technetium-tc-99m-medronate and Sepsis

Topics: Child; Humans; Kidney; Male; Pyelonephritis; Radionuclide Imaging; Sepsis; Shock, Septic; Streptococcal Infections; Technetium Tc 99m Medronate

We studied the occurrence, magnitude, and kinetics of bacteremia and the resultant osteomyelitis and septic arthritis in an avian model of Staphylococcus aureus infection. Thirty-day-old male broiler chicks were inoculated i.v. with 10(5), 10(6), or 10(7) cfu of strain Duntravis, a beta-hemolytic, coagulase-producing, capsular type 8 isolate from the synovial fluid of a 2-year-old black boy. Bacteremia occurred in 80%, 90%, and 100% of animals inoculated with 10(5), 10(6), or 10(7) cfu, respectively. The magnitude of bacteremia in surviving, bacteremic animals increased for 96 hours after inoculation and then decreased after a plateau phase. Osteomyelitis and septic arthritis occurred only in chicks that were continuously bacteremic. The occurrence of osteomyelitis was uniform among continuously bacteremic animals and developed 1 to 23 hours after inoculation. Chickens are susceptible to systemic infections with S. aureus. Bacteremia, osteomyelitis, and septic arthritis may be induced in healthy chickens without prior manipulations that depress their resistance.

Topics: Animals; Bone and Bones; Chickens; Disease Models, Animal; Male; Osteomyelitis; Radiography; Radionuclide Imaging; Sepsis; Staphylococcal Infections; Technetium Tc 99m Medronate; Time Factors

Topics: Diphosphonates; Humans; Male; Middle Aged; Osteomyelitis; Radionuclide Imaging; Sepsis; Staphylococcal Infections; Staphylococcus epidermidis; Technetium; Technetium Tc 99m Medronate; Tuberculosis, Osteoarticular

Thirty-nine bone scans were performed in children (1 week - 14 years of age), with symptoms and signs of acute osteomyelitis. All but two scintigrams were obtained within the first week of the disease. Nine scans showed locally increased isotope accumulation. The diagnosis of osteomyelitis was later confirmed by radiological examination or by positive cultures. Twenty-nine scans were reported negative. Nevertheless, four patients developed characteristic radiological signs of osteomyelitis. In one of these four cases a decreased uptake ("cold" lesion) in the scintigram was over-looked. In spite of surgical drainage the patient developed chronic osteomyelitis. It is concluded that bone scanning is a valuable adjunct in the early diagnosis of osteomyelitis. A negative scintigram, however, does not exclude this diagnosis. A "cold" lesion may indicate a high pressure abscess and a risk for sequestrum formation. Prompt surgical drainage is advocated when such lesions are encountered in the scintigram.

Topics: Acute Disease; Adolescent; Anti-Bacterial Agents; Bone and Bones; Child; Child, Preschool; Diagnosis, Differential; Diphosphonates; Female; Humans; Infant; Infant, Newborn; Male; Osteomyelitis; Radionuclide Imaging; Sepsis; Technetium; Technetium Tc 99m Medronate