1/194. Septic arthritis following arthroscopic meniscus repair: a cluster of three cases.Three cases of staphylococcus epidermidis septic arthritis following inside-out arthroscopic meniscus repair within a 4-day period at the same facility are described. All three patients responded to surgical debridement and 4 to 6 weeks of intravenous antibiotics. In each instance, the meniscus and repair sutures were left intact; 12- to 38-month follow-up revealed no evidence of infection or meniscal symptoms. Epidemiological investigation implicated the meniscus repair cannulas as one of the few factors common to all three cases. molecular typing of bacterial dna revealed that two of the three isolated organisms showed identical pulsed-field gel electrophoretic patterns, implying a common source of inoculation. Experimental contamination of the cannulas revealed that only sterilization involving ultrasonification, lumen washing by water jet, and steam sterilization resulted in clean and sterile cannulas.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
2/194. Septic arthritis and osteomyelitis of the wrist: reconstruction with a vascularized fibular graft.A case of spontaneous staphylococcus arthritis of the wrist with associated carpal and distal radius osteomyelitis is reported. Following sequential debridements and a 6-week course of parenteral antibiotics, an extensive defect was bridged with a vascularized fibular autograft to achieve a successful fusion. There was no donor site morbidity or recurrent infection. Follow-up radiographs 41 months later demonstrated complete incorporation and hypertrophy of the graft.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
3/194. Acute inflammatory (non-purulent) arthritis concomitant with a developing breast abscess.A 34 year old female presented 7 weeks post-partum with acute diffuse arthritic manifestations and pyrexia. Extensive investigations (grossly raised erythrocyte sedimentation rate [ESR], c-reactive protein [CRP], normal serology and others) were performed to pursue a diagnosis. Subsequently a breast abscess was diagnosed. Surgical treatment of this led to almost immediate resolution of the joint complaints and return of ESR/CRP to normal levels. This was considered a hitherto unreported case of acute non-purulent inflammatory arthritis concomitant to an existing infection elsewhere in the body. The pathogenic mechanism is unclear but speculatively toxin-mediated.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
4/194. 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 = 1.2keywords = arthritis (Clic here for more details about this article) |
5/194. Pathophysiology of surgical site infection in total hip arthroplasty.This article is a case report of a 69-year-old man who underwent a right total hip replacement procedure and developed a surgical site infection. Areas of concern in prevention and treatment of hip arthroplasty infection are presented, focusing on the pathophysiologic process involved. A review of the patient risk factors and the pathophysiologic action potentiating risk for infection include host immunity, nutritional status, diabetes, age, use of steroids or immunosuppressive drugs, rheumatoid arthritis, and urinary tract or other infections. The case report identifies the patient's age, multiple instrumentation of the bladder resulting in bacteriuria and the reinfusion of 400 cc of autologous shed blood via cell saver, a controversial risk subject, as the primary risk factors for surgical site infection in this patient. Readmission to the hospital on day 16 after the operation was completed on identification of 2 pathogenic organisms, methicillin-resistant staphylococcus aureus and acinetobacter calcoaceticus bio anitratus. The infection was successfully treated with oral ciprofloxacin and intravenous administration of tobramycin, preventing progression from superficial to deep infection and preserving the prosthesis.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
6/194. Septic arthritis in hemophilia with central venous catheter: a case report.A case is reported of septic arthritis in a child with human immunodeficiency virus-negative hemophilia a associated with a Staphylococcus aureus catheter-associated septicemia. The infection occurred in relation to the use of a totally implantable central venous catheter. The organism was eventually eradicated with antibiotics injected via the catheter. With increasing use of such catheters in the hemophilic population, clinicians should be alerted to the possibility of septic arthritis for prompt diagnosis and treatment.- - - - - - - - - - ranking = 1.2keywords = arthritis (Clic here for more details about this article) |
