1/94. Characteristics of septic arthritis in human immunodeficiency virus-infected haemophiliacs versus other risk groups.The cases are presented of four haemophiliacs infected with human immunodeficiency virus (hiv) and with septic arthritis among the 340 patients followed at our centre. The data of these cases and 39 additional hiv-infected haemophiliacs with septic arthritis, identified in a literature search, are reviewed. The spectrum of bacterial pathogens is limited and somewhat different from that in other risk groups. The localization is exclusively to joints affected by haemophilic arthropathy. The laboratory picture is characterized by the absence of peripheral leucocytosis, varying CD4-helper cell counts, a high erythrocyte sedimentation rate and fever. The clinical picture mimics that of haemarthrosis, often causing a delay in diagnosis. Treatment with systemic antibiotics is often sufficient, obviating the need for arthrotomy and open drainage. prognosis related to the joint function is relatively good, but poor when related to the medium- to long-term survival of the patient.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
2/94. Synchronous pyomyositis and septic hip arthritis.The authors report a rare concomitant pyogenic infection of the iliopsoas, iliacus and external obturator muscles and of the hip joint in a 68-year-old woman. Because the patient showed the classic symptomatic triad of limping, hip pain and fever, in addition to positive hip arthrocentesis, the diagnosis of septic hip arthritis was routine, but the simultaneous pyomyositis was almost overlooked. Unusual localised heat and swelling on the front of the proximal thigh prompted a CT scan that identified remarkable muscle abscesses in addition to the septic arthritis. Surgical debridement and antibiotics resolved the infection relatively rapidly without sequelae. We noted that reaching a definitive diagnosis of such a concomitant infection requires a suspicion of the presence of pyomyositis, which can be definitively determined using advanced imaging studies.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
3/94. Septic arthritis of the hip secondary to rat bite fever: a case report.Rat bite fever is a rare infection typically caused by streptobacillus moniliformis. The mode of transmission is most commonly through a bite or scratch from an infected rat. This disease is characterized by polyarthritis, fever, and a delayed onset erythematous maculopapular rash of the extremities. The authors report a case of rat bite fever, which led to septic arthritis of the hip. To the authors' knowledge, the complication of hip sepsis requiring an arthrotomy has not been reported in the literature. The orthopaedist should be aware of not only streptobacillus moniliformis, but also of other zoonotic organisms, which potentially can cause septic arthritis and warrant treatment with specific antibiotics.- - - - - - - - - - ranking = 7keywords = fever (Clic here for more details about this article) |
4/94. Septic arthritis of a lumbar facet joint due to pyonex.We present a case of septic arthritis of a lumbar facet joint with an associated epidural abscess. A 13-year-old boy was hospitalized with acute severe back pain and fever after pyonex was done. The infection was precisely localized with magnetic resonance imaging, bone and gallium scintigraphy. He responded to antibiotic therapy. We suppose that the infection was caused by pyonex because the blood cultures were negative, and the patient had an abrupt onset of severe pain and fever 24 h after the acupuncture.- - - - - - - - - - ranking = 2keywords = fever (Clic here for more details about this article) |
5/94. Septic arthritis of the hip caused by salmonella typhi.We describe septic arthritis of the hip in a child with typhoid fever. The aetiological diagnosis was confirmed by a positive Widal test as well as by isolation of salmonella typhi from joint aspirate. Treatment with ceftriaxone along with surgical drainage was successful.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
6/94. A rare and serious consequence of a rat bite.Contact with rat saliva or faeces can lead to infection with streptobacillus moniliformis and the condition known as 'rat bite fever'. We report a case of septic arthritis of the hip due to this organism following a bite on the finger of a 14-year-old boy from a rat for sale in a pet shop. The case was successfully treated by arthrotomy, drainage and joint lavage followed by administration of penicillin. Septic arthritis of the hip due to S. moniliformis has not been previously described and this case highlights a possible danger of keeping rats as pets.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
7/94. gout-induced arthropathy after total knee arthroplasty: a report of two cases.gout, although relatively rare in joint replacements, can present as an acute or chronic painful knee or hip arthroplasty. gout and acute infection of a joint replacement can be difficult to differentiate, with the physical examination and laboratory study results frequently being similar. Both conditions can present with a rapid onset of joint pain, swelling, erythema, and constitutional symptoms, including fevers and malaise. Laboratory findings in both conditions often include an elevated leukocyte count, erythrocyte sedimentation rate, and c-reactive protein level. Negatively birefringent, needle-shaped crystals in the synovial fluid confirm the diagnosis of gout. The mistaken diagnosis of septic arthritis in a joint replacement with crystal-induced synovitis can lead to inappropriate open debridement or component removal. The current study includes a review of the literature and presents two cases of gout after total knee arthroplasty. These cases suggest that in situations of suspected sepsis without synovial fluid crystals, operative intervention is indicated with a presumed diagnosis of septic arthritis. The identification of chalky white or yellow deposits in the synovium or bone is highly suggestive of gout. The definitive diagnosis is made by polarized light histologic evaluation of these tissues. If these deposits are present in the absence of a positive preoperative culture, positive Gram stain for bacteria, or component loosening, component retention is indicated.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
8/94. psoas abscess as a complication of pyogenic sacroiliitis: report of a case.A psoas abscess is, either primary or secondary, a rare entity for a general surgeon. Images by ultrasonography and computed tomography (CT) can help a general surgeon to make an accurate diagnosis when encountering the patient complaining of unilateral lower abdominal deep pain with fever. A case of pyogenic abscess of the psoas muscle as a result of sacroiliitis in a 22-year-old man is reported herein. The abdominal CT and magnetic resonance imaging scans demonstrated a large multilocular abscess extending along the iliopsoas muscle, and erosion and a widening of the left sacroiliac joint. The abscess was drained with an open surgical approach and the patient responded well to antibiotic therapy. Aggressive surgical and medical treatment is necessary in patients with psoas abscess to prevent complications.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
9/94. Septic arthritis of the hip caused by yersinia enterocolitica: a case report.We report a case of bacteriologically documented hip infection caused by yersinia enterocolitica. A 67-year-old male with a history of valvular disease was admitted for pain and motion range limitation in the left hip with a fever. No organisms were recovered by needle aspiration, but yersinia enterocolitica grew in joint fluid obtained by surgical arthrotomy. Investigations of the gastrointestinal tract were normal, and there was no evidence of endocarditis. After 6 weeks of appropriate antibiotic therapy and immobilization with transtibial traction, the clinical and laboratory test abnormalities improved. However, the patient died from an intercurrent condition. Y. enterocolitica, a well-known cause of reactive arthritis, can cause septic arthritis.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
10/94. Septic arthritis caused by erysipelothrix rhusiopathiae infection after arthroscopically assisted anterior cruciate ligament reconstruction.A case of septic arthritis caused by erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, c-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks.- - - - - - - - - - ranking = 1keywords = fever (Clic here for more details about this article) |
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