brodie's abscess

  • 文章类型: Case Reports
    Brodie的arsal角状脓肿是这种疾病的相对罕见表现。在这项研究中,我们介绍了一例20岁的男性,他患有创伤后Brodie的骨长方体脓肿,在创伤后未治疗三年(用一块锋利的木头进行穿透性损伤)。病人在受伤部位表现出疼痛,一瘸一拐的,而平足X光片显示长方体中有一个小的溶血性空洞区域。磁共振成像显示,在长方体骨的2厘米直径腔中存在脓肿,并且周围足底肌肉组织有慢性炎症。治疗方案包括刮宫,清创术的炎症组织,和抗生素的管理,根据术中收获的培养物,六个星期.在此期间,症状完全解决。
    Brodie\'s abscess of the tarsal cuboid is a relatively rare presentation of this disease. In this study, we present the case of a 20-year-old male with post-traumatic Brodie\'s abscess of the tarsal cuboid that was left untreated for three years after the traumatic episode (penetrating injury with a sharp piece of wood). The patient presented pain over the injured area, limping, while plain foot radiographs showed a small lytic cavitary area in the cuboid. The magnetic resonance imaging revealed the presence of the abscess in a 2-cm diameter cavity in the cuboid bone and chronic inflammation of the surrounding plantar musculature. The treatment regime included curettage of the cavity, debridement of the inflammatory tissues, and administration of antibiotics, according to the cultures harvested intraoperatively, for six weeks. During this period, symptoms completely resolved.
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  • 文章类型: Case Reports
    结核病(TB)是由细菌结核分枝杆菌引起的具有潜在肺外表现的肺部疾病。尽管在治疗方面取得了进展,结核病仍然是全球公共卫生问题。结核病骨髓炎约占所有肺外结核病病例的3-5%。我们介绍了一例22个月大的女性肱骨结核骨髓炎,没有肺部或全身症状。此病例提供了对结核病骨髓炎的诊断和管理的见解。一名22个月大的先前健康的海地裔美国女性,在肱骨近端前外侧有一个月明显的肿块,没有覆盖红斑或软组织肿胀。没有报告其他症状。她最近没有生病的接触,但在婴儿期访问过海地。右肱骨近端X线和随后的MRI显示肱骨近端骨髓炎伴有骨内Brodie脓肿。切开和引流提取的干酪样材料,通过聚合酶链反应检测结核分枝杆菌呈阳性。通过阳性QuantiFERON-TB金和纯化的蛋白质衍生物测试确认了诊断。患者接受了左氧氟沙星治疗,异烟肼,吡嗪酰胺,吡哆醇,住院期间还有利福平.放电后,她继续接受抗生素治疗,并由佛罗里达卫生部管理。放电后,3个月和12个月的X射线显示病变愈合的证据。结核病骨髓炎是结核病感染的一种罕见表现,可能隐匿而无全身或肺部症状。及时治疗对预防并发症至关重要,病因不明的骨块应调查结核感染,即使没有其他症状。
    Tuberculosis (TB) is a pulmonary disease with potential extrapulmonary manifestations that is caused by the bacteria Mycobacterium tuberculosis. Despite advancements in treatment, TB remains a worldwide public health concern. TB osteomyelitis accounts for approximately 3-5% of all extrapulmonary TB cases. We present a case of humeral TB osteomyelitis in a 22-month-old female with no pulmonary or systemic symptoms. This case offers insight into the diagnosis and management of TB osteomyelitis. A 22-month-old previously healthy Haitian-American female presented with a one-month history of a palpable mass over the anterolateral aspect of the proximal humerus without overlying erythema or soft tissue swelling. No additional symptoms were reported. She had no recent sick contacts but had visited Haiti during her infancy. Right proximal humerus X-ray and subsequent MRI revealed proximal humeral osteomyelitis with an intraosseous Brodie\'s abscess. Incision and drainage extracted caseous material, which tested positive for Mycobacterium tuberculosis via a polymerase chain reaction. The diagnosis was confirmed via positive QuantiFERON-TB Gold and purified protein derivative testing. The patient was treated with levofloxacin, isoniazid, pyrazinamide, pyridoxine, and rifampin during the hospitalization. Following discharge, she was continued on her antibiotic regimen and managed by the Florida Department of Health. Post-discharge, X-rays at three and twelve months showed evidence of lesion healing. TB osteomyelitis is a rare manifestation of TB infection, which may present insidiously without systemic or pulmonary symptoms. As timely treatment is vital to preventing complications, bone masses of unknown etiology should be investigated for TB infection, even without additional symptoms.