7/194. Acute non-purulent inflammatory arthropathy associated with Staphylococcus aureus abscess.Case 1. A 20-year-old woman presented 4 weeks post-partum with widespread symmetrical inflammatory polyarthropathy with marked synovitis. Investigations revealed grossly raised CRP with negative immunology screen. A few days before presentation she saw her general practitioner with left-sided mastitis, which then developed into a Staphylococcus breast abscess. Surgical drainage of this led to almost immediate resolution of the joint complaints and return of CRP to normal. Case 2. A 27-year-old man developed widespread symmetrical inflammatory arthropathy. A few days prior to this he had developed folliculitis with a furuncle on his neck. Swab grew Staphylococcus aureus. His arthritis settled immediately following spontaneous drainage of his abscess and a full course of antibiotic. The pathogenic mechanism is unclear but could be toxin-mediated.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
8/194. Septic arthritis of a lumbar facet joint caused by Staphylococcus aureus.STUDY DESIGN: Case report of a 35-year-old woman with septic arthritis of a lumbar facet joint. OBJECTIVES: To report a rare case of severe low back pain and the specific differential diagnostic problems. SUMMARY OF BACKGROUND DATA: Differential diagnosis between spondylodiscitis and facet joint septic arthritis on a clinical basis is very difficult. The lesions of the joint appear on a plain film only approximately 1.5 months after onset of the symptoms. Although the radionuclide bone scan is sensitive and shows a more laterally and vertically localized uptake than in spondylodiscitis, this technique is not very specific. Computed tomography scan and magnetic resonance imaging are the most reliable investigations even at the very early stages of the disease. Confirmation of the diagnosis has to be obtained by blood cultures or, in exceptional cases, by direct puncture of the joint. Appropriate antibiotic treatment is in most cases sufficient to heal this lesion. methods: The etiology, clinical presentation, technical examinations, and treatment are reviewed. RESULTS: Computed tomography scan and magnetic resonance imaging complemented by positive blood cultures led to the very early diagnosis of septic arthritis of the lumbar facet joint in this relatively young patient. CONCLUSIONS: With our case report we confirm the very small number of data reported in the literature, indicating that infections of the facet joint can be detected at a very early stage using magnetic resonance imaging and computed tomography scan.- - - - - - - - - - ranking = 1.4keywords = arthritis (Clic here for more details about this article) |
9/194. Septic arthritis of the spine facet joint: early positive diagnosis on magnetic resonance imaging. review of two cases.We report two cases of septic arthritis of the spine facet joint in two patients with no previous medical history. Clinical symptoms were consistent with a spondylodiscitis. blood cultures were positive for Staphylococcus aureus. The infection was initially shown and precisely localised with magnetic resonance imaging, despite an initially negative or aspecific bone scintigraphy. magnetic resonance imaging of the spine demonstrated infection involving the epidural space and paraspinal musculature and enhancement of the infected thoracic and lumbar facet joint after gadolinium injection.- - - - - - - - - - ranking = 1keywords = arthritis (Clic here for more details about this article) |
10/194. pyomyositis in a 5-year-old child.We present a case of pyomyositis in an otherwise healthy 5-year-old child that underscores the potential for serious, life-threatening complications. pyomyositis of the gluteal, psoas, and iliacus muscles was associated with osteomyelitis, septic arthritis, a large inferior vena cava thrombus, septic pulmonary emboli, and eventual pneumonia. Primary pyomyositis is a purulent infection of striated muscle thought to be caused by seeding from a transient bacteremia. The focal infection typically forms an abscess that generally responds to intravenous antibiotics and occasionally requires adjunctive computed tomography-guided aspiration and drainage. This localized infectious process rarely produces further sequelae unless treatment is delayed. pyomyositis is rare in healthy individuals and requires a high clinical suspicion in patients who present with fever, leukocytosis, and localized pain.- - - - - - - - - - ranking = 0.2keywords = arthritis (Clic here for more details about this article) |
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