Pseudomonas-associated discospondylitis in a two-month-old llama.
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A 2-month-old female llama with a history of tetraparesis was presented for necropsy. This cria was apparently normal until it became ataxic during its second week of life. It had diminished flexor reflexes of the left forelimb and both hind limbs. Hematology and serum biochemistry revealed neutrophilia, elevated alkaline phosphatase, elevated phosphorus, and modest hyperglycemia. Radiography of the cervical spine demonstrated an abnormal C3-C4 intervertebral disc and bony proliferation of the vertebral end plates. The llama was treated with antibiotics and corticosteroids but failed to respond. Postmortem examination revealed cervical intervertebral disc disease and vertebral exostosis. Microscopically, there was necrosis of intervertebral connective tissue and focal malacia of the spinal cord. Pseudomonas aeruginosa was isolated from the intervertebral disc space and from cerebrospinal fluid. To the authors' knowledge, this is the first description of Pseudomonas-associated discospondylitis in a llama. (+info)
Current therapeutic strategy in spinal brucellosis.
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Spontaneous pyogenic spondylitis caused by Klebsiella pneumoniae.
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A 72-year-old woman without a history of spinal injury was admitted to our hospital with prolonged severe back pain and high fever. Clinical laboratory findings and magnetic resonance imaging (MRI) revealed severe inflammation of the L2 and L3 lumbar vertebrae. Meropenem trihydrate administration improved her symptoms. Klebsiella pneumoniae isolated from the patient's blood indicated that the organism caused the spontaneous pyogenic spondylitis. (+info)
A 60-year-old Indian man presented with lower thoracic pain and bilateral lower limb weakness. Radiographs showed compression fractures of T8 and T9 and destruction of the T7 and T10 endplates. Magnetic resonance imaging confirmed the vertebral changes and showed subligamentous spread, paravertebral masses, and epidural involvement leading to cord compression. Computed tomography-guided biopsy showed granulomatous caseous necrosis and acid-fast bacilli, confirming the diagnosis of tuberculosis spondylitis. The imaging features of infective spondylitis, with emphasis on tuberculous spondylitis, are discussed. (+info)
Is HLA-B27 a useful test in the diagnosis of juvenile spondyloarthropathies?
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INTRODUCTION: Seronegative spondyloarthritis (SSA) is a type of arthritis that involves joints in the spine, as well as the hips, shoulders, knees and ankles. The diagnosis of juvenile spondyloarthritis is rarely entertained in young children who present with back and leg pain. The aim of the present study was to assess the role of HLA-B27 as a diagnostic marker in children with spondyloarthropathy, and correlation of HLA-B27 with radiological features and tuberculosis. METHODS: Routine haematological and immunological tests were done by standard method and HLA-B27 typing was done by the lymphocytotoxicity method. A total of 70 cases of juvenile spondyloarthropathy were studied from May 2006 to September 2007. It included both males and females. RESULTS: Positivity of HLA-B27 in childhood SSA was only 71.4 percent (50/70). Gender-wise analysis showed that 76.7 percent (46/60) males and 20.0 percent (2/10) of the female patients were HLA-B27 positive. In HLA-B27-positive cases, the sacroiliac, hip, ankle, lower spine and knee joints were more involved. Urinary tract infection, diarrhoea and constipation were more common in HLA-B27-positive cases. None of the HLA-B27 cases were positive for rheumatoid factor; however, C-reactive protein was raised in 60.5 percent. In bilateral/unilateral sacroiliitis diagnosed by radiographs, only 81.5 percent patients were HLA-B27 positive. Tuberculosis was diagnosed in 14.3 percent (10/70) of total cases in which HLA-B27 positivity was seen in 60 percent of cases (6/10). CONCLUSION: Our study concludes that both HLA-B27 and radiological tests should be done in male children suspected to have SSA, because it can indicate early cases of juvenile spondyloarthropathy when radiological changes are not present, and it produces a more severe disease. HLA-B27 positivity probably also predisposes to tuberculosis. (+info)
Spinal infection caused by Mycobacterium avium complex in a patient with no acquired immune deficiency syndrome: a case report.
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Spinal infection caused by Mycobacterium avium complex (MAC) is rarely seen in people who do not have acquired immune deficiency syndrome. We report such a case in a 60-year-old man who underwent anterior spinal fusion after treatment with antibiotics had failed. The presentation of MAC spinal infection is different from that seen in MAC lung infection, with more than half presenting with urgent or semi-urgent neurological deficits. Younger patients who are not immunocompromised can also be infected. It should be considered as a differential diagnosis in patients with tuberculosis of the spine. The use of antibiotics should be based on the cultured organism's sensitivity results. Indications for surgery are progressive bony destruction, abscess formation, and neurological compression. (+info)
Osteomyelitis and discospondylitis due to Scedosporium apiospermum in a dog.
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A 6-year-old, 30-kg, female German Shepherd Dog, living in a leishmaniasis enzootic area, was presented with a severe rear limb motor disorder and a medical history of acute onset of fever. Routine hematology indicated neutrophilia. Spinal survey radiographs were consistent with osteomyelitis and discospondylitis. Because of the poor clinical prognosis and the painful nature of the lesions, the dog was euthanized at the owners' request. At necropsy, T13-L1 vertebrae had large areas of necrosis within the vertebral bodies. Histopathological findings were consistent with chronic, severe, fungal osteomyelitis and discospondylitis. Polymerase chain reaction identified Scedosporium apiospermum, a eutrophic filamentous fungus now recognized as an emerging agent of severe infections in immunosuppressed human patients. (+info)