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  • 文章类型: Journal Article
    BACKGROUND: Septic osteomyelitis is a hematogenous bacterial bone infection. The acute presentation is the most common; the subacute one is less frequent. The aim of our case report is to put forward the features of this uncommon presentation and to propose a therapeutic management.
    METHODS: We report a rare case of subacute osteomyelitis associated with Brodie\'s abscess of the tibial diaphysis in a four-year-old child. The chief complaint was a pain in the left tibia evolving for five weeks. The radiological findings and the unusual location of this pathology suggested a malignant bone tumor. Thanks to imaging assessment and bone biopsy the diagnosis of subacute osteomyelitis associated with Brodie\'s abscess was made. Therefore, the child had antibiotic therapy and plaster immobilization to avoid pathological fracture. Pain relief and radiological improvement was obtained after 3 months of antibiotic treatment. At a two-year follow-up, the X-ray was normal.
    CONCLUSIONS: We report an uncommon case of subacute osteomyelitis which evolved to Brodie\'s abscess with diaphyseal location. The mainstream treatment is surgery combined with antibiotics. However, medical treatment alone can lead to recovery without sequelae.
    CONCLUSIONS: Because of the atypical location and presentation of subacute osteomyelitis, the other differential diagnoses, especially malignant bone tumors have to be eliminated. In some cases, treatment may be based on antibiotics therapy alone.
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  • 文章类型: Case Reports
    Atraumatic limb pain in a child raises concerns in a medical setting. That is how a typical case of Brodie\'s abscess presents, having pain without any other symptoms of systemic illness. Assessment and investigations might also not reveal anything significant unless adequate imaging is done. Although Brodie\'s abscess has a very low rate of complications and morbidity/disability, it is important that such a presentation is assessed clinically with a diagnosis of Brodie\'s abscess in mind to ensure an uneventful and good outcome. We illustrate in this case report a similar presentation of an 11-year-old girl who had multiple visits to primary care. She was then assessed through radiological imaging. By the time of her diagnosis, her abscess had protruded through the skin. Thankfully management was done swiftly after identification and the final outcome was good with complete recovery.
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  • 文章类型: Case Reports
    Brodie脓肿是一种相对罕见的亚急性骨髓炎。由于其隐匿的发作和模糊的症状,早期诊断具有挑战性。磁共振成像有助于Brodie脓肿的诊断;然而,到目前为止,没有研究描述这种疾病的早期影像学表现。这里,我们介绍了一例14岁男孩在胫骨近端有Brodie’s脓肿的病例。在MRI上,病变最初表现为左胫骨近端干phy端的骨髓水肿,并被误解为骨瘀伤。1个月后进行进一步的放射学检查;这显示脓肿腔的形成,这表明布罗迪的脓肿。病人被转诊到我们医院接受了刮宫清创,这导致Brodie脓肿的明确诊断根据组织病理学发现和细菌培养。在仔细的回顾性评估中,最初的放射学发现提示生长板的干phy端有微脓肿,骨髓水肿从病变扩散到骨p。这些放射学变化可能是可靠的证据,证明生长板的干phy端侧是Brodie脓肿的起源。此外,骨髓水肿伴疑似长骨干干端微脓肿可能是Brodie脓肿形成的初始阶段,应仔细随访。
    Brodie\'s abscess is a relatively rare subacute form of osteomyelitis. Early diagnosis is challenging because of its insidious onset and vague symptoms. Magnetic resonance imaging is helpful in the diagnosis of Brodie\'s abscess; however, to date, no study has described the imaging findings of this disease in the early stage. Here, we present the case of a 14 year-old boy with Brodie\'s abscess in the proximal tibia. The lesion initially presented as a bone marrow edema in the proximal metaphysis of the left tibia on MRI and was misinterpreted as a bone bruise. Further radiological examination was performed 1 month later; this revealed the formation of an abscess cavity, which suggested Brodie\'s abscess. The patient was referred to our hospital and underwent curettage and debridement, which led to the definitive diagnosis of Brodie\'s abscess on histopathological findings and bacterial culture. On careful retrospective evaluation, the initial radiological findings suggested a microabscess on the metaphyseal side of the growth plate and bone marrow edema spreading from the lesion to the epiphysis. These radiological changes could be reliable evidence proving that the metaphyseal side of the growth plate is the origin of Brodie\'s abscess. Moreover, bone marrow edema with suspected microabscess in the metaphysis of the long bones can be the initial stage of the formation of Brodie\'s abscess and should be carefully followed up.
