Isolated Iliac Crest Tuberculosis: A Case Report.

CASE: Following an insidious onset of symptoms, a 29-year-old man who had no risk factors for tuberculosis was diagnosed with tuberculosis of the iliac crest. The red flag in this case was the patient's progressive deterioration despite a variety of antibiotic regimens. Histopathologic demonstration of necrotic granulomatous inflammation and a positive culture led to the diagnosis. A combination of surgery and antitubercular-drug therapy resulted in clinical recovery. CONCLUSION: Iliac crest tuberculosis represents <1% of all skeletal tuberculosis cases. Even in the absence of classic symptoms and risk factors, orthopaedic surgeons should maintain a low threshold for tuberculosis in the differential diagnosis.

The effect of volatile oil mixtures on the performance and ilio-caecal microflora of broiler chickens.

The aim of this study was to investigate the individual and combined effects of rosemary, oregano and fennel volatile oil (FVO) supplementation on the performance and ilio-caecal bacteriological flora of broiler chickens. A total of 800 male Ross-308 broiler chickens were divided equally into 8 groups; each contained 100 chickens. The study included a control treatment (NC) with no dietary additives that was supplemented with oils according to the following 7 treatments: 200 mg α-tocopherol acetate/kg (PC), 100 mg oregano volatile oil (OVO)/kg, 100 mg rosemary volatile oil (RVO)/kg, 100 mg FVO/kg and an equal mixture of oregano+rosemary+fennel VO (100, 200, 400 mg/kg, VOM-1, VOM-2 and VOM-3, respectively). The experiment lasted for 6 weeks. At the end of the experiment, dietary supplementation with α-tocopherol, oregano, rosemary and FVO and two different volatile oil mixtures (VOMs) (VOM-2; VOM-3) significantly increased the body weights (BWs) of broilers at 7, 14 and 21 d of age compared to the negative control (NC) (-) and VOM-1 groups. At 0-42 d, birds fed on VOM-3 were considerably heavier and also gained more weight than NC (-) and VOM-1 groups. The blend of VOs at 400 mg/kg significantly increased Lactobacillus spp. in faeces. The blends of oregano, rosemary and FVOs (VOM-3) at 400 mg/kg concentration and also VOM-3 group exhibited stronger antibacterial activity against coliform bacteria compared to the NC (-) group. In conclusion, the blend of oregano, rosemary and fennel VOs at higher concentrations (400 mg/kg concentration) in diets can be used to stimulate the growth and can improve the intestinal microbial balance (including a reduction of coliform bacteria and an increase in Lactobacillus spp. counts) of broiler chickens.

Mycobacterium tuberculosis Contaminant Risk on Bone Marrow Aspiration Material from Iliac Bone Patients with Active Tuberculous Spondylitis.

There was a concern on Mycobacterium tuberculosis spreading to the bone marrow, when it was applied on tuberculous spine infection. This research aimed to study the probability of using autologous bone marrow as a source of mesenchymal stem cell for patients with tuberculous spondylitis. As many as nine patients with tuberculous spondylitis were used as samples. During the procedure, the vertebral lesion material and iliac bone marrow aspirates were obtained for acid fast staining, bacteria culture, and PCR (polymerase chain reaction) tests for Mycobacterium tuberculosis at the Clinical Microbiology Laboratory of Faculty of Medicine Universitas Indonesia. This research showed that there was a relationship between diagnostic confirmation of tuberculous spondylitis based on the PCR test and bacterial culture on the solid vertebral lesion material with the PCR test and bacterial culture from the bone marrow aspirates. If the diagnostic confirmation concluded positive results, then there was a higher probability that there would be a positive result for the bone marrow aspirates, so that it was not recommended to use autologous bone marrow as a source of mesenchymal stem cell for patients with tuberculous spondylitis unless the PCR and culture examination of the bone marrow showed a negative result.

Irradiated allograft bone in spine surgery: to culture or not? A single center retrospective study.

