10,236 results on '"Septic arthritis"'
Search Results
2. Anchoring Sequential Intermittent Long Acting Antimicrobials With Medication for Opioid Use Disorder (MOUD) for Invasive Infections Related to Opioid Use (AIM-STOP)
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Shivakumar Narayanan, Asst Professor
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- 2024
3. Septic Arthritis of the Sternoclavicular Joint
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Koshy, George V., Davis, Richard, and Wilson, Christopher
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septic arthritis ,sternoclavicular joint ,ultrasound - Abstract
Introduction: Sternoclavicular joint (SCJ) septic arthritis is a rare but rapidly fatal joint infection. Without proper medical or surgical management, it can progress to osteomyelitis, chest wall abscess, mediastinitis, or myositis.Case Report: A 57-year-old male with a past history of intravenous drug use presented to the emergency department (ED) with chest tenderness of one week duration. Vital signs were unremarkable, and exam was notable for tender, raised right SCJ without any fluctuance. On point-of-care ultrasound we noted fluid collection and capsular distention along the SCJ, which aided in rapidly diagnosing septic arthritis. The patient was immediately started on antibiotics and taken to the operating room for excision and debridement.Conclusion: While computed tomography is routinely used in the emergency department for diagnosing septic arthritis, ultrasound offers a rapid and safe alternative for diagnosis.
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- 2024
4. The Predictive Role of C-reactive Protein to Albumin Ratio (CAR) in the Treatment of Septic Arthritis in Young Chlidren
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wangxiaodong, Professor of Medicine
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- 2024
5. Ankle Joint Replacement Outcomes Study
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- 2024
6. Exploratory Study of Ultrasound Signs of Native Septic Arthritis of the Knee (USAK)
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- 2024
7. Oral-only Antibiotics for Bone and Joint Infections in Children (CHILD@HOME_BJI)
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The research foundation of Copenhagen University Hospital, Rigshospitalet, Copenhagen Health Science Partners, Innovation Fund Denmark, and Allan Bybeck Nielsen, Principal investigator
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- 2024
8. Clinical characteristics of and risk factors for poor outcomes in children with bacterial culture-negative septic arthritis of the hip.
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Feng, Wei, Yao, Ziming, Liu, Haonan, Zhu, Danjiang, Song, Baojian, and Wang, Qiang
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SYNOVIAL fluid , *LOGISTIC regression analysis , *BLOOD proteins , *C-reactive protein , *BACTERIAL cultures , *INFECTIOUS arthritis - Abstract
Septic arthritis of the hip is a serious infection in children. However, blood and joint fluid cultures are often negative, which makes the diagnosis and treatment challenging. We analyzed the clinical features of children with septic arthritis of the hip with negative bacterial cultures and identified the risk factors for poor outcomes. The clinical data of children with septic arthritis of the hip with negative bacterial cultures who were treated at our hospital from January 2010 to December 2020 were retrospectively analyzed. The clinical characteristics and outcomes of the culture-negative cohort were compared with those of children with positive bacterial cultures treated during the same period. Culture-negative patients were divided into a group with good outcomes and a group with poor outcomes. The differences between the two groups were compared. Thirty-nine children with culture-negative septic arthritis of the hip were compared with 37 children with culture-positive sepsis. Compared with the culture-positive group, the culture-negative group had a significantly younger mean age and a significantly lower mean serum C-reactive protein concentration. Logistic regression analysis of culture-negative patients with good versus poor outcomes revealed that the independent risk factors for poor outcomes were an increased serum C-reactive protein concentration and prolonged time from onset to surgery. The cut-off values for predicting a poor outcome in the culture-negative group were a time from onset to surgery of greater than 21 days and a C-reactive protein concentration of greater than 23 mg/L. Culture-negative septic arthritis of the hip has similar clinical features to culture-positive septic arthritis of the hip and can result in sequelae of varying severity. Therefore, active anti-infective and hip drainage therapy should be performed when children present with clinical symptoms, inflammatory marker concentrations, and imaging findings that are clinically diagnostic for septic arthritis of the hip. Level II, retrospective study. [ABSTRACT FROM AUTHOR]
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- 2024
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9. The many faces of sickle cell disease in children: complications in the appendicular skeleton.
