Cephalhematoma Complicated by Osteomyelitis Presumed due to Gardnerella vaginalis

Nightingale, Luke M.; Eaton, Charles B.; Fruehan, Alice E.; Waldman, John B.; Clark, William; Lepow, Martha L.

doi:10.1001/jama.1986.03380140106032

Cited by 30 publications

(18 citation statements)

References 10 publications

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“…Osteomyelitis of the right parietal bone was described by Nightingale et al (155) as a complication of a cephalhematoma at the site of a scalp electrode insertion. On day 16 after delivery, bloody purulent material was aspirated from a raised, reddened, and devitalized area superimposed on the cephalhematoma.…”

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 98%

“…The disease can be symptomatic or asymptomatic depending on the particular interactions among members of the vaginal populations and between them and the host. (118,133,147), intra-amniotic infections (77,149), chorioamnionitis (31,90,122,155), postabortal pelvic inflammatory disease (87), and postpartum endometritis following cesarean section (148). Large studies of postpartum endometritis in women who delivered at hospitals in Houston, Tex., and Seattle, Wash., identified G. vaginalis, often mixed with other bacteria, in endometrial cultures from 25% (136) and 38% (193,241) of infected patients.…”

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

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Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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The clinical significance, Gram stain reaction, and genus affiliation of Gardnerella vaginalis have been controversial since Gardner and Dukes described the organism as the cause of "nonspecific vaginitis," a common disease of women which is now called bacterial vaginosis. The organism was named G. vaginalis when taxonomic studies showed that it was unrelated to bacteria in various genera including Haemophilus and Corynebacterium. Electron microscopy and chemical analyses have elucidated the organism's gram-variable reaction. Controversy over the etiology of bacterial vaginosis was largely resolved by (i) studies using improved media and methods for the isolation and identification of bacteria in vaginal fluids and (ii) standardization of criteria for clinical and laboratory diagnosis. Besides G. vaginalis, Mobiluncus spp., Mycoplasma hominis, and certain obligate anaerobes are now acknowledged as participants in bacterial vaginosis. The finding that G. vaginalis, Mobiluncus spp., and M. hominis inhabit the rectum indicates a potential source of autoinfection in addition to sexual transmission. Extravaginal infections with G. vaginalis are increasingly recognized, especially when the toxic anticoagulant polyanetholesulfonate is omitted from blood cultures and when urine cultures are incubated anaerobically for 48 h. The finding that mares harbor G. vaginalis suggests that an equine model can be developed for studies of Gardnerella pathogenesis.

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Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 98%

Section: Transmission Of Bacteria Associated With Vaginosismentioning

confidence: 99%

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

1992

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“…One could speculate that modern identification techniques, such as MALDI-TOF mass spectrometry, could have contributed to diagnosing these infections more recently. Nevertheless, osteoarticular G. vaginalis infections remain exceptional (6)(7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

“…Extravaginal G. vaginalis infections are very infrequent. Rare bone-and-joint infections have been reported (6)(7)(8)(9)(10). Only one joint arthroplasty infection has been published to date (10).…”

Section: Introductionmentioning

confidence: 99%

Gardnerella vaginalis, from the Vaginal Microbiota to Prosthetic Joint Infection

Thomas

Zeller

Heym

et al. 2019

J. Bone Joint Infect.

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“…Two nosological forms have been described: the first one is associated with a reactive arthritis (13), and it is characterized by a negative culture of joint fluid; the second one corresponds to a true osteoarticular infection as demonstrated by the ability to isolate G. vaginalis from clinical samples (especially joint fluid). Only a few cases of G. vaginalis-related septic osteoarticular infections have been reported in the literature (Table 1), including one case of osteomyelitis of the parietal bone in a neonate (11), two cases of discitis in women (5,6), and one case of hip arthritis in a woman (14). In all these cases, no genital infection could be demonstrated.…”

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confidence: 99%

Gardnerella vaginalis as a Rare Cause of Prosthetic Joint Infection

et al. 2012

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We describe a septic loosening of a hip prosthesis in a 71-year-old woman caused by Gardnerella vaginalis. Infection was confirmed by culture and molecular identification of this bacterium. The patient was treated by a one-step exchange of prosthesis and antibiotic therapy combining trimethoprim-sulfamethoxazole and rifampin, with favorable evolution. CASE REPORTA 71-year-old woman was hospitalized in the infectious diseases unit of Grenoble University Hospital for prolonged fever, altered general status, and pain of the right hip with cruralgia for 3 months. Her medical history included tuberculosis, diphtheria, hepatitis A, and dyslipidemia for which she received rosuvastatin. The patient had undergone replacement surgery of both hips 10 years earlier. A septic loosening of the right hip prosthesis was evoked.On admission, the patient was subfebrile at 38°C. Pain of the right hip and cruralgia were not relieved by analgesic treatment, including morphine and nonsteroidal anti-inflammatory drugs (visual analogue score, 6/10). A limitation of hip joint mobility was noted. Walking was possible but with a limp. There were no motor or sensory deficits, and tendon reflexes were normal and symmetrical. The rest of the physical examination was unremarkable. There were no clinical signs suggestive of localized infection, especially no signs of pulmonary or urinary tract infection.Laboratory tests showed anemia (hemoglobin, 11 g/dl) and inflammation (C-reactive protein, 70 mg/liter; ferritinemia, 489 g/liter; increased production of alpha 1 and 2 globulins on serum protein electrophoresis but immunoglobulins within normal limits). The leukocyte count was 5.2 ϫ 10 9 cells/liter. Cultures of blood and urine samples were negative. A chest radiograph was normal. A computed tomography (CT) scan (chest-abdomen-pelvis) was performed and did not show any cancer or abscess. No fluid effusion was found around the right hip prosthesis by ultrasonography, and hip radiographs were normal. However, fluorine-18 fluorodeoxyglucose (FDG) scintigraphy revealed intense uptake around the hip prosthesis that was highly suggestive of a septic process.Debridement and one-step surgical replacement of the right hip prosthesis were performed. During the intervention, the surgeon noticed a turbid synovial fluid and confirmed the loosening of the femoral component of the hip prosthesis. A new prosthesis was reimplanted, the process corresponding to uncemented total hip arthroplasty with a dual-mobility acetabular cup. Fifteen clinical specimens were sampled during the intervention for microbiological analysis: the femoral cortex (1 specimen), the femoral centromedullary channel (4 specimens), the articular fluid (1 specimen), synovial biopsy specimens (5 specimens), and the acetabulum (4 specimens). Direct examination of Gram-stained smears prepared from clinical samples was negative in all cases. The 15 specimens were inoculated onto blood agar plates, including Columbia-5% sheep blood agar plates (bioMérieux, Marcy l'Etoile, France) and chocolate...

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Cephalhematoma Complicated by Osteomyelitis Presumed due to Gardnerella vaginalis

Cited by 30 publications

References 10 publications

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Gardnerella vaginalis: characteristics, clinical considerations, and controversies

Gardnerella vaginalis, from the Vaginal Microbiota to Prosthetic Joint Infection

Gardnerella vaginalis as a Rare Cause of Prosthetic Joint Infection

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