| Osteomyelitis of the fibula due to septic embolism: a rare complication of a graft enteric erosion. Case report. | |
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MedLine Citation:
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PMID: 9639000 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We report the case of a 70-year-old female who experienced a graft enteric erosion (GEE) three years after a right aorto-femoral bypass. She was treated by right axillo-femoral bypass, removal of the aortic prosthesis and direct aortic suture. The duodenum was stitched up and separated from the aorta by omentoplasty. Bacteriological culture of the removed graft identified Escherichia coli and Peptostreptococcus. Antibiotic therapy consisting of Amoxicillin and Gentamycin was given for seven days. A month later this patient developed a fibula osteomyelitis due to the same germs. She was then treated by surgical excision of the infected tissues and by antibiotics: Amoxicillin, Metronidazole and Gentamycin for one month. This case of embolism into bone due to GEE is a rare complication which indisputably establishes a link between the spontaneously septic cavity of the bowel and bone tissue by way of blood via the interstices of the fabric. The prosthesis may be responsible for blood seeding infection and not only a mere victim. The prosthesis acts as a porous membrane which allows two opposite flows: the passage of blood from graft to bowel and germ migration from naturally septic bowel to blood. When a GEE is encountered, a rigorous management is required to prevent septic embolism. The precise timing of each step of the surgical procedure remains difficult to codify. |
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Authors:
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P M Moreau |
Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: The Journal of cardiovascular surgery Volume: 39 ISSN: 0021-9509 ISO Abbreviation: J Cardiovasc Surg (Torino) Publication Date: 1998 Apr |
Date Detail:
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Created Date: 1998-07-06 Completed Date: 1998-07-06 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0066127 Medline TA: J Cardiovasc Surg (Torino) Country: ITALY |
Other Details:
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Languages: eng Pagination: 171-3 Citation Subset: IM |
Affiliation:
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Centre Medical du Trencavel Beziers, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anastomosis, Surgical / adverse effects Anti-Bacterial Agents Aorta, Abdominal / surgery Bacteremia / complications*, drug therapy Blood Vessel Prosthesis / adverse effects*, microbiology Drug Therapy, Combination / therapeutic use Embolism / complications* Escherichia coli / isolation & purification Escherichia coli Infections / complications, drug therapy Female Femoral Artery / surgery Fibula* / microbiology Follow-Up Studies Gram-Positive Bacterial Infections / complications*, drug therapy Humans Iliac Artery / surgery Intermittent Claudication / surgery Osteomyelitis / drug therapy, etiology* Peptostreptococcus / isolation & purification Peripheral Vascular Diseases / surgery Prosthesis-Related Infections / drug therapy, etiology* |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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