STUDY DESIGN: Retrospective chart review. OBJECTIVE: We aimed to document the rate of infection in our institution after the use of irradiated cancellous allograft or iliac crest bone autograft in vertebral fusion procedures. We also reviewed the pertinence of microbiological culture of cadaveric allograft bone prior to its implantation. SUMMARY OF BACKGROUND DATA: Recent studies have shown similar postoperative infection rates between allograft and autograft. The pertinence of microbiological culture of allograft bone prior to its implantation is currently controversial. METHODS: Retrospectively, we identified 338 patients who underwent spine fusion procedures for which there was a minimum of a 1-year follow-up. Files from both the neurosurgery and orthopedics divisions of the Centre hospitalier universitaire de Sherbrooke were reviewed during 1999 to 2009. Irradiated allografts were used in 164 patients and autografts were used in 174 patients. Of the 164 allografts implanted, 53 were cultured peroperatively. Postoperative spinal infection was based on documented positive spine cultures at the time of re-exploration for presumed infection. Infection rates were compared using Fisher exact test. RESULTS: From the 53 peroperative cultures, 5 were positive (9.4%) and none of them led to antibiotherapy or surgical revision at 1 year. No significant difference was observed in the rate of surgical site infection at 1 year, after the use of irradiated allografts (1.8%) or autografts (1.7%), P = 1.0. CONCLUSION: Perceived association with infection should not influence the surgeon in bone graft choice for spinal fusion. There is a lack of scientific evidence to recommend for or against routine cultures on allograft implantation in the literature. Our results strongly underline the pertinence of larger multicenter clinical trials to assess the pertinence of peroperative allograft bone culture.

Iliac bone Candida albicans osteomyelitis in a patient with iliac crest bone autograft: a case report and review of the literature.

Candida osteomyelitis is a well recognized but infrequent entity. We describe an interesting case of iliac bone C. albicans osteomyelitis as a result of a surgical trauma of an iliac bone for the auto-grafting of a fracture in the lumbar spine. The peri-operative acquisition of Candida was by the inoculation of a yeast colonizing the skin. Remarkably, several risk factors described for Candida infection and candidemia were absent. The patient also presented with a local fistula. The iliac crest was the only bone affected and local pain was the only symptom present in our case. Diagnosis was made by multiple-specimen biopsy obtained by surgery. Treatment with fluconazole was successful.

Application of phylogenetic microarrays to interrogation of human microbiota.

Human-associated microbiota is recognized to play vital roles in maintaining host health, and it is implicated in many disease states. While the initial surge in the profiling of these microbial communities was achieved with Sanger and next-generation sequencing, many oligonucleotide microarrays have also been developed recently for this purpose. Containing probes complementary to small ribosomal subunit RNA gene sequences of community members, such phylogenetic arrays provide direct quantitative comparisons of microbiota composition among samples and between sample groups. Some of the developed microarrays including PhyloChip, Microbiota Array, and HITChip can simultaneously measure the presence and abundance of hundreds and thousands of phylotypes in a single sample. This review describes the currently available phylogenetic microarrays that can be used to analyze human microbiota, delineates the approaches for the optimization of microarray use, and provides examples of recent findings based on microarray interrogation of human-associated microbial communities.

Iliac osteomyelitis in a newborn: a case report.

Pelvis is a rare location of the hematogeneous osteomyelitis during the newborn period. Successful cure of osteomyelitis during the newborn period is dependent on a fast and true diagnosis and on sufficient treatment. In this case report, iliac osteomyelitis of a newborn that was clinically suspected on the fifth day, was diagnosed radiologically and was found to be caused by methicillin-sensitive Staphylococcus aureus, is presented. According to our knowledge, this is the youngest osteomyelitis case in the literature and the third presented iliac osteomyelitis case of the newborn period.

Disseminated pseudallescheriosis in a dog.

A case of disseminated pseudallescheriasis in a German Shepherd bitch is presented. Bones (ilium, a rib and phalanges), joints (elbow and acetabulum) and the surrounding tissues were the principal organs affected. In addition, Pseudallescheria boydii was isolated, in lower numbers, from the eye, kidney, lymph nodes draining the affected regions and urine. The dog was euthanized. P. boydii was identified by morphologic characteristics and molecular techniques (beta tubulin sequence). In addition, an ITS nucleotide sequence analysis showed that this strain differed from another isolate identified as Scedosporium apiospermum that had caused a disseminated infection in another German Shepherd. The importance of the molecular characterization of fungi belonging to the Pseudallescheria/Scedosporium complex, isolated from animals is stressed in light of the ongoing attempts to recharacterize these fungi.

