To determine whether rep-PCR genotyping can improve the diagnosis of coagulase-negative staphylococci(CoNS)bone and joint infection relative to the standard method based on phenotypic identification. Observational study comparing diagnostic tests (January 2011-March 2015), including all orthopaedic surgery patients with clinically suspected infection and ≥2 surgical specimens culture-positive for CoNS. Data collection included epidemiologic and clinical information, current clinical signs of suspected infection, and microbiological information. Each CoNS strain was analyzed by both methods (phenotyping, VITEK and API;and genotyping, rep-PCR). In accordance with current IDSA guidelines, CoNS strains identified as identical in ≥2 samples within the same surgical episode were considered pathogenic. The results of the two techniques were compared and statistically analyzed.Aim
Method
Glomus tumours are rare and benign, arising from a neuromyoarterial glomus body, most commonly in the hand. We report a patient with such a tumour in an atypical site, the right vastus lateralis. Pain was aggravated by muscle contraction, and ultrasonography and MRI were required to locate the lesion accurately. Surgical excision gave immediate pain relief.
