American Journal of Medical Case Reports

Aims: To isolate and identify the causative agents for chronic osteomyelitis in patients and understanding their virulence factors for identification of targets for novel drugs and design of new vaccines. Study Design: samples of swab and bone tissues biopsy from chronic osteomylitis patients were collected in order to study the infectious agents by investigating their virulence factors. Place and Duration of study: Twenty five specimens of osteomyelitis were collected from chronic osteomyelitis patients at Surgical Specialist Hospital, Al-Yarmook Teaching Hospital and Baghdad Teaching Hospital during June 2010 to May 2011. Methodology: a form was designed to be filled by each patient, which included information about their age, sex, duration of infection, infection site. Specimens were collected using a sterile cotton swab and bunch of biopsy. The pus was taken before the surgery by swabbing an open infected area and from the deeper part of the infected bone, while, biopsies were taken from osteomyelitis patients during surgical management at the operation theater. Results: from fifty swab and twenty-five bone tissue biopsy samples, the results showed high prevalence of osteomyelitis in male patients with 84% (21), and 16% (4) in females. It was found that chronic osteomyelitis has a high prevalence among males with 84%, and the highest incidence was recorded at the age group of 30-39 years. Cultural, microscopic examination and bioc-hemical characterization of both swab and biopsy specimens, showed that 50% of the isolates were Staphylococcus aureus, 26% Enterobacter cloacae, 14% Pseudomonas aeruginosa, 6% Escherichia coli, and 4% Klebseilla sp. From the results of the antimicrobial susceptibility test using different (11) antibiotic discs against S. aureus, Enterobacter cloacae, Pseudomonas aeruginosa, E.coli, and Klebsiella sp. six isolates of S. aureus were selected and designated as (S1, S3, S4, S7) which showed multiple resistances to antibiotics. Conclusion: It was found that multiple resistances S. aureus isolates were able to produce haemolysin enzyme, capsules, slime layer, biofilm and hyaluronidase enzyme.

American Journal of Medical Case Reports. 2014, 2(6), 126-132. DOI: 10.12691/ajmcr-2-6-5
Pub. Date: July 22, 2014

Full-Text PDF

25984 Views6855 Downloads35 Likes

Gossypiboma or Textiloma: A Report of 2 Cases and Strategies for Prevention

by M E Aghahowa, F F Achem, E O Umobong and B A Ojo

Case Report

2 cases of Gossypiboma also called Textiloma or Gauzeoma are presented with the attendant management challenges. One of them presented with an intra peritoneal abscess and a fistula necessitating a 2 staged bowel resection and colostomy then closure while the other simulated a complete intra luminal colonic tumor with sub acute intestinal obstruction. Despite the serious medico-legal and psychological issues involved the patients were duly informed. The doctors that did the previous surgeries were also informed. The surgical team is advised to be meticulous with swab counts in order to avoid its occurrence and when it does a high index of suspicion is required for early diagnosis and management. The policy of prevention coupled with use of several adjunct technologies which accounts for sponge use will help to reduce the incidence of gossypibomas. These strategies to avoid its occurrence are also discussed.

American Journal of Medical Case Reports. 2014, 2(6), 123-125. DOI: 10.12691/ajmcr-2-6-4
Pub. Date: July 15, 2014

Full-Text PDF

13839 Views4452 Downloads34 Likes

Cervical Vertebra Synostosis (C2-C3) - A Case Report

by Yogesh Yadav, Preeti Goswami and Veena Bharihoke

Case Report

Skeletal abnormalities of cervical region or in craniocervical region are of interest to the anatomists, orthopaedicians, neurologists, neurosurgeons and even orthodontists. These abnormalities may result in severe neck pain, decreased neck mobility, muscular weakness and sensory deficits of both upper limbs and sudden unexpected death. During the routine osteology teaching, it was observed that the axis vertebra is fused with the third cervical vertebra. It was observed that body, laminae and pedicles of C2 and C3 were completely fused on both anterior and posterior aspects. The features of these fused cervical vertebrae were analysed and the specimen was photographed from different aspects. This is a condition of block vertebra which has embryological importance and clinical implications.

American Journal of Medical Case Reports. 2014, 2(6), 120-122. DOI: 10.12691/ajmcr-2-6-3
Pub. Date: July 14, 2014

Full-Text PDF

39977 Views8472 Downloads33 Likes

Diarrhea, Demyelinating Neuropathy and Dyspnea: An Occam’s Razor Dilemma

by Abimbola Aderinto-Adike, Hung Q Doan, Cima Nowbakht, Elizabeth Looke-Stewart and Soma Jyothula

Case Report

POEMS disease is a rare paraneoplastic syndrome resulting from an underlying plasma cell disorder. We present a unique case of POEMS disease with predominant clinical symptoms of diarrhea and paresthesias.

American Journal of Medical Case Reports. 2014, 2(6), 117-119. DOI: 10.12691/ajmcr-2-6-2
Pub. Date: July 01, 2014

Full-Text PDF

17030 Views5285 Downloads32 Likes

Submitral Aneurysm: A Rare Congenital Anomaly

by Manish Ruhela, Dinanath kumar, Chandra Bhan Meena and Rajeev Bagarhatta

Case Report

Submitral aneurysm is a congenital out pouching of the left ventricular wall invariably occurring adjacent to the posterior mitral leaflet. This rare congenital cardiac anomaly was initially described among the African population and is considered rare in the other parts of world. The clinical picture is dominated by congestive cardiac failure in the presence of mitral regurgitation. Echocardiography provides precise non-invasive diagnosis. The literature is reviewed to increase the awareness of clinicians, especially novice echocardiographers about this rare cardiac anomaly when coming across congestive cardiac failure with mitral regurgitation in young population.

American Journal of Medical Case Reports. 2014, 2(6), 114-116. DOI: 10.12691/ajmcr-2-6-1
Pub. Date: June 23, 2014

Full-Text PDF

23904 Views7050 Downloads34 Likes