Cases reported "Arthritis, Infectious"

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1/18. helicobacter cinaedi septic arthritis and bacteremia in an immunocompetent patient.

    We report on the first case of documented helicobacter cinaedi septic arthritis in an immunocompetent heterosexual young man. The patient presented no identified risk factor except for contact with animals that have been incriminated as a possible source of infection, particularly for these patients. Despite prolonged bacteremia, the response to long-term therapy with ciprofloxacin and rifampin was excellent.
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keywords = animal
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2/18. Acute bacterial arthritis caused by group C streptococci.

    OBJECTIVES: To summarize the characteristics of and clinical experience with joint infection by group C streptococcus. methods: Two new cases of acute bacterial arthritis due to group C streptococci are reported, and a medline search was performed, which located 22 additional cases. RESULTS: Mean age ( /- standard deviation) of all 24 patients was 46 /- 25 years, and most patients were men (75%). The species most frequently identified was streptococcus equisimilis (12 cases). Eight patients (33%) had a general risk factor for infection, and the same percentage had some type of arthropathy. Only 3 patients had previous contact with animals. The infection was polyarticular in a third of cases, and the joint most frequently involved was the knee. The majority of patients showed a good response to the treatment with intravenous penicillin. However, 3 patients had functional sequelae, 2 more had residual radiological lesions, and 3 died. CONCLUSIONS: Acute bacterial arthritis due to group C streptococci is a serious but uncommon entity that can affect patients without risk factors. Rapid diagnosis and treatment may improve the outcome. Semin arthritis rheum 31:43-51.
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keywords = animal
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3/18. Gonarthritis in the course of lyme disease in a one-and-a-half-year-old child.

    A case of a one-and-a-half-year-old girl is reported in whom gonarthritis in the course of lyme disease was diagnosed. The girl was brought up in an urban environment. She never was in a forest and had no contact with animals (except for a healthy pet-dog, which was under veterinary supervision). She did not attend a nursery, and went for walks only within urban area under the careful guidance of her parents. In spite of the negative family history the level of antibodies against borrelia burgdorferi was estimated. A very high level of IgG antibodies and a low level of IgM borrelia burgdorferi antibodies, accompanied by physical symptoms allowed to diagnose the second stage of lyme disease. We considered the described case as worth presentation due to the child's very early age. Moreover, the infection was caused supposedly due to the contact with a dog (which may be unusual carrier of ticks), and not--as in most cases--in a forest.
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keywords = animal
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4/18. Acute pasteurella multocida in total knee arthroplasty.

    Pasturella multocida is a rare cause of joint sepsis in total joint arthroplasty, and all case reports have identified a distant source of infection from an animal bite that has caused potential hematogenous seeding of the prosthesis. We report a case in which no potential distal wound source was found and the only likely etiology was local wound seeding from an old injury. In that injury, a saddle stirrup had caused a severe traumatic soft tissue injury as a horse had rolled over the patient. We draw attention to the fact that this particular bacteria is virulent in producing septic contamination of a total joint prosthesis, and aggressive treatment is indicated when such infection is identified.
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keywords = animal
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5/18. Septic arthritis due to pasteurella multocida.

    We have reported two cases of septic arthritis caused by pasteurella multocida, the first, septic polyarthritis unrelated to animal contact and the other, septic monarthritis after a cat scratch. Serious infections with this gram-negative bacillus must be treated with intravenous penicillin, ampicillin, or a third-generation cephalosporin; aminoglycosides are not effective. A high index of suspicion is appropriate when there is a history of a recent animal-inflicted wound, though infection may also occur with either nontraumatic animal contact or no recognized animal contact at all.
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keywords = animal
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6/18. Report of 4 cases of pasteurella multocida septic arthritis.

    pasteurella multocida is frequently responsible for infections in man due to wounds inflicted by animals (generally cats or dogs). However, the development of septic arthritis is a rare complication. We report 4 cases of pasteurella multocida septic arthritis with demonstration of the organism in the joint in each case. Two cases presented with monoarthritis (sternoclavicular joint and wrist) and 2 cases had polyarticular involvement from the outset.
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keywords = animal
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7/18. erythromycin failure with subsequent pasteurella multocida meningitis and septic arthritis in a cat-bite victim.

    We report the case of a 75-year-old woman who developed pasteurella multocida meningitis and septic arthritis while being treated for a cat-bite wound infection with erythromycin. review of the literature revealed that erythromycin has poor in vitro activity against this bacterium and has been associated with serious clinical failures. We recommend that erythromycin not be prescribed for empiric therapy of established animal-bite infections. Suggestions for optimal empiric therapy of animal-bite infections and the differential diagnosis of severe cat-bite-associated sepsis are discussed.
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keywords = animal
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8/18. salmonella infection in total hip replacement: tests to predict the outcome of antimicrobial therapy.

    We report a hematogenous implant infection with salmonella dublin in a renal transplant patient with total hip replacement. A 16-month treatment with cotrimoxazole failed, as evidenced by culture and electron microscopy, despite persisting low MIC after therapy. Data from a foreign body animal model and in vitro tests, which take into account the properties of adhering and stationary-phase bacteria, explain the failure of a long-term treatment with cotrimoxazole. The patient was subsequently cured by ciprofloxacin which was successful in these tests. No relapse was noted after a follow-up of 1 year.
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keywords = animal
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9/18. Septic arthritis and osteomyelitis from a cat bite.

    A 39-year-old man with no prior history of underlying arthritis developed osteomyelitis and septic arthritis in his hand following a cat bite. This case illustrates the virulence of pasteurella multocida infections associated with animal bites, particularly those of cats, whose teeth can inoculate bone directly. The onset of cellulitis caused by P. multocida infections is often rapid, and the drug of choice for such infections remains penicillin. Appropriate antibiotic therapy, however, does not always prevent complications such as those seen in this patient.
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keywords = animal
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10/18. Crystal shedding in septic arthritis: case reports and in vivo evidence in an animal model.

    Two cases of coexisting septic and crystalline joint disease are reported. In one patient polyarticular septic arthritis occurred simultaneously with gout and pseudogout. In a second patient septic arthritis preceded the appearance of calcium pyrophosphate dihydrate (CPPD) crystals in the joint fluid, supporting an earlier postulate that lysosomal enzymes released during sepsis lead to shedding of crystals from cartilage and synovium into the joint space. This sequence was demonstrated in a rat air pouch model of synovium, in which CPPD crystals embedded in facsimile synovial tissue were released after injection of pyogenic bacteria. Coexisting septic arthritis should always be considered when crystals are identified in inflamed joints, particularly in elderly patients with concurrent infections.
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ranking = 4
keywords = animal
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