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De La Hoz Polo, Marcela, Hudson, Victoria E., Adu, John, Chakravorty, Subarna, and Haque, Saira
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SICKLE cell anemia , *INFECTIOUS arthritis , *ERYTHROCYTES , *CHILD patients , *SYMPTOMS - Abstract
Sickle cell disease (SCD) is a hereditary red cell disorder with clinical manifestations secondary to sickling or crescent-shaped distortion of the red blood cells. Musculoskeletal complications of SCD are often the main causes for acute and chronic morbidities in children with manifestations including osteomyelitis, osteoporosis and osteonecrosis. This article aims to familiarise the paediatric radiologist with appendicular skeletal complications of SCD in the paediatric population and their imaging appearance. [ABSTRACT FROM AUTHOR]
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- 2024
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10. Is choice of approach associated with risk of avascular necrosis in pediatric septic hip?
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Nihalani, Shrey, Cruz, Francis, Hawkins, Jacob K, Griswold, Branum Gage, Mabry, Scott E, McGwin, Gerald, Gilbert, Shawn R, and Conklin, Michael J
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INFECTIOUS arthritis , *HIP joint dislocation , *CHILD patients , *OLDER patients , *FEMORAL artery - Abstract
Purpose: Septic arthritis of the hip in children and adolescents is a common condition requiring timely diagnosis and intervention. Surgical irrigation and debridement is typically performed through the anterior approach because of concerns about injury to the medial femoral circumflex artery leading to avascular necrosis. While there are multiple studies investigating the sequelae of anterior and medial approaches for reduction of developmental dislocation of the hip, none have compared these approaches for the pediatric septic hip. We hypothesize that there will be no significant difference in the rate of avascular necrosis when comparing the medial and anterior approaches to the septic hip in pediatric patients. Methods: A retrospective review was performed of pediatric septic hips treated with irrigation and debridement through either a medial or anterior approach at a single institution over an 18-year period of time. The primary outcome measure was the development of avascular necrosis. Results: Thirteen of 164 patients (7.9%) developed avascular necrosis. Avascular necrosis was noted in 9 of 101 patients who had anterior approach and 4 of 63 patients who underwent medial approach (p = 0.76). The average age for patients developing avascular necrosis was 10.0 years old versus 6.8 years old in patients who did not develop avascular necrosis (p = 0.01). The average follow-up was 3.3 years in patients with avascular necrosis versus 1.5 years for patients who did not develop avascular necrosis (p = 0.01). Conclusion: Medial approach to the pediatric septic hip does not increase the rate of avascular necrosis compared to the anterior approach. Level of evidence: Retrospective comparison study, Level III [ABSTRACT FROM AUTHOR]
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- 2024
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11. Difficult diagnosis: Disseminated gonorrheal infection manifesting as septic arthritis.
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Alleyne, Dwayne and Mitchell, Sheryl
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GONORRHEA diagnosis , *ANTIBIOTICS , *DIFFERENTIAL diagnosis , *AZITHROMYCIN , *SKIN inflammation , *INFECTIOUS arthritis , *SYNOVIAL fluid , *BLOOD sedimentation , *INTRAVENOUS therapy , *GONORRHEA , *TENOSYNOVITIS , *JOINT pain , *CEPHALOSPORINS , *LEUCOCYTE disorders , *RANGE of motion of joints , *C-reactive protein , *CEFTRIAXONE , *SYMPTOMS - Abstract
Disseminated gonococcal infection is the causative agent of approximately 0.6%-1.2% of septic arthritis cases in North America and Europe. Typical presentations of this disorder include tenosynovitis, dermatitis, polyarthralgia, or oligoarticular purulent arthritis affecting the distal joints. Diagnosis is contingent on clinical presentation, with urine nucleic acid amplification testing as the preferred diagnostic modality. Synovial fluid cultures, along with imaging, can confirm diagnosis. The recommended treatment is a third-generation cephalosporin, such as intravenous ceftriaxone for 7-14 days and a dose of oral azithromycin. [ABSTRACT FROM AUTHOR]
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- 2024
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12. Impact of delayed presentation and surgical management on radiologic and clinical outcomes of pediatric septic hip.
