[Intra-osseus gas formation in osteomyelitis of vertebrae and pelvis by Klebsiella pneumoniae].
A 59-year-old woman had persistent sepsis after abdominal operations because of a volvulus and subsequently a retroperitoneal abscess, in spite of antibiotic treatment against Klebsiella pneumoniae, which grew in blood cultures. During abscess drainage, a haemorrhage from the infrarenal part of the aorta had occurred; in view of a presumed aortitis this part had been replaced by a bifemoral bypass. Computer tomography revealed intraosseous formation of gas in vertebrae and pelvis. At operation, abscesses were drained and necrotomy and sequestrotomy of the bone were performed. Cultures of the pus from the iliac crests showed K. pneumoniae. The antibiotic management was changed; the wounds were flushed regularly. After exposure of the wounds still draining after 6 months and vascular surgery because of occlusion of the bypass after 7 months, the patient recovered well. She died 2 years later from a cerebral haemorrhage.
Lewin
F
F
Afd. Chirurgie, Academisch Ziekenhuis, Utrecht.
Visser
M R
MR
van Vroonhoven
T J
TJ
van der Werken
C
C
D000038:Abscess / Q000601:surgery; D000900:Anti-Bacterial Agents; D004322:Drainage; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000150:complications / Q000601:surgery; D007710:Klebsiella Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000601:surgery; D007711:Klebsiella pneumoniae / Q000302:isolation & purification*; D008875:Middle Aged; D010019:Osteomyelitis / Q000382:microbiology* / Q000628:therapy; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000382:microbiology*; D011183:Postoperative Complications / Q000628:therapy; D012187:Retroperitoneal Space / Q000601:surgery; D013131:Spine / Q000000981:diagnostic imaging / Q000382:microbiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Intra-ossale gasvorming bij osteomyelitis van wervels en bekken door Klebsiella pneumoniae.