Cases reported "Arthritis"

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1/10. Refractory arthropathy after intravesical bacillus Calmette-Guerin therapy. Usefulness of isoniazide.

    BACKGROUND: arthritis associated with bacillus Calmette-Guerin immunotherapy usually responds dramatically to nonsteroidal antiinflammatory drug therapy. isoniazid is generally reserved for other complications such as granulomatous hepatitis. CASE-REPORT: A 73-year-old man was admitted for fever, arthritis of the knees and right temporomandibular joint, an inflammatory swelling over the left achilles tendon and bilateral conjunctivitis. The symptoms started in the wake of a course of intravesical bacillus Calmette-Guerin immunotherapy. Laboratory tests showed evidence of severe inflammation. Cultures of blood, urine and joint fluid specimens were negative, as were tests for autoantibodies and serologic tests for organisms known to cause reactive arthritis. Nonsteroidal antiinflammatory therapy was ineffective and glucocorticoid therapy produced only a partial response. All the symptoms resolved under isoniazid therapy in a dosage of 300 mg/day for three months. CONCLUSION: Use of antituberculous agents may be required in some cases of arthritis associated with bacillus Calmette-Guerin immunotherapy, most notably those with severe pyrexia.
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ranking = 1
keywords = bacillus
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2/10. Polyarthritis as a complication of intravesical bacillus Calmette-Guerin immunotherapy for bladder cancer.

    Bacillus Calmette-Guerin (BCG) is the most effective agent currently available for the treatment of superficial bladder cancer. However, this form of treatment is associated with some complications, including arthritis. In this report, we present a 69-year-old woman who developed inflammatory polyarthritis following BCG treatment for superficial bladder cancer. The arthritis resolved following treatment with a non-steroidal anti-inflammatory drug and chloroquinine.
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ranking = 0.57142857142857
keywords = bacillus
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3/10. Chronic destructive oligoarthritis associated with propionibacterium acnes in a female patient with acne vulgaris: septic-reactive arthritis?

    propionibacterium acnes is an anaerobic bacillus implicated in certain chronic arthritides. This report describes an HLA-B27 17-year-old woman with acne vulgaris who presented with rapidly destructive arthritis in the left shoulder as well as an evolving left subclavicular adenopathy. One year later, arthritis was detected in the left knee; the inflammatory synovial fluid was sterile. growth of P acnes was observed in cultures of the shoulder synovium and lymph nodes, but polymerase chain reaction was negative for borrelia, chlamydia, and ureaplasma dna. Three months of treatment with amoxicillin and rifampicin led to clinical disappearance of the oligoarthritis, but arthritis recurred in the left knee after discontinuation of therapy. On biopsy, bacteria were undetectable in the knee synovium, but chronic arthritis was evident histologically. Antibiotics were reintroduced for 12 months and were again effective against the clinical symptoms. Although the asymmetry, histologic features, arthritis-acne association, and genetic predisposition of this chronic destructive oligoarthritis would seem to indicate a reactive arthropathy, the isolation of P acnes from 2 distinct specimens prompted us to propose calling this a case of septic-reactive arthritis, which is further supported by the absence of progression after antibiotic therapy and the persistence of the rheumatism. To our knowledge, this is the first demonstration of the efficacy of prolonged antibiotic therapy on the joint manifestations of chronic rheumatism associated with acne.
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ranking = 0.14285714285714
keywords = bacillus
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4/10. Remitting seronegative symmetrical synovitis with pitting edema associated with subcutaneous streptobacillus moniliformis abscess.

    We describe an 84-year-old woman who developed remitting seronegative symmetrical synovitis with pitting edema (RS3PE) associated with a subcutaneous abscess of the hand due to streptobacillus moniliformis. Polyarthritis and edema were relieved after therapy with corticosteroids. We review the association of RS3PE to different rheumatologic, neoplastic, or infectious diseases.
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ranking = 0.71428571428571
keywords = bacillus
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5/10. Remitting seronegative symmetrical synovitis with pitting edema following intravesical bacillus Calmette-Guerin instillation.

    Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare syndrome of undetermined etiology occurring in the elderly. We describe the first case of RS3PE in a HLA-B27 positive 65-year-old man following intravesical bacillus Calmette-Guerin (BCG) instillation for bladder carcinoma. He developed symmetrical arthritis and synovitis involving wrists, knees, ankles, and metatarsophalangeal joints, with marked pitting edema of the dorsa of both hands and feet, fever, and elevated acute phase reactants. Right knee effusion revealed nonspecific sterile inflammatory fluid. He responded dramatically to nonsteroidal antiinflammatory drugs. BCG instillation may have triggered active symmetrical synovitis via local T cell activation and a T-helper-1 (Th-1)/Th-2 inflammatory profile.
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ranking = 0.71428571428571
keywords = bacillus
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6/10. Rat bite fever without fever.

    Rat bite fever is a rarely reported acute febrile bacterial illness caused by streptobacillus moniliformis or spirillum minus following a rat bite. It is classically characterised by abrupt onset of fever with rigors, myalgias, headache, and the appearance of a generalised maculopapular petechial skin rash. Polyarthritis complicates the course of the disease in up to 50% of infected patients, and numerous hurdles can make the diagnosis particularly difficult in the absence of fever or rash, as in the present case. A high degree of awareness is necessary to make the correct diagnosis in such cases. diagnosis has important prognostic implications as the disease is potentially lethal, but easily treatable.
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ranking = 0.14285714285714
keywords = bacillus
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7/10. Haverhill fever with spine involvement.

    Haverhill fever and rat-bite fever are closely-related syndromes caused by streptobacillus moniliformis. This infection is characterized by the abrupt onset of fever with rigors, myalgias, headache, polyarthritis, and rash. We report a case of infection with S. moniliformis that manifested as acute polyarthritis with involvement of the spine. To our knowledge, involvement of the spine has not been reported previously with this infection. diagnosis can be particularly difficult in the absence of fever or obvious exposure to rodents, as in our case. A high degree of awareness is necessary to make the diagnosis of this potentially fatal infection, which is easily treatable.
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ranking = 0.14285714285714
keywords = bacillus
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8/10. arthritis associated with adjuvant mycobacterial treatment for carcinoma of the bladder.

    A patient who developed an inflammatory polyarthritis following intravesical administration of bacillus Calmette-Guerin (BCG) used in the treatment of bladder cancer is described. An inflammatory synovitis comprising predominantly T lymphocytes was demonstrated on synovial biopsy. The synovitis resolved spontaneously within 14 days in this 'human model' of adjuvant arthritis.
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ranking = 0.14285714285714
keywords = bacillus
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9/10. Acute polyarthritis after BCG-therapy for bladder carcinoma in a patient with ankylosing spondylitis.

    A case of polyarthritis following intravesical administration of bacillus Calmette-Guerin (BCG) for bladder carcinoma is reported in a patient with long-standing ankylosing spondylitis. Possible links between BCG-therapy and joint manifestations are discussed in the light of data from the literature. patients who develop joint manifestations after BCG-therapy are often HLA B27-positive.
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ranking = 0.14285714285714
keywords = bacillus
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10/10. eikenella corrodens osteomyelitis, arthritis, and cellulitis of the hand.

    eikenella corrodens was isolated from an orally contaminated hand wound which resulted in cellulitis, osteomyelitis, and arthritis. E corrodens is a gram-negative, microaerophilic bacillus which only lately has received attention as a possible pathogen. The organism grows characteristically as small, corroding, or pitting colonies on blood agar. It typically requires hemin or blood for reliable aerobic growth. Oral contamination of wounds predisposes to infection with E. corrodens. The management of these infections includes treatment with an effective antibiotic and surgical debridement. Because it is gram-negative, microaerophilic, and often difficult to isolate, infections caused by E corrodens may mimic those caused by gram-negative obligate anaerobes. However, E corrodens is resistant to clindamycin and lincomycin and sensitive to most other commonly used antimicrobial agents.
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ranking = 0.14285714285714
keywords = bacillus
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