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Moein, Seyed Arman, Fereidooni, Reza, Gerami, Mohammad Hadi, Seifaei, Asal, Zarifkar, Houyar, and Kamalinia, Amirhossein
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HIP joint radiography ,HIP surgery ,INFECTIOUS arthritis ,SCIENTIFIC observation ,MULTIPLE regression analysis ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,HIP joint ,ODDS ratio ,TREATMENT delay (Medicine) ,CONFIDENCE intervals - Abstract
Septic arthritis of the hip joint (septic hip) is the bacterial infection of the hip. Delayed treatment increases the risk of extensive joint damage, systemic infection, prolonged recovery, higher healthcare costs, and long-term disability. This study explores the repercussions of delayed surgical treatment in pediatric septic hip. In this observational study, pediatric patients diagnosed with septic hip between 2012 and 2021 were retrospectively selected from a major referral center in Shiraz, Iran. We collected clinical and radiological data, including Kocher score and determined Choi classification in follow-up radiographs. Multivariate logistic regression analysis was used to assess the impact of delay to surgery on the development of clinical sequelae and radiological deformities in the presence of potential confounders of age and Kocher criteria. Out of 49 children with delayed presentation, 46 survived and entered the study. Mean delay from symptom presentation to admission was 12.67 ± 10.51 days, and mean delay from admission to surgery was 5.33 ± 6.47 days. Of the 46 patients, 28.26% developed clinical sequelae. The Choi classification revealed that 54.35% of patients developed no residual deformity. A multivariate logistic regression analysis indicated a statistically significant association between delay to surgery and the development of radiological deformities (adjusted odds ratio: 1.36, 95% CI: 1.14–1.64, p = 0.001). Additionally, a separate analysis revealed that each additional day of delay was associated with a 12% increase in the odds of clinical sequelae (adjusted odds ratio: 1.12, 95% CI: 1.03–1.22, p = 0.006). Sensitivity analyses confirmed the relationship of delay from admission to surgery in developing both outcomes. Delay in medical care and surgical management remains the most important factor affecting the outcomes of septic hip. The study underscores the critical role of timely surgical intervention in reducing complications in pediatric septic hip patients. [ABSTRACT FROM AUTHOR]
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- 2024
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13. Utilization of In Vivo Imaging System to Study Staphylococcal Sepsis and Septic Arthritis Progression in Mouse Model.
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Deshmukh, Meghshree, Hu, Zhicheng, Mohammad, Majd, and Jin, Tao
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SIGNAL detection ,IMAGING systems ,INFECTION control ,SEPSIS ,STAPHYLOCOCCUS aureus ,INFECTIOUS arthritis - Abstract
Staphylococcus aureus [S. aureus] is a leading cause of sepsis and septic arthritis, conditions that pose significant medical challenges due to their high mortality and morbidity. No studies have used an in vivo imaging system [IVIS] to monitor S. aureus sepsis and septic arthritis. Here, we employed a bioluminescent reporter strain of S. aureus, Newman AH5016, administered intravenously to induce sepsis and intra-articularly to induce local septic arthritis in mice. Disease progression was monitored using IVIS to capture bioluminescent signals from kidneys, joints, and whole mice. Cytokines in the blood and joints were measured. The efficacy of cloxacillin treatment was evaluated. In the sepsis model, bioluminescent signals from kidneys, but not from whole mice, were correlated with kidney bacterial load and abscess formation. Ex vivo kidney imaging