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Connie Y Chang - One of the best experts on this subject based on the ideXlab platform.

  • best practices ct guided percutaneous sampling of vertebral Discitis osteomyelitis and technical factors maximizing biopsy yield
    American Journal of Roentgenology, 2021
    Co-Authors: Jad S Husseini, Sandra B Nelson, Sina Habibollahi, Daniel I Rosenthal, Connie Y Chang
    Abstract:

    Vertebral Discitis-osteomyelitis is an infection of the intervertebral disc and vertebral bodies that may extend to adjacent paraspinal and epidural soft tissues. Its incidence is increasing, likel...

  • ct guided Discitis osteomyelitis biopsies with negative microbiology how many days should we wait before repeating the biopsy
    Skeletal Radiology, 2020
    Co-Authors: Kaitlyn J Yeh, Jad S Husseini, Robert Hemke, Sandra B Nelson, Connie Y Chang
    Abstract:

    To determine the number of days to positive CT-guided biopsy sample culture in patients with Discitis-osteomyelitis. Our study was IRB approved and HIPAA compliant. All CT-guided biopsies performed for acute Discitis-osteomyelitis with positive microbiology between 2002 and 2018 were reviewed. Microbiological organism and days to positive biopsy were documented. Mean, median, skew, and standard deviation were calculated. The proportion of positive cultures that become positive after each day has elapsed was also calculated. There were 96 true positive cultures, with 64 (67%) male and 32 (33%) female, ages 57 ± 18 (range 19–87) years. Overall, including all culture results, the mean number of days to positive culture was 2.9 ± 3.5 days. The median number of days was 2, with a positive skew of 2.9. At days 1, 2, 3, 4, and 5, 48%, 68%, 78%, 85%, and 89%, respectively, of biopsy samples had a positive microbiology culture. Approximately three-quarters of Discitis-osteomyelitis pathogens will be identified by biopsy sample culture by 3 days after CT-guided biopsy. This finding should be considered if planning for a repeat biopsy in the setting of a negative microbiology culture.

Shangxin Yang - One of the best experts on this subject based on the ideXlab platform.

  • community acquired stenotrophomonas maltophilia Discitis diagnosis aided by shotgun metagenomic sequencing
    International Journal of Infectious Diseases, 2019
    Co-Authors: Gang Wang, Lulu Yang, Feng Zheng, Lintao Sai, Jiale Zhou, Shangxin Yang
    Abstract:

    We report a rare case of culture negative L4-L5 Discitis and epidural abscess in an immunocompetent child who had dry cupping therapy performed to treat low back strain. The causative pathogen was identified as Stenotrophomonas maltophilia by shotgun metagenomic sequencing of spinal cord aspirate after more than one month of unsuccessful empirical treatment with 6 different antibiotics. The patient was successfully treated with Sulfamethoxazole-trimethoprim and minocycline. Cupping therapy is a very popular medical procedure widely used in China, but the potential risk for severe infections such as Discitis and epidural abscess described in this case should be recognized.

  • Community acquired Stenotrophomonas maltophilia Discitis: Diagnosis aided by shotgun metagenomic sequencing
    Elsevier, 2019
    Co-Authors: Gang Wang, Lulu Yang, Feng Zheng, Lintao Sai, Jiale Zhou, Shangxin Yang
    Abstract:

    We report a rare case of culture negative L4-L5 Discitis and epidural abscess in an immunocompetent child who had dry cupping therapy performed to treat low back strain. The causative pathogen was identified as Stenotrophomonas maltophilia by shotgun metagenomic sequencing of spinal cord aspirate after more than one month of unsuccessful empirical treatment with 6 different antibiotics. The patient was successfully treated with Sulfamethoxazole-trimethoprim and minocycline. Cupping therapy is a very popular medical procedure widely used in China, but the potential risk for severe infections such as Discitis and epidural abscess described in this case should be recognized. Keywords: Stenotrophomonas maltophilia, Discitis, Epidural abscess, Shotgun metagenomic sequencing, Dry cupping therap

J. A. Eklund - One of the best experts on this subject based on the ideXlab platform.

  • ORIGINAL RESEARCH Diskography: Infectious Complications from a Series of 12,634 Cases
    2015
    Co-Authors: R. S. Pobiel, Kurt P. Schellhas, Steven R. Pollei, B. A. Johnson, J. A. Eklund
    Abstract:

    BACKGROUND AND PURPOSE: Diskography is commonly performed to investigate pain of suspected diskogenic origin. Although uncommon, diskitis is a feared complication of this procedure. We reviewed the incidence of diskitis and other infectious complications following diskography in a large busy outpatient practice and discuss technical aspects that may contribute to infection prevention. METHODS: We reviewed the electronic records of all diskograms obtained at our institution during a 12.25-year period, looking for all cases of procedure-related infection. All diskograms had been obtained by skilled and experienced procedural radiologists in dedicated spine-injection suites with specialized technical staff. RESULTS: There were 12,634 examinations performed on 10,663 patients for a total of 37,135 disk levels. Of the disk levels, 5981 were cervical; 3083, thoracic; and 28,071, lumbar. Two cases of confirmed lumbar diskitis and no cases of either cervical or thoracic diskitis were seen in our series. No other infectious complications were found. The incidence of diskitis was 0.016 % per examination and 0.0054 % per disk level. CONCLUSION: In skilled and experienced hands using proper technique, diskography is a safe outpa-tient procedure with an extremely low incidence of diskitis and other procedure-related infections. Since its introduction by Lindblom in the 1940s,1 diskogra-phy has evolved into a valuable tool in assessing patients with pain of suspected diskogenic origin. Reported complica-tions of diskography are uncommon and include spinal head-ache, intrathecal hemorrhage, arachnoiditis, inadvertent sub-dural injection, diskitis, epidural abscess, subdural empyema, retropharyngeal abscess, sudden quadriplegia, and nucleus pulposus pulmonary embolism.2-8 The most commonly en-countered feared complication, diskitis, is reported to range in frequency from 0 % to 4.92%of patients and 0 % to 3%of disks injected, with an overall occurrence of0.25%of patients and 0.14 % of disks.2 In this report, we review the cases of cervical, thoracic, and lumbar diskography performed on more than 10,000 patients at our institution during a 12-year period, looking specifically at infectious complications. Technical considerations in rela-tion to diskography are reviewed

