RESUMEN
BACKGROUND: Percutaneous endoscopic lumbar diskectomy (PELD) has evolved over the last decades and has become an effective treatment for soft disk herniations. However, while its use increases, newer complications have been discovered. CASE DESCRIPTION: We present the unique case of a woman who underwent PELD/foraminotomy to treat right-side foraminal disk herniations on L4-5 and L5-S1 in the same procedure. Ten days after surgery, the patient developed fever and severe low back pain radiated down her right leg. Magnetic resonance imaging showed a right pseudomeningocele arising from L4-5 and a nerve root herniated through the dural sac at the same lumbar segment. Blood cultures and fluid culture obtained from pseudomeningocele drainage depicted infection. Specific antibiotics were administrated, direct dura repair under the microscope was performed, and the patient improved symptomatically. CONCLUSIONS: PELD combined with foraminotomy is a relatively new and skill-demanding surgery which is indicated only in cases where foraminal disk herniation is combined with foraminal stenosis. This surgical strategy requires experience by the endoscopic surgeon to prevent procedure-related complications. Although rare, these complications can lead to increased morbidity.
Asunto(s)
Infecciones Bacterianas/etiología , Discectomía Percutánea/efectos adversos , Endoscopía/efectos adversos , Pseudomonadaceae/patogenicidad , Infecciones Bacterianas/diagnóstico por imagen , Femenino , Humanos , Imagen por Resonancia Magnética , Persona de Mediana EdadRESUMEN
Xylella fastidiosa is a fastidious, xylem-limited bacterium that causes a range of economically important plant diseases. Here we report the complete genome sequence of X. fastidiosa clone 9a5c, which causes citrus variegated chlorosis--a serious disease of orange trees. The genome comprises a 52.7% GC-rich 2,679,305-base-pair (bp) circular chromosome and two plasmids of 51,158 bp and 1,285 bp. We can assign putative functions to 47% of the 2,904 predicted coding regions. Efficient metabolic functions are predicted, with sugars as the principal energy and carbon source, supporting existence in the nutrient-poor xylem sap. The mechanisms associated with pathogenicity and virulence involve toxins, antibiotics and ion sequestration systems, as well as bacterium-bacterium and bacterium-host interactions mediated by a range of proteins. Orthologues of some of these proteins have only been identified in animal and human pathogens; their presence in X. fastidiosa indicates that the molecular basis for bacterial pathogenicity is both conserved and independent of host. At least 83 genes are bacteriophage-derived and include virulence-associated genes from other bacteria, providing direct evidence of phage-mediated horizontal gene transfer.
Asunto(s)
Genoma Bacteriano , Plantas/microbiología , Pseudomonadaceae/genética , Análisis de Secuencia de ADN , Adhesión Bacteriana , Proteínas Bacterianas/metabolismo , Transporte Biológico , Mapeo Cromosómico , Citrus/microbiología , Reparación del ADN , ADN Bacteriano , Metabolismo Energético , Datos de Secuencia Molecular , Plantas Tóxicas , Biosíntesis de Proteínas , Pseudomonadaceae/metabolismo , Pseudomonadaceae/patogenicidad , Nicotiana/microbiología , Transcripción Genética , Virulencia/genéticaRESUMEN
The case of abdominal actinomycosis is, as far as we are aware, the first to be recorded from Jamaica. In addition, no reports on the occurrence of gangrene of the scrotum are known from this island. The presence of a member of the family, Pseudomonadaceae, which is at present under study is intriguing. Its possible role as the cause of the gangrene is discussed (AU)
Asunto(s)
Humanos , Adulto , Masculino , Actinomicosis/diagnóstico , Actinomicosis/etiología , Gangrena/diagnóstico , Gangrena/etiología , Abdomen , Escroto/patología , Pseudomonadaceae/patogenicidadRESUMEN
An acute fulminating septicemic illness has been described. The lesions consist of a metastatic necrosis of muscle tissue. The causative organism is believed to be a member of the pseudomonadaceae family. Details of a further study of the disease from the human, bacteriological and experimental aspects will be published later (AU)