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  • 文章类型: Case Reports
    桡骨远端骨折是最常见的小儿骨折。在不稳定骨折中,治疗方法包括闭合或开放复位和经皮钉扎克氏针(K-wire)。这份报告介绍了一个13岁的男孩,他的桡骨远端和尺骨骨折不稳定,发生事故后,接受切开复位和克氏针固定治疗。他有6个月的疼痛和有限的手腕活动范围。常规X线照相显示有明显的硬化边缘的溶解性病变。还显示了慢性骨髓炎和Brodie脓肿。完全刮宫和抗生素治疗3个月是成功的。培养结果表明,金黄色葡萄球菌和病理结果有利于慢性骨髓炎。亚急性骨髓炎和Brodie脓肿是小儿桡骨远端骨折经皮钉扎术中罕见的迟滞并发症。病灶刮除和抗生素治疗至少3个月将是成功的,并且可以在儿童中获得良好的预后。
    Distal radius fractures are among the most common pediatric fractures. In unstable fractures, treatment methods include closed or open reduction and percutaneous pinning with Kirschner wire (K-wire). This report presents a 13-year-old boy with an unstable distal radius and ulnar fractures, following an accident, who was treated with open reduction and K-wire fixation. He had pain and limited wrist range of motion for 6 months. Conventional radiography revealed a lytic lesion with evident sclerotic margin. Chronic osteomyelitis and Brodie\'s abscess were also indicated. A complete curettage and antibiotic therapy for 3 months was successful. Culturing results showed that Staphylococcus aureus and pathologic findings were in favor of chronic osteomyelitis. Subacute osteomyelitis and Brodie\'s abscess are rare retarded complications in percutaneous pinning of distal radius pediatric fractures. The curettage of the lesion and antibiotic therapy for at least 3 months would be successful and could result in good prognosis among children.
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  • 文章类型: Case Reports
    我们报告了一例罕见的由kansasii分枝杆菌引起的Brodie脓肿(M.kansasii)。我们的患者是一名39岁的男性,在新诊断为HIV感染后一个月出现右脚疼痛。做了X线和MRI检查,并确诊Brodie的脓肿。进行了手术清创,五周后,骨骼培养物生长。Brodie脓肿是一种亚急性骨髓炎,通常由葡萄球菌引起。一些病例报告中还涉及其他一些细菌。据我们所知,这是Brodie\的第一例由M.kansasii引起的脓肿。KansasiiM.是引起免疫受损宿主感染的非典型分枝杆菌,如CD4计数低的HIV患者。与我们的病例一样,KansasiiM.通常与肺部感染有关,并伴有罕见的肺外表现。
    We report a rare case of Brodie\'s abscess caused by Mycobacterium kansasii (M. kansasii). Our patient is a 39-year-old male who presented with right foot pain a month after a new diagnosis of HIV infection. X-ray and MRI were done, and the diagnosis of Brodie\'s abscess was confirmed. Surgical debridement was done, and bone cultures grew M. kansasii after five weeks. Brodie\'s abscess is a subacute form of osteomyelitis usually caused by Staphylococcus. Some other bacteria have been implicated in several case reports. To best of our knowledge, this is the first case of Brodie\'s abscess caused by M. kansasii. M. kansasii is the atypical mycobacteria causing infections in immunocompromised hosts as in HIV patients with low CD4 count. M. kansasii is usually associated with lung infections with rare extrapulmonary manifestations as in our case.