  • Diskography: Infectious Complications from a Series of 12,634 Cases
    AJNR. American journal of neuroradiology, 2006
    Co-Authors: R. S. Pobiel, Kurt P. Schellhas, Steven R. Pollei, B. A. Johnson, M.j. Golden, J. A. Eklund
    Abstract:

    BACKGROUND AND PURPOSE: Diskography is commonly performed to investigate pain of suspected diskogenic origin. Although uncommon, diskitis is a feared complication of this procedure. We reviewed the incidence of diskitis and other infectious complications following diskography in a large busy outpatient practice and discuss technical aspects that may contribute to infection prevention. METHODS: We reviewed the electronic records of all diskograms obtained at our institution during a 12.25-year period, looking for all cases of procedure-related infection. All diskograms had been obtained by skilled and experienced procedural radiologists in dedicated spine-injection suites with specialized technical staff. RESULTS: There were 12,634 examinations performed on 10,663 patients for a total of 37,135 disk levels. Of the disk levels, 5981 were cervical; 3083, thoracic; and 28,071, lumbar. Two cases of confirmed lumbar diskitis and no cases of either cervical or thoracic diskitis were seen in our series. No other infectious complications were found. The incidence of diskitis was 0.016% per examination and 0.0054% per disk level. CONCLUSION: In skilled and experienced hands using proper technique, diskography is a safe outpatient procedure with an extremely low incidence of diskitis and other procedure-related infections.

Liu Zhongjun - One of the best experts on this subject based on the ideXlab platform.

  • Calcific Discitis with giant thoracic disc herniations in adults
    EUROPEAN SPINE JOURNAL, 2016
    Co-Authors: Xu Nanfang, Wei Feng, Liu Xiaoguang, Jiang Liang, Liu Zhongjun
    Abstract:

    Purpose Calcific Discitis is a self-limiting process most commonly seen in the cervical spine of children. Rare literature exists regarding the natural history and management of this condition in adults, especially when it presents as a giant thoracic disc herniation into the spinal canal. Giant herniations in the thoracic spine are typically surgically removed to reduce the chance of permanent neurologic deficit from spinal cord compression. However, when associated with calcific Discitis, they may undergo spontaneous regression with the need for surgery obviated. Methods Medical records and radiographic studies of two adult patients with calcific Discitis and myelopathy due to spinal cord compression by giant thoracic disc herniations were retrospectively reviewed. Search of the literature on calcific Discitis in adults and spontaneous regression of calcified thoracic disc herniations was separately performed. Results Both patients were young male adults presenting with back pain and early signs of myelopathy. With restriction of activities and oral NSAIDs, their symptoms were relieved within 3 months. Four adult cases of calcific Discitis (characteristic central calcification confined within the nucleus pulposus) and three instances of spontaneous regression of small-to medium-sized thoracic calcified disc herniations were identified from the literature. Conclusions The demonstration of spontaneous resorption of giant calcified thoracic disc herniations in two adult patients with calcific Discitis supplements the existing literature and provides the first evidence that giant calcified thoracic disc herniations may still undergo spontaneous remission and a "wait and watch" strategy may be justified at least in the initial management of these patients, even with the presence of mild myelopathy.SCI(E)PubMedARTICLEputhliuzhongjun@163.comSuppl 1S204-S2082

Zhongjun Liu - One of the best experts on this subject based on the ideXlab platform.

  • calcific Discitis with giant thoracic disc herniations in adults
    European Spine Journal, 2016
    Co-Authors: Feng Wei, Xiaoguang Liu, Liang Jiang, Zhongjun Liu
    Abstract:

    Calcific Discitis is a self-limiting process most commonly seen in the cervical spine of children. Rare literature exists regarding the natural history and management of this condition in adults, especially when it presents as a giant thoracic disc herniation into the spinal canal. Giant herniations in the thoracic spine are typically surgically removed to reduce the chance of permanent neurologic deficit from spinal cord compression. However, when associated with calcific Discitis, they may undergo spontaneous regression with the need for surgery obviated. Medical records and radiographic studies of two adult patients with calcific Discitis and myelopathy due to spinal cord compression by giant thoracic disc herniations were retrospectively reviewed. Search of the literature on calcific Discitis in adults and spontaneous regression of calcified thoracic disc herniations was separately performed. Both patients were young male adults presenting with back pain and early signs of myelopathy. With restriction of activities and oral NSAIDs, their symptoms were relieved within 3 months. Four adult cases of calcific Discitis (characteristic central calcification confined within the nucleus pulposus) and three instances of spontaneous regression of small- to medium-sized thoracic calcified disc herniations were identified from the literature. The demonstration of spontaneous resorption of giant calcified thoracic disc herniations in two adult patients with calcific Discitis supplements the existing literature and provides the first evidence that giant calcified thoracic disc herniations may still undergo spontaneous remission and a “wait and watch” strategy may be justified at least in the initial management of these patients, even with the presence of mild myelopathy.