Clostridium septicum aortitis in a patient with extensive atheromatous disease of the aorta.

By London Spine
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Clostridium septicum aortitis in a patient with extensive atheromatous disease of the aorta.

J Infect Chemother. 2012 Dec;18(6):948-50

Authors: Annapureddy N, Agarwal SK, Kanakadandi V, Sabharwal MS, Ammakkanavar N, Simoes P, Sanjani HP, Nadkarni GN

Abstract
A 69-year man presented with 3 days of progressively worsening abdominal pain, radiating to his back, with nausea and vomiting. Computed tomography scan of the abdomen showed evidence of aortitis, for which he eventually underwent surgery. The surgical specimen of the aorta grew Clostridium septicum that was treated with antibiotics.

PMID: 22410855 [PubMed – indexed for MEDLINE]

Excellent Treatment Results

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I was extremely happy with my treatment results.  Everything was excellent starting with the London Spine Unit staff and Mr Akmal.  I have recommended this unit to my friends for future treatments.   Sh A

An unusual case of radioactive seed migration to the vertebral venous plexus and renal artery with nerve root compromise.

By London Spine

An unusual case of radioactive seed migration to the vertebral venous plexus and renal artery with nerve root compromise.

Brachytherapy. 2011 Jul-Aug;10(4):295-8

Authors: Hau EK, Oborn BM, Bucci J

Abstract
PURPOSE: We report a case of prostate brachytherapy seed migration to the vertebral venous plexus and subsequently to the renal artery with corresponding dosimetry analysis describing nerve doses.
METHODS AND MATERIALS: A 52-year-old male with low-risk prostate carcinoma (clinical stage T1c; Gleason score=6; prostate-specific antigen level of 5.5) underwent transperineal permanent prostate seed implant. Postimplantation routine imaging had failed to locate the missing seed, but he subsequently presented with back pain and parathesia with radiation down the leg.
RESULTS: CT with bony windows and MRI had located the seed in the left L5 vertebral venous plexus. Neurosurgical intervention failed to locate and remove the migrated seed. Postsurgery, the left lower limb parathesia persisted but had normal nerve conduction studies. Dose to the spinal nerve roots and nearby structures were estimated using a GEANT4 Monte Carlo simulation. Serial X-ray imaging and CT had found that the seed had further migrated to left renal hilum.
CONCLUSIONS: Seed migration to vertebral venous plexus is uncommon and to our knowledge this is the third reported case. Its subsequent migration to the renal hilum is most unusual. CT with bony windows or MRI are required if this is suspected. There is risk of spinal or nerve root damage and dose to these structures has to be estimated using GEANT4, although the tissue tolerance in the setting of low-dose rates are unknown and long-term followup of this patient is required.

PMID: 20843748 [PubMed – indexed for MEDLINE]