ABSTRACT
INTRODUCTION: The aim, of our retrospective study, was to determine the epidemiological and susceptibility profile of bacterial osteitis isolates in the Rabat Mohammed V Military Hospital, to optimize the probabilistic antibiotherapy. MATERIALS AND METHODS: A study was made from August 2004 to December 2005. All the positive specimen for the etiologic diagnosis of osteitis and osteoarthritis were included. RESULTS: During this period, 85 osteitis cases were documented. 123 isolates were collected. 31 cases of osteitis allowed for the isolation of at least 2 bacteria (36.5%). The Gram positive cocci rate was 54.5%, the Gram negative bacilli rate 39.8%, and the Gram positive bacilli rate 5.7%. The distribution by groups was staphylococcus spp 46.4%, enterobacteriaceae 25.2% and non-fermenting Gram negative bacilli 12.9%. The most frequently isolated species were Staphylococcus aureus (23,6%) followed by Pseudomonas aeruginosa (8.9%), and Klebsiella pneumoniae (5.7%). All the S. aureus isolates were susceptible to oxacillin and 30.8% of the coagulase negative staphylococci were resistant. The enterobacteriaceae resistance rates were 64.5% for clavulanic acid-amoxicillin and 16% for third generation cephalosporin and ciprofloxacin. The non-fermenting Gram negative bacilli resistance rate was 37.5% for ceftazidim, 62.5% for ticarcillin, and 12.5% for imipenem. CONCLUSION: Our results show the potential efficient therapy for community osteitis, using the traditional association: methicillin-aminosides and oral relay with fluoroquinolones. In nosocomial osteitis, the antibiotherapy must be modulated according to the identification and an antibiogram.
Subject(s)
Bacterial Infections/classification , Bacterial Infections/diagnosis , Enterobacteriaceae Infections/diagnosis , France , Gram-Negative Bacterial Infections/diagnosis , Gram-Positive Bacterial Infections/diagnosis , Hospitals, University , Humans , Microbial Sensitivity Tests , Osteitis/microbiology , Retrospective Studies , Staphylococcal Infections/diagnosis , Streptococcal Infections/diagnosisABSTRACT
We report a case of a dorsal coronal fracture of the hamate associated with an unstable hematometacarpal dislocation in a 15 year old patient. An accurate assessment was done only after a 3D-CT was performed. Open reduction and intramedullary fixation yielded a very good result.
Subject(s)
Fractures, Bone/complications , Hamate Bone/injuries , Joint Dislocations/complications , Metacarpal Bones/injuries , Adolescent , Follow-Up Studies , Fracture Fixation, Intramedullary/methods , Fractures, Bone/diagnostic imaging , Fractures, Bone/surgery , Humans , Imaging, Three-Dimensional , Joint Dislocations/diagnostic imaging , Male , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
A patient taking corticosteroids for rheumatoid arthritis experienced a spontaneous bilateral rupture of the patellar tendon. Initially neglected, the rupture was repaired surgically by tendinoplasty using the semitendinous tendon for the right knee and inversion of the quadriceps tendon for the left. Functional results were similar. On the right knee, the wire cerclage loosened leading to posterior sagittal displacement of the patella, pointing out the difficulties encountered when repairing neglected rupture of the patellar tendon. Due to the small number of cases and difficulties in assessing the techniques proposed, no large-scale series has been reported in the literature.