5 research outputs found
Spontaneous vertebral aspergillosis, the state of art: a systematic literature review
Objective: Vertebral aspergillosis are quite rare conditions, often misdiagnosed, that requires long-term antibiotic therapy and, sometimes, surgical treatments. The present investigations was aimed to investigate epidemiology, clinical-radiological aspects, treatment protocols, and outcomes of Aspergillus-mediated vertebral osteomyelitis.
Methods: A systematic review of the pertinent English Literature according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was performed. The research was conducted on Cochrane library, MEDLINE, PubMed and Scopus using as search-terms “Aspergillus”, “vertebral osteomyelitis”, “spondylodiscitis”, “spine infection”. A case of vertebral apsergillosis conservatively managed was also reported.
Results: Eighty-nine articles were included in our systematic review. Including the reported case, our analysis covered 112 cases of vertebral aspergillosis. Aspergillus fumigatus was isolated in 68 cases (61.2%), Aspergillus flavus in 14 (12.6%), Aspergillus terreus in 4 (3.6%), Aspergillus nidulans in 2 (1.8%). Seventy-three patients (65.7%) completely recovered at last follow-up evaluation; in 7 (6.3%) patients radiological signs of chronic infection were reported, whereas 32 (28.8%) patients died during the follow-up.
Conclusion: This systematic review summarized the state of the art on vertebral aspergillosis, retrieving data on clinical features, diagnostic criteria and current limitations, treatment alternatives and their outcomes
A rare case of tertiary syphilis spondylodiscitis of the upper cervical spine: Diagnostic and therapeutic complexity, review of literature
Syphilis is a sexually transmitted disease caused by the spirochetes Treponema pallidum. Syphilitic spinal lesions present as erosive bone lesions often simulating spondylodiscitis or cancer. In this article we describe a rare case of cervical osteolytic lesion from tertiary syphilis. A 45-year-old male with axial neck pain, without fever presented with an isolated osteolytic lesion at C3. Tuberculous spondylitis was initially suspected. A new CT and contrast enhanced MRI of the cervical spine and of the neck showed an extention of the bone lesion at C3 with bilateral lymphadenomegaly. To confirm the diagnosis of tertiary syphilis, US-guided biopsy of the lymph nodes was performed. The patient was treated with i.m. benzylpenicillin 2.4 MIU and the follow-up showed clinical and radiological resolution of the condition. The aim of this case report is to raise awareness of tertiary syphilis in the differential diagnosis of lytic lesions of the spine among the spinal community
Increased Frequency of Hand Hygiene and Other Infection Prevention Practices Correlates with Reduced Surgical Wound Infection Rates in Spinal Surgery during the COVID-19 Pandemic
Background: Due to the COVID-19 pandemic outbreak, many changes were done in the hospital practice, and new guidelines were issued in order to contain the infection spread. One of the most common measures is represented by a correct and frequent hand washing. Recently, an association between increased adherence to hand hygiene (HH) protocols and reduction in hospital infections was documented however no studies about the surgical wound infection rate were reported in the Literature. Methods: The present study represents a multicentric retrospective epidemiological study. The HH compliance rate was recorded through direct observations by trained nurses, 24 h a day. The primary outcome was HH compliance rate. The association of HH with spinal surgical wound infections was the secondary outcome. Results: We reported a compliance to HH practices during the pandemic period of 85.2% compared with 57% observed during 2019. Our analysis showed an overall surgical wound infection reduction of 66.6% during the hospital stay in the pandemic period. Conclusion: Hand hygiene has always been considered one of the most effective, reproducible and low-cost weapons to deal with hospital infections. The good health habits acquired during the COVID-19 pandemic should be maintained even after the virus is eradicated
Comparison between metal and biodegradable suture anchors in the arthroscopic treatment of traumatic anterior shoulder instability: a prospective randomized study.
PURPOSE: The purpose of this study was to compare the clinical outcome of
arthroscopic treatment of shoulder instability with metal and biodegradable
suture anchors.
METHODS: Arthroscopic stabilization was performed in 78 patients with recurrent
traumatic anterior shoulder instability. They were divided into 2 groups of 39
patients each, according to suture anchors used: metal anchors in group 1, and
biodegradable anchors in group 2. Results were evaluated by use of the
Disabilities of the Arm, Shoulder and Hand (DASH) self-administered
questionnaire; Rowe score; Constant score normalized for age and gender, and
recurrence of dislocation.
RESULTS: On analyzing the results at a 2-year follow-up, we considered the
following independent variables: age; gender; arm dominance; duration of
symptoms, age at first dislocation, number of dislocations, type of work; type of
sport; sports activity level; lesion of the anterior labrum and anterior-inferior
gleno-humeral ligament; SLAP lesion, and number of suture anchors. Comparison
between groups did not show significant differences for each variable considered.
Overall, according to the results, median DASH scores were 4.5 points (range
0-27) in group 1 and 7 points (range 0-25) in group 2 (n.s.); median Rowe scores
were 100 points (range 60-100) and 100 points (range 25-100), respectively
(n.s.); and median Constant scores were 98 points (range 81-107) and 98 points
(range 87-121), respectively (n.s.). Recurrence was observed in 1 patient (2.8%)
in group 1 and in 2 patients (5.9%) in group 2. Overall recurrence rate was 4.3%.
Univariate and multivariate analysis showed that age, duration of symptoms,
number of dislocations, type of work, and type of sports significantly and
independently influenced the outcomes. Differences between groups 1 and 2 were
not significant.
CONCLUSION: At a short-term follow-up, differences between arthroscopic shoulder
stabilization with metal and biodegradable suture anchors were not statistically
significant. Clinical relevance of the study is that there is no difference in
the use of metal or biodegradable suture anchors for the arthroscopic treatment
of shoulder instability
Prevention and treatment of knee periprosthetic infection with antibiotic composites sponges
Knee replacement surgery is a very safe and effective procedure but may be unsuccessful because of periprosthetic joint infections (PJI). Antibiotic-loaded collagen sponges have been described to be effective in treating soft tissue and bone infections and have the advantage to reduce the risk of systemic toxicity. This study report a brief description of the literature and some applications of a collagen antibiotic loaded sponge in total knee revision surgery for deep PJI