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Multifocal bacterial osteomyelitis in a renal allograft recipient following urosepsis.

Valson AT, David VG, Balaji V, John GT - Indian J Nephrol (2014)

Bottom Line: Non-tubercular bacterial osteomyelitis is a rare infection.We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.

ABSTRACT
Non-tubercular bacterial osteomyelitis is a rare infection. We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

No MeSH data available.


Related in: MedlinePlus

X-ray taken at the time of initial presentation in November 2006, showing lytic areas in the right upper tibia, consistent with acute osteomyelitis
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Figure 1: X-ray taken at the time of initial presentation in November 2006, showing lytic areas in the right upper tibia, consistent with acute osteomyelitis

Mentions: In November 2006, he developed high grade fever lasting a month, which was empirically treated with cefepime, ampicillin and cloxacillin for 10 days without benefit and returned to our center with fever and pain over the right upper tibia. X-ray showed multiple lytic lesions in the tibial tuberosity consistent with acute osteomyelitis [Figure 1] and pus grew E. coli susceptible to imipenem and amikacin. As fungal, mycobacterial and anaerobic cultures of pus and blood and urine cultures were sterile, a diagnosis of primary osteomyelitis was made, surgical drainage was carried out and IV imipenem 1 g twice daily commenced. Although on imipenem, he developed left tibial osteomyelitis requiring surgical drainage. Bone scan showed no lesions elsewhere with no evidence of infective endocarditis on transthoracic and transesophageal echocardiography. He received a 2-month course of valgancyclovir for CMV viremia (7961 copies/ml of blood) and azathioprine reduced to 50 mg/D.


Multifocal bacterial osteomyelitis in a renal allograft recipient following urosepsis.

Valson AT, David VG, Balaji V, John GT - Indian J Nephrol (2014)

X-ray taken at the time of initial presentation in November 2006, showing lytic areas in the right upper tibia, consistent with acute osteomyelitis
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127842&req=5

Figure 1: X-ray taken at the time of initial presentation in November 2006, showing lytic areas in the right upper tibia, consistent with acute osteomyelitis
Mentions: In November 2006, he developed high grade fever lasting a month, which was empirically treated with cefepime, ampicillin and cloxacillin for 10 days without benefit and returned to our center with fever and pain over the right upper tibia. X-ray showed multiple lytic lesions in the tibial tuberosity consistent with acute osteomyelitis [Figure 1] and pus grew E. coli susceptible to imipenem and amikacin. As fungal, mycobacterial and anaerobic cultures of pus and blood and urine cultures were sterile, a diagnosis of primary osteomyelitis was made, surgical drainage was carried out and IV imipenem 1 g twice daily commenced. Although on imipenem, he developed left tibial osteomyelitis requiring surgical drainage. Bone scan showed no lesions elsewhere with no evidence of infective endocarditis on transthoracic and transesophageal echocardiography. He received a 2-month course of valgancyclovir for CMV viremia (7961 copies/ml of blood) and azathioprine reduced to 50 mg/D.

Bottom Line: Non-tubercular bacterial osteomyelitis is a rare infection.We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

View Article: PubMed Central - PubMed

Affiliation: Department of Nephrology, Christian Medical College Hospital, Vellore, Tamil Nadu, India.

ABSTRACT
Non-tubercular bacterial osteomyelitis is a rare infection. We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

No MeSH data available.


Related in: MedlinePlus