Salmonella osteomyelitis in pregnancy.

Salmonella osteomyelitis is rare in the immunocompetent host, even though Salmonella is not an infrequent public health problem. Invasive salmonellosis has in general a poor outcome in pregnancy with regard to fetal survival. We report the case of a healthy woman who developed Salmonella osteomyelitis of the iliac bone four weeks after a febrile gastroenteritis in the first trimester of pregnancy. Diagnosis was confirmed by magnetic resonance imaging scanning of the iliac bone and a growth of Salmonella enteritidis in blood culture. The patient recovered fully after six weeks treatment with intravenous antibiotics and delivered a healthy infant at 40 weeks.

Effect of barley and oat cultivars with different carbohydrate compositions on the intestinal bacterial communities in weaned piglets.

This experiment was aimed at comparing the intestinal microbial community composition in pigs fed hulled common barley supplemented with isolated barley mixed-linked beta-glucan, four hulless barley varieties and breeding lines with mixed-linked beta-glucan contents ranging from 41 to 84 g kg(-1) and different amylose/amylopectin ratios as well as two oat varieties. Seventy-two weaned piglets were allocated to one of nine diets composed of 81.5% cereal, 6% whey, 9% soy protein isolate and 3.5% minerals. After 15 days, pigs were sacrificed and ileum and colon contents were collected for quantitative real-time PCR (qPCR) and denaturing gradient gel electrophoresis to evaluate microbial communities. Shifts in intestinal microbial communities were observed with the hulless barley cultivars with a normal to high beta-glucan content and from normal starch toward either high-amylopectin or high-amylose starch. These hulless barleys had the lowest (P<0.05) microbial diversity, whereas oats had intermediate diversity compared with low-beta-glucan hulless cultivars and hulled varieties. Furthermore, hulless varieties favoured xylan- and beta-glucan-degrading bacteria whereas mixed-linked beta-glucan-supplemented hulled barley favoured lactobacilli. Numbers of lactobacilli decreased in the ileum of pigs fed hulless/high mixed-linked beta-glucan barley-based diets. Thus, cultivar differences in both the form and the quantity of carbohydrates affect gut microbiota in pigs, which provides information for future feeding strategies.

Feeding of Lactobacillus sobrius reduces Escherichia coli F4 levels in the gut and promotes growth of infected piglets.

The microbial community in the guts of mammals is often seen as an important potential target in therapeutic and preventive interventions. The aim of the present study was to determine whether enterotoxigenic Escherichia coli (ETEC) F4 infection in young animals might be counteracted by a probiotic treatment with Lactobacillus sobrius DSM 16698. The experiment was conducted in three randomized consecutive replications, each consisting of 16 piglets, and including a control group and an L. sobrius fed group, both experimentally challenged with ETEC. During the entire trial, the animals' health status, body weight, and microbial parameters were monitored periodically. Probiotic supplementation containing L. sobrius significantly reduced the levels of ETEC in the ileum when fed directly to piglets after weaning. In contrast, the number of days when the piglets had an increased faecal water content was significantly higher in the probiotic group. Nevertheless, an improved daily weight gain was also observed in the animals that received probiotic L. sobrius relative to the control fed group. The data indicate that L. sobrius may be effective in the reduction of the E. coli F4 colonization and may improve the weight gain of infected piglets.

The effect of dietary phosphorus and calcium level, phytase supplementation, and ileal infusion of pectin on the chemical composition and carbohydrase activity of fecal bacteria and the level of microbial metabolites in the gastrointestinal tract of pigs.

