Карточка-задание по английскому языку на тему «MEDICAL WRITING: CASE ABSTRACT_253»
«MEDICAL WRITING: CASE ABSTRACT_253»
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Hyperbaric oxygen therapy
for primary sternal osteomyelitis: a case report
Primary osteomyelitis of the
sternum is a rare condition, which accounts for 0.3% of all cases of
osteomyelitis reported in the literature. The diagnosis requires a high degree
of suspicion and confirmation by percutaneous biopsy. The treatment consists of
resection of the periosteum and affected bone. Despite reports of successful
conservative treatment using antibiotics alone, early surgical intervention
plus bacterial control is the definitive treatment; it reduces morbidity, and
is the most cost-effective approach for the patient. We report a case of
primary osteomyelitis surgically treated with debridement and antibiotics,
followed by hyperbaric oxygen therapy.
A 39-year-old Brazilian man
without a significant medical history presented with primary osteomyelitis.
After a normal chest radiograph and normal laboratory test results, he was
treated with 2 weeks of nonsteroidal anti-inflammatory drugs. One month later a
presumptive diagnosis of Tietze syndrome was made and he was prescribed
prednisolone (60mg/day) for 3 weeks. The following month he presented to our
service with swelling, redness, and warmth in the area between his left third
and fourth ribs. Subsequent magnetic resonance imaging revealed a large
collection of liquid (8.8×6.8×20.2cm) in his chest wall, between
the body and the manubrium of the sternum. An area of soft, friable tissue with
a large amount of pus was found in his sternum during surgical debridement.
Subsequent treatment consisted of antibiotic therapy using metronidazole and
cefotaxime plus hyperbaric oxygen therapy. On postoperative day 10 the incision
was sutured. The patient was discharged on postoperative day 15 on a regimen of
oral ciprofloxacin, and completed hyperbaric oxygen therapy as an out-patient.
The satisfying outcome of this
patient reflects the quick action to promote surgical debridement and use of
antibiotics, which are both recommended treatments. The closure of the wound in
10 days after debridement suggests that the hyperbaric oxygen therapy might
have indirectly, but not conclusively, aided in the premature closure of the
wound, avoiding a longer healing by second intention or muscle flap rotation
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