Reliability of white blood cell scan in the follow-up of osteomyelitis

Liberatore, M.; Calandri, Enrico; Pavoni, Gian Luca; Baiocchi, P; Iurilli, Anna Paola; Venditti, Mario; Al-Nahhas, Adil; Rubello, Domenico

doi:10.1016/j.biopha.2007.02.004

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…The disturbed vitamin C redox status was not improved during clinical treatment and worsened upon development of subacute OM. Consistently with previous reports [18, 19], the routine laboratory inflammation markers, such as WBC, ESR, and CRP, were increased already at the time of diagnosis, with approximately 76% of PMN in differential. There is considerable evidence that oxidant-mediated PMN bactericidal activity is necessary for limitation and resolution of bone infections.…”

Section: Discussionsupporting

confidence: 91%

Sequential Analysis of Oxidative Stress Markers and Vitamin C Status in Acute Bacterial Osteomyelitis

Grbić¹,

Mirić²,

Kisic³

et al. 2014

Mediators of Inflammation

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In bacterial bone infections, excessively formed oxidants may result in local and systemic oxidative stress. Vitamin C is the major extracellular nonenzymatic antioxidant, also implicated in bone cells metabolism and viability. The physiological functions of vitamin C largely depend on its redox status. We sequentially assessed oxidative stress markers, hydroperoxides and malondialdehyde (MDA), total antioxidant activity (AOA), total vitamin C, ascorbic acid (Asc), and oxidized/reduced vitamin C ratio in 137 patients with acute osteomyelitis (OM). Compared to 52 healthy controls, in OM group baseline serum hydroperoxides, MDA and oxidized/reduced vitamin C ratio were higher whilst Asc and AOA were lower (P < 0.05, resp.). On the other side, total vitamin C levels in patients and controls were similar (P > 0.05), thereby suggesting a relative rather than absolute vitamin C deficiency in OM. During the follow-up, oxidative stress markers, AOA, and oxidizedreduced vitamin C ratio were gradually returned to normal, while there was no apparent change of total vitamin C concentrations. Persistently high values of oxidized/reduced vitamin C ratio and serum MDA were found in subacute OM. In conclusion, acute OM was associated with enhanced systemic oxidative stress and the shift of vitamin C redox status towards oxidized forms.

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Section: Discussionsupporting

confidence: 91%

Sequential Analysis of Oxidative Stress Markers and Vitamin C Status in Acute Bacterial Osteomyelitis

Grbić¹,

Mirić²,

Kisic³

et al. 2014

Mediators of Inflammation

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“…The effect of antibiotic therapy on LS is debatable, and this issue is still debatable [54]. Recent data suggest that antibiotic treatment does not significantly affect the results of the LS [55]. Since none of the aforementioned diagnostic methods is perfect, several authors have stressed the need to use more than one modality to improve diagnostic accuracy [26,29,30,46,50,56].…”

Section: Discussionmentioning

confidence: 99%

The Labeled-Leukocyte Scan in the Study of Abdominal Abscesses

et al. 2010

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“…Conversely 67 Ga‐citrate and leukocytes scintigraphy demonstrate high specificity for infection in SBO . In a series of eight patients with SBO, Stokkel et al reported that 67 Ga‐citrate scintigraphy was useful at initial diagnosis (8 of 8 positive scans), and could confirm healing at the end of antibiotherapy in five of eight patients .…”

Section: Discussionmentioning

confidence: 99%

“…[21][22][23] Conversely 67 Ga-citrate and leukocytes scintigraphy demonstrate high specificity for infection in SBO. [25][26][27][28][29][30] In a series of eight patients with SBO, Stokkel et al reported that 67 Ga-citrate scintigraphy was useful at initial diagnosis (8 of 8 positive scans), and could confirm healing at the end of antibiotherapy in five of eight patients. 28 To our knowledge, only one study compared LS to CT, MRI and bone scintigraphy during posttherapeutical follow-up in SBO, showing higher accuracy of LS.…”

Section: Discussionmentioning

confidence: 99%

^99mTc‐HMPAO‐leukocyte scintigraphy for diagnosis and therapy monitoring of skull base osteomyelitis

Rozenblum

Vérillaud

Paycha

et al. 2018

Laryngoscope Investig Oto

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ObjectiveSkull base osteomyelitis (SBO) is a rare but life‐threatening disease observed in elderly diabetic patients, with high risk of recurrence and difficult therapeutic management. The diagnosis is ascertained from a set of clinical, biological, and imaging findings. CT and MRI allow initial diagnosis, but are not accurate to affirm healing at the end of therapy. 99mTc‐HMPAO‐Leucocyte Scintigraphy (LS) is highly sensitive and specific for the detection of infection. The aim of this study was to evaluate LS i) for initial diagnosis, and ii) to confirm healing at the end of antibiotherapy in SBO.Study designWe retrospectively reviewed from November 2011 to September 2015 all patients with confirmed SBO who underwent LS twice, at diagnosis and at the end of antibiotic therapy in our nuclear medicine department (n = 27).MethodsClinical, biological, CT, LS, and follow‐up data were recorded in all patients. LS images (planar and tomographic performed 4 hours and 24 hours after intravenous injection of autologous Tc‐99m‐HMPAO‐leucocytes) were visually assessed and quantified.ResultsAt initial diagnosis, 25 of 27 patients had a positive LS. At the end of antibiotic therapy (3 ± 1 months duration), 26 of 27 patients had a negative LS. During subsequent follow‐up (= or >6 months), the disease recurred in four patients including three with a negative postantibiotherapy LS scan.ConclusionIn this retrospective study, LS was powerful for initial diagnostic of SBO and for healing assessment at the end of antibiotic therapy. We conclude it is a useful technique for therapeutic monitoring of SBO.Level of Evidence4

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Reliability of white blood cell scan in the follow-up of osteomyelitis

Cited by 9 publications

References 18 publications

Sequential Analysis of Oxidative Stress Markers and Vitamin C Status in Acute Bacterial Osteomyelitis

Sequential Analysis of Oxidative Stress Markers and Vitamin C Status in Acute Bacterial Osteomyelitis

The Labeled-Leukocyte Scan in the Study of Abdominal Abscesses

^99mTc‐HMPAO‐leukocyte scintigraphy for diagnosis and therapy monitoring of skull base osteomyelitis

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