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  • 文章类型: Case Reports
    Atraumatic limb pain and limp is a common pediatric presentation in the emergency department in the United States. In a majority of cases, these presentations are benign. However, in cases where pediatric patients are repeatedly presenting for atraumatic limb pain, further investigation is required. We present such the case of a 14-year-old female with acute worsening of progressive atraumatic knee pain who was found to have a Brodie\'s abscess, a subacute pyogenic form of osteomyelitis. This is a particularly challenging diagnosis, as it often presents with no associated symptoms such as fever or weight loss. The consequences of missing this diagnosis include permanent disability and potential amputation, but excellent outcomes can be expected for those who undergo timely surgical debridement and irrigation. We discuss the etiology, common presentations, and treatment of this rare but potentially limb-threatening disease in the hope that clinicians will consider this diagnosis in cases of persistent or progressive atraumatic limb pain.
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  • 文章类型: Case Reports
    Brodie\'s abscess is a rare form of subacute osteomyelitis, most commonly found in children between the ages of two to fifteen years. It has slight preponderance for males. It is characterised by centrally placed, well-circumscribed abscess within the medulla or metaphysis of long bone, most commonly tibia, surrounded by a sclerotic wall. It is sometimes considered a transitional phase for the development of chronic osteomyelitis due to infection persisting between two to six months without showing any systemic symptoms specific to osteomyelitis. It is assumed that it is clinically quiescent due to its intraosseous location. It rarely presents with overt symptoms, which occurs if either the abscess enlarges to create pressure against the periosteum, or if the purulent material extrudes from the confines from its sclerotic walls. Due to subliminal clinical features and indolent clinical course, radiologic investigations are the diagnostic modality of choice. Diagnosis requires a high degree of suspicion, especially in the scenario of sepsis with an unknown source of infection. We describe a case of Brodie\'s abscess in a sickle-cell disease patient which presented as episodes of vaso-occlusive crisis repeatedly before it was diagnosed along with a review of the literature.
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  • 文章类型: Journal Article
    Introduction: Brodie\'s abscess is a form of osteomyelitis. Since its first appearance in the medical literature in 1832, numerous cases have been described. The aim of this article is to provide the first comprehensive overview of published cases of Brodie\'s abscess, and to describe diagnostic methods, therapeutic consequences and outcomes. Methods: According to PRISMA guidelines a systematic review of the literature was performed. All published data in English or Dutch were considered for inclusion with no limitations on publication date. Data was extracted on demography, duration of symptoms, signs of inflammation, diagnostic imaging, causative agent, treatment and follow-up. Results: A total of 70 articles were included, reporting on a total of 407 patients, mostly young (median age 17) males (male:female ratio 2.1:1). The median duration of symptoms before diagnosis was 12 weeks (SD 26). Mostly consisting of pain (98%) and/or swelling (53%). 84% of all patients were afebrile, and less than 50% had elevated serum inflammation markers. Diagnosis was made with a combination of imaging modalities: plain X-ray in 96%, MRI (16%) and CT-scan (8%). Treatment consisted of surgery in 94% of the cases, in conjunction with long term antibiotics in 77%. Staphylococcus aureus was the pathogen most often found in the culture (67,3%). Outcome was generally reported as favorable. Recurrence was reported in 15,6% of the cases requiring further intervention. Two cases developed permanent disability. Conclusion: Brodie\'s abscess has an insidious onset as systemic inflammatory signs and symptoms were often not found. Treatment consisted mostly of surgery followed by antibiotics (77%) or only surgery (17%) and outcomes were generally reported as favourable.
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