Salmonella Typhi cause a broad spectrum of human illnesses like gastroenteritis, typhoid fever, and bacteremia. It has also been recognized as a causative organism of osteomyelitis for more than a century but the incidence appears to be uncommon. Microbiological workup plays important role in the diagnosis of Typhoid spondylodiscitis as most of the time it mimics tuberculosis and misguide the clinician, especially in the developing world. Here, we reported an uncommon case of lumbar spondylodiscitis by Salmonella Typhi in an immunocompetent teenager, with the help of clinical, microbiological and radiological evidence. The case was managed conservatively after posterior spinal stabilization.
Hydatid disease is an important emerging neglected disease worldwide, with significant geographic variation in seroprevalance. The disease is commonly diagnosed on basis of clinical suspicion, imaging and serology. This study was conducted to evaluate our experience with serology in diagnosing hydatid disease in terms of identifying the numbers of patients testing positive for antibodies against Echinococcus, and to study their clinical profile. This retrospective study included all patients who tested for anti-Echinococcus IgG antibodies by ELISA in the years 2014-2015. The clinical characteristics of seropositive patients were contrasted with seronegative patients, and the test results were correlated with radiological findings and, where performed, with histopathological studies. Analysis was performed on SPSS (IBM, Inc). Chi-square test was used to statistically compare between patient groups. Out of 54 patients evaluated by serology for Echinococcosis during the study period, Fourteen (26%) were seropositive. The two groups were comparable with respect to age, gender and most hematological parameters, excepting eosinophilia, which was more frequent among seropositive patients (28.6% vs. 2.5%; p=0.01). Alkaline phosphatase also tended to be higher among seropositives (42.9% vs 20%; p=0.09). Liver was the most frequent site involved (12 patients; 86%). Of the 29 patients who also underwent biopsy, all the seven patients with positive biopsy were seropositive, suggesting 100% sensitivity. The specificity was 81.8%, but this might be a lower estimate due to potentially high rate of false-negative biopsies, as all the seropositive patients also had imaging features suggestive of disease. The positive and negative predictive values were 63.6% and 100%, respectively. ELISA for detection of anti-Echinococcus antibodies is a simple serological test that helps in correlation with imaging finding in the diagnosis and subsequent management of hydatid disease.
Background: The role of airborne microorganisms in the nosocomial infections is debatable since past. Very limited and inconclusive data available about the contribution of the air microflora, especially the multidrug resistant (MDR) one, to the hospital-acquired infections in the Intensive Care Units (ICUs).
Purpose:The study was aimed to explore the differences between the Staphylococcus aureus osteosynthesis-associated infection (OAI) and non-implant related infections (NIRI) in terms of epidemiology, resistance characteristics, virulence determinants, treatment, risk factors, and outcome. Methods: A prospective study was conducted from 2018 through 2019. The phenotypic and genotypic characterization of S. aureus, risk factors, treatment, and outcome were compared. Results: A total of 60 patients were included. 50% had OAIs (70%) (p = .045). Overall, MRSA (OR 0.69; p = .020) and old age (OR 0.95; p = 0.035) were the important risk factors. Implanted patients presented with the features of chronic osteomyelitis (93.3%, p = 0.01). NIRI cases composed of only 66.7% of OM, and 55% of them were acute. OAI isolates were more frequently luk gene positives (50%) than isolates from the NIRI group (33.3%). Patients with OAI by luk positive isolates significantly had prolonged hospital stay (p = 0.043; OR-0.96, CI-0.91-1.0). Most of the NIRIs (60%) managed with antibiotics, but frequent surgical intervention (OR 10.68; p = .024) with prolonged systemic antibiotics (OR 1.07; p = .029) helped all OAIs to recover. Patients without implants were recovered in a higher number (83.3%).
Conclusion:Our study highlighted that the differences exist between the OAI and NIRI, specifically in terms of clinical features, distribution of luk genes, treatment approach, and outcome. Risk factors for both types of infection remained the same.
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