Cases reported "Bacteroides Infections"

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1/12. Some clinical, immunological and bacteriological observations in a case of pyogenic arthritis due to bacteroides fragilis.

    A case of recurrent pyogenic arthritis in a knee joint and abscess formation of the lower limb is described. The infection occurred in a 70-year-old male patient treated with steroids for rheumatoid arthritis. A strain of bacteroides fragilis was repeatedly isolated both from the knee joint and the abscess. The isolated strain was used as antigen in tube agglutination tests and significant titre changes were observed during the course of the disease. The isolated strain was initially sensitive to doxycycline but developed resistance to this drug during therapy. The sensitivity to lincomycin remained unaffected.
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2/12. Isolated septic arthritis of a lumbar facet joint.

    This is a report of an isolated septic arthritis of a lumbar facet joint where the infectious agent was Bacteroides sp. and where an early diagnosis was made using MRI.
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3/12. Anaerobic osteomyelitis of femoral head with intraosseous, intra-articular, bursal and muscle pneumatosis.

    A case is presented of anaerobic osteomyelitis with intraosseous pneumatosis resulting in extension of gas in soft tissue structures and femur in a patient with mitral valve vegetation and bacteremia. The finding of intraosseous pneumatosis and its extension into the hip joint, iliopsoas bursa and subgluteus medius bursa is depicted. Intraosseous pneumatosis is a rare but concerning finding for osteomyelitis in the absence of a penetrating wound, recent surgery, biopsy or fracture.
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4/12. metronidazole resistant bacteroides fragilis infection of a prosthetic hip joint.

    A case of infection involving a prosthetic joint in a patient with adult Still's disease is described. The causative organism was a strain of bacteroides fragilis which was resistant to metronidazole. The rarity of this occurrence is emphasised. Diagnostic difficulties which arose are described and the problems encountered with therapy discussed.
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5/12. air in painful total hip arthroplasty: diagnosis and treatment.

    A 78-year-old woman presented with a painful total hip arthroplasty five years postoperation. Plain radiographs revealed air in the hip joint. Aspiration of the hip indicated hip sepsis, and arthrogram showed communication of the hip joint with the sigmoid colon. Cultures grew bacteroides fragilis. Abdominal exploration showed a ruptured diverticulum that decompressed through the sciatic notch into the total hip arthroplasty. A colostomy was performed, and the hip joint was drained and debrided laterally at the same operation. The prosthesis was later removed with all cement, and the hip was converted to a Girdlestone resection. The authors conclude that air or gas shadows in a painful total hip arthroplasty are an ominous finding and mean either joint sepsis with a gas-forming bacteria or communication of the joint with a hollow viscus and sepsis.
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6/12. A case of septic arthritis in multiple joints due to bacteroides fragilis in a patient with rheumatoid arthritis.

    A case of arthritis in multiple joints due to B. fragilis ssp. fragilis is described. The patient was a 55-year-old man badly disabled by rheumatoid arthritis. The patient's immune response to the isolated strain was studied and a significant titre reduction during the course of the disease was observed. The serum antibodies of the patient cross-reacted with heterologous strains of B. fragilis ssp. fragilis. It is suggested that indirect immunofluorescence tests against a certain number of B. fragilis strains could be performed with serum from a patient in whom an infection with B. fragilis is suspected.
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7/12. Septic polyarthritis due to bacteroides fragilis in a patient with rheumatoid arthritis. A case report.

    Gram-negative septic arthritis is an uncommon but serious complication of rheumatoid arthritis and is usually mono-articular. The present case is unusual in that a septic polyarthritis due to bacteroides fragilis developed in nine joints. The organism was grown only in anaerobic synovial fluid and blood cultures. The patient recovered after treatment which included repeated needle aspirations of the joints under anaesthesia and oral metronidazole (Flagyl; Maybaker). Any patient with rheumatoid arthritis who develops an acute flare-up of disease in one or more joints should have these aspirated to exclude the possibility of septic arthritis. Both anaerobic and aerobic cultures of synovial fluid and blood should be done. Prompt antibiotic treatment and joint drainage are the cornerstones of treatment.
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8/12. Late infection with bacteroides fragilis in a prosthetic joint.

    A late infection caused by bacteroides fragilis in a prosthesis knee joint is presented. The patient's underlying disease may have predisposed her to this organism.
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9/12. bacteroides fragilis arthritis in a sickle cell-thalassaemia patient.

    Anaerobic arthritis due to bacteroides fragilis was diagnosed in a 33-year-old patient with prolonged fever suffering from sickle cell/thalassaemia. The causative agent was isolated from blood and purulent synovial fluid from both knee joints. A combination of chloramphenicol plus metronidazole treatment proved effective. Anaerobic arthritis has not previously been described in patients with sickle cell disease, and may reflect the well-known susceptibility of these patients to pathogens.
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10/12. sternoclavicular joint infection due to Bacteroides oralis.

    A 60-year-old man in good health with no history of intravenous drug abuse was hospitalized for sternoclavicular joint pain and swelling. His complicated course required extensive debridement of the sternoclavicular joint. An insidious course, negative blood culture and requirement for surgery is common in infections of this joint.
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