Activiteit

The case presented falls within the spectrum of those rare cases which escalate due to bacterial superinfection.

Many victims of Scolopendra envenomation do not seek medical attention since most symptoms will resolve spontaneously. The case presented falls within the spectrum of those rare cases which escalate due to bacterial superinfection.

To report the history and clinical presentation of a 60-year-old male who developed a rare soft tissue infection of the right leg caused by Bacillus megaterium and to perform a Literature review focusing on clinical manifestations and diagnostic difficulties of the aforementioned bacterium.

Medical history and clinical presentation suggested the infectious etiology, which led to the surgical procedure of fistulectomy and to further histological and microbiological investigations with bacterial cultures.

The histological report tested negative for osteomyelitis. Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. The oral antibiotic therapy was set for 12 days with benefits. The patient has always been apyretic, inflammation indexes and white cells count have been within normal limits. Conclusions This was a rare case of soft tissue infection caused by Bacillus megaterium known to be a “non-pathogenic” bacterium. The infection was likely acquired by the penetration through the injury wound. The combination of surgical and antibiotic therapy lead to complete skin healing and infection resolution at the 6-months follow up.

The histological report tested negative for osteomyelitis. Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. The oral antibiotic therapy was set for 12 days with benefits. The patient has always been apyretic, inflammation indexes and white cells count have been within normal limits. Conclusions This was a rare case of soft tissue infection caused by Bacillus megaterium known to be a “non-pathogenic” bacterium. The infection was likely acquired by the penetration through the injury wound. The combination of surgical and antibiotic therapy lead to complete skin healing and infection resolution at the 6-months follow up.Osteosarcopenia is a new concept of association of osteoporosis and sarcopenia. Enarodustat Both of these pathologies are more frequent in old people and general affects all the skeleton with increased risk of falls and fractures, loss of global function, fragility, and mortality, but also surgical failures. The coexistence of these condition derives from a close relationship, not only anatomical, between bone and muscle tissues. Sometimes these pathological conditions can involve only a skeleton segment, due to local disuse, causing a district form of sarcopenia. In this clinical case, Authors describes a case of isolated lower limb osteosarcopenia in a young non-osteoporotic patient, due to a prolonged limb disuse, complicated by surgical treatment failure for previous pathology, diagnosed by clinical, laboratory, instrumental and histopathological exams.

High-energy tibial plateau fractures are complex lesions that may be associated with extensive soft tissue damages and severe complications, such as compartment syndrome and neurological injuries. This case report interests a professional motocross freestyler with complex tibial plateau fracture associated to compartment syndrome and partial common peroneal nerve impairment which complicated with a dehiscence of the surgical wound and infection after plate and screws fixation. One year later, despite the complexity of the fracture, the gravity of the soft tissue lesions and subsequent complications, the patient healed. This satisfactory result depended on the correct management in terms of type of treatment and timing.

High-energy tibial plateau fractures are complex lesions that may be associated with extensive soft tissue damages and severe complications, such as compartment syndrome and neurological injuries. This case report interests a professional motocross freestyler with complex tibial plateau fracture associated to compartment syndrome and partial common peroneal nerve impairment which complicated with a dehiscence of the surgical wound and infection after plate and screws fixation. One year later, despite the complexity of the fracture, the gravity of the soft tissue lesions and subsequent complications, the patient healed. This satisfactory result depended on the correct management in terms of type of treatment and timing.Bone lesion of the proximal tibia are common findings; depending on the site, age of the patient and symptoms a carefull differential diagnosis must be carried out. We present the case of a 60 years old active patient presenting at our clinic with atraumatic knee pain. X-Rays performed revealed an osteolitic lesion of the medial tibial condyle; MRI highlighted a lobulated cystic lesion of the medial tibial condyle without evidence of interruption of the suchondral bone. The cavity appeared with low signal intensity on T1 weighted images and with a high signal intensity on T2 images The tissue obtained from the incisional biopsy macroscopically revealed a clear, yellowish gelatinous and mucinous material; the microscopical hystological exam confirmed a cystic area of the lesion; the lumen contained some dense, fibrous matherial with focal mucoid degeneration, while the wall was composed of a fibrous tissue with rare ossification and calcification. Clinical history, imaging and histhological findings lead to a certain diagnosis of an intraosseous ganglion cyst. We decided to surgically treat the lesion with courettage and bone grafting with allograft;the anterior part of the deep medial collateral ligament was used to avoid the leakage of the transplanted bone. With limitations concerning the short follow up, we obtained an optimal result in terms of patients satisfaction; this result is mainly related to the relief of the pain and the possibility for the patient to return to his activities. An accurate follow up must be carried out to verify the integration of the allograft.