We present the case of a 33-year-old male who sustained a burst fracture D12 vertebrae with spinal cord injury (ASIA impairment scale A) and a right mid-diaphysial femoral shaft fracture around 1.5 years back. The patient reported 1.5 years later with a swelling over the right buttock. Arthrotomy revealed serous fluid and fragmented bone debris. The biopsy showed a normal bony architecture with no evidence of infection and malignant cells. Hence, a diagnosis of Charcot’s hip was made. Charcot’s neuroarthropathy of the feet is a well-recognized entity in the setting of insensate feet resulting from causes such as diabetes or spina bifida. Although Charcot’s disease of the hips has been described, it is uncommon in association with spinal cord injury, syphilis and even with the use of epidural injection. The present case highlights the fact that neuroarthropathy of the hip can occur in isolation in the setting of a spinal cord injury, and this can lead to considerable morbidity.
Conclusions Recommended antibiotic treatment was nearly always offered to patients. However general advice and written documentation were poor and non-attendance at follow up was high. Urine culture testing and documentation should be significantly improved for initial management, and a robust system developed to assess compliance with treatment, PN and symptom resolution. Background Group B Streptococcus (GBS), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) cervico-vaginal infections can be involved in pregnancy complications such as preterm birth and premature rupture of membrane (PROM). These infections can also be transmitted to the newborn during delivery leading to serious consequences. Therefore, CDC guidelines suggest microbial prenatal screening for administration of target prophylaxis based on culture results. To accurately predict the colonisation of genital tract, the test should be better performed during labour, because microbial presence may be transient/intermittent and re-colonisation can occur. GeneXpert ® GBS and GeneXpert ® CT/NG tests (Cepheid), fully-automated, easy-to-use and rapid PCR-assays (about 45 and 90 min, respectively) can be the right alternative to culture tests (at least 72 hours). GeneXPert GBS andThis study evaluates the advantages of GeneXpert ® GBS in the management of women, with unknown cervico-vaginal microbial status, during labour. Moreover, it assesses whether the prevalence of CT, NG and GBS infections is higher in pregnancy complicated by preterm labour or PROM. Methods During a four months' period, all women with singleton pregnancy at beginning of labour either-term or preterm or PROM were enrolled. Exclusion criteria were planned caesarean section or recent use of systemic or topical antibiotics. Cervico-vaginal (for CT/NG) and vaginal-rectal (for GBS) swabs were collected from each patient and analysed by GeneXpert ® GBS and GeneXpert ® CT/ NG assays on GeneXpert ® System. Results CT/NG screening showed positive results only among PROM pregnancies (2.5% CT positive) while no positive results were found among preterm/term pregnancies.Among pregnant women analysed for GBS, 24.4% resulted positive and 75.6% negative. Only positive patients received IAP, instead of current guidelines, for which all patients would have been treated due to unknown GBS infection status. Conclusion With GeneXpert ® GBS test, we could correctly manage all women and reduce administration of IAP. We calculated that the savings for the hospital was 3,500 EUR every three months. Background For characterization of the vaginal microflora, it is often necessary to assess quantities of microorganisms. The study objective was to evaluate vaginal microflora in norm, bacterial vaginosis (BV) and vulvovaginitis (VV) using quantitative real-time PCR. Methods A total of 255 women of reproductive age, who addressed a gynaecologist due to vaginal discharge, were included
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