Two experiments with growing pigs were conducted to determine the effects of dietary P and Ca level, phytase supplementation, and ileal pectin infusion on ileal and fecal P and Ca balance, chemical composition of fecal mixed bacterial mass (MBM), and bacterial metabolic activity. Pigs (initial BW = 30 kg) were fitted with simple T-cannulas at the distal ileum. They were fed a low-P corn-soybean meal control diet (3 g of P/kg) or the control diet supplemented with monocalcium phosphate (MCP; 7 g of P/kg; Exp. 1) or 1,000 FTU phytase/kg (Exp. 2). The daily infusion treatments consisted of 60 g of pectin dissolved in 1.8 L of demineralized water or 1.8 L of demineralized water as the control infusion, infused via the ileal cannula. In each experiment, 8 barrows were assigned to 4 dietary treatments according to a double, incomplete 4 x 2 Latin square. The dietary treatments in Exp. 1 were the control (Con-) diet with water infusion; the control (Con+) diet with pectin infusion; the MCP diet with water infusion; and the MCP diet with pectin infusion. In Exp. 2, the pigs received the same Con- and Con+ treatments as in Exp. 1 and, in addition, the phytase-supplemented diet in combination with water or pectin infusion. After a 15-d adaptation period, feces were collected for 5 d followed by ileal digesta collection for 24 h. In Exp. 1, supplemental MCP increased (P

Tuberculosis of the ilium: a case report.

A twenty year old man presented with pain in the upper part of right hip. CT scan showed multiple osteolytic areas in the right ilium, suggesting malignancy. CT guided needle biopsy was done and diagnosis of tuberculosis was made. The patient was cured with medical management only. Isolated tuberculosis of the ilium is an extremely rare condition. It is important to have a high clinical suspicion to diagnose early and manage the patient without surgical intervention.

Characterization of spore forming Bacilli isolated from the human gastrointestinal tract.

AIMS: To isolate and characterize spore-former bacteria able to colonize the human gastrointestinal tract (GIT). METHODS AND RESULTS: A total of 25 spore-formers was isolated from faeces and ileal biopsies of healthy human volunteers and identified at the species level. Physiological analysis was performed to evaluate the ability of the various isolates to form biofilms, to swarm, to produce surfactants and molecules that have antimicrobial activity against selected pathogens. To assess the potential probiotic activity of the isolates, we tested the resistance of cells and spores to simulated gastric conditions, the ability to grow and sporulate in anaerobic conditions and the presence of toxin-encoding genes in their genome. CONCLUSIONS: Spore-formers belonging to various bacterial species have been isolated from the gut of healthy human volunteers. These strains appear to be well adapted to the intestinal environment and we propose them as potential probiotic strains for human use and as oral vaccine vehicles. SIGNIFICANCE AND IMPACT OF THE STUDY: To our knowledge this is the first detailed characterization of spore-forming Bacilli from the human GIT. Our data suggest that the isolated species do not transit, but rather colonize this specific habitat and propose them as probiotic strains for human use.

Influence of flavomycin on microbial numbers, microbial metabolism and gut tissue protein turnover in the digestive tract of sheep.

Flavomycin is an antibiotic that promotes growth in ruminant and non-ruminant livestock. The aim of this study was to determine the mechanism of action of flavomycin in sheep by measuring microbial numbers, microbial metabolism and gut tissue protein turnover at different sites in the digestive tract. Two weight-matched groups (n 5) of male castrate lambs (30 kg) received 800 g grass cubes/d for 6 weeks, with one group receiving 20 mg/d flavomycin during the last 2 weeks. Samples of digesta and gut tissue segments were obtained immediately post mortem, 90 min after a flood-dose of [ring-D5]phenylalanine. Viable bacterial counts and volatile fatty acid concentrations were highest in ruminal digesta, followed by the colon and caecum, then the duodenum and ileum. The only effect of flavomycin was an increased bacterial count in the rumen (3.5 v. 1.2 x 10(9) per g; P=0.04). Acetate was proportionally greater and propionate and butyrate were lower in the caecum and colon than the rumen. Flavomycin had no effect on volatile fatty acid proportions or ammonia concentrations. Bacteria growing on peptides as sole C source were not affected by flavomycin. Proteolytic, peptidolytic and amino acid deamination activities were similar in the rumen, caecum and colon; they tended to be lower in animals receiving flavomycin. Protein turnover in ruminal wall and duodenal tissues, measured by a flood-dose technique, decreased with flavomycin (P=0.075 and 0.027, respectively). Thus, flavomycin differs from ionophores in its mode of action. It may influence protein metabolism of both digesta and tissue throughout the ruminant digestive tract.