affected bone. Adjuvant antifungal treatment was not given. Ten months after amputation, the dog was in good health, and the antibody titer for B dermatitidis was low, indicating resolution of the infection. Localized bone infection with B dermatitidis is rare in dogs. In this dog, it was believed that blastomycosis was contracted through direct inoculation of the organism, because the lesion was associated with puncture wounds and other sites of involvement were not found.
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Affiliation(s)
- D J Marcellin-Little
- Department of Companion Animal and Special Species Medicine, College of Veterinary Medicine, North Carolina State University, Raleigh 27606, USA
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