7 research outputs found
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Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report
Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis.Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy.Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition.Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging
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Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report
Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis.Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy.Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition.Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging
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This Article Corrects: "Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report"
Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis.Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy.Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition.Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging
Recommended from our members
This Article Corrects: "Subacute Presentation of Central Cord Syndrome Resulting from Vertebral Osteomyelitis and Discitis: A Case Report"
Introduction: Central cord syndrome (CCS) is a clinical syndrome of motor weakness and sensory changes. While CCS is most often associated with traumatic events. There have been few documented cases being caused by abscesses resulting from osteomyelitis.Case Report: A 56-year-old male presented to a regional trauma center complaining of excruciating neck and bilateral upper extremity pain. Computed tomography of the cervical and thoracic regions revealed severe discitis and osteomyelitis of the fourth and fifth cervical (C4-C5) with near-complete destruction of the C4 vertebral body, as well as anterolisthesis of C4 on C5 causing compression of the central canal. Empiric intravenous (IV) antibiotic therapy with ampicillin/sulbactam and vancomycin was initiated, and drainage of the abscess was scheduled. After the patient refused surgery, he was planned to be transferred to a skilled nursing facility to receive a six-week course of IV vancomycin therapy. A month later, patient returned to emergency department with the same complaint due to non-compliance with antibiotic therapy.Discussion: Delayed diagnosis and treatment of osteomyelitis can result in devastating neurological sequelae, and literature supports immediate surgical debridement. Although past evidence has suggested surgical intervention in similar patients with presence of abscesses, this case may suggest that antibiotic treatment may be an alternative approach to the management of CCS due to an infectious etiology. However, the patient had been non-compliant with medication, so it is unknown whether there was definite resolution of the condition.Conclusion: In patients presenting with non-traumatic central cord syndrome, it is vital to identify risk factors for infection in a thoroughly obtained patient history, as well as to maintain a low threshold for diagnostic imaging
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Plexus 2018: Synergy
PLEXUS is a student-organized publication that showcases artwork by medical students, physicians, faculty, patients, and others in the medical community. True to its name, PLEXUS aspires to connect those who seek to heal and to be healed through the unifying language of art. This year we continued to expand our presence in the UCI medical community and beyond.For our 19th edition of PLEXUS, we chose the theme of “Synergy” - a theme that implies collaboration, teamwork, and a merging of perspectives. In the interdisciplinary field of medicine, patients and their team of healthcare providers come to the table with unique beliefs, experiences, and insights that inform their decisions and attitudes. While the journal submission and publication process is run by medical students, we believe that the medical humanities is a creative space open to everyone in the medical community. This year we included wonderful submissions from students in the UCI School of Nursing, as well as graduate students from the biological sciences. It is in seeing and hearing from others’ perspectives that we broaden our horizons and improve ourselves.Every year we are amazed by the emotions, reflections, stories, richness, and creativity of the submissions. We thank all of our submitters for their time and thought. Additionally, please find our performing arts pieces on our website, www.uciplexus.org. Previous publications and submissions are also available online.Winners of the PLEXUS medical student competitions were made possible by the Program in Medical Humanities & Arts.Congratulations to this year’s winners:Writing competition: 1st: Melinda Schneider, MS2 “Mouse Brains and Microtomes”; 2nd: Leigh Goodrich, MS4 “One Million and One”; 3rd: Nazin Sedehi, MS2 “To my class with Love”Visual competition: 1st: Soe Thein, MS3 “Nurture”; 2nd: Kimberly Watanabe, MS3 “Black Diamond Healer”; 3rd: Stephanie Noh, MS2 “Field of Psammoma Bodies”Performing arts competition: 1st: Jovauna Currey, Resident “The Synergy of the Patient/Physician Relationship”; 2nd: Alex Miner, Resident “Squeeze”; 3rd: Nathan Calixto & Chris Gabriel, MS3s “Tears in Heaven” by Eric Clapton.Thank you to our superb editors, staff, and faculty for their support in making this 19th edition possible. We would like to give special thanks to our faculty advisor, Dr. Johanna Shapiro and Dr. Ellena Peterson, Associate Dean of Admissions & Outreach - this book would not have been possible without your continuous support and guidance. We hope you enjoy PLEXUS 2018 – Synergy. Plexus Editors-In-Chief: Celia Cheung, Joanna TurkiewiczProject HX - Editor-In-Chief: Thalia NguyenCreative Writing & Visual Arts Team: Yvonne Lu, Julie Ferris, Shreya Aiyar, Arnie Shah, Julia Tran, Sarah O’Dell, Priyanka Sharma, Ava RungeDesign Team: Priyanka Sharma, Christina Kong, Nazin SedehiDigital And Social Media Editor: Christine PhamPerforming Arts Chair: Melinda SchneiderTo contribute to PLEXUS or to request a PLEXUS exhibit at your event, please visit www.uciplexus.orgFollow us at www.facebook.com/uciplexus
Contest winners1st place winner: Melinda Schneider2nd place winner: Leigh Goodrich3rd place winner: Nazin Sedeh
The database of the PREDICTS (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems) project
The PREDICTS project—Projecting Responses of Ecological Diversity In Changing Terrestrial Systems (www.predicts.org.uk)—has collated from published studies a large, reasonably representative database of comparable samples of biodiversity from multiple sites that differ in the nature or intensity of human impacts relating to land use. We have used this evidence base to develop global and regional statistical models of how local biodiversity responds to these measures. We describe and make freely available this 2016 release of the database, containing more than 3.2 million records sampled at over 26,000 locations and representing over 47,000 species. We outline how the database can help in answering a range of questions in ecology and conservation biology. To our knowledge, this is the largest and most geographically and taxonomically representative database of spatial comparisons of biodiversity that has been collated to date; it will be useful to researchers and international efforts wishing to model and understand the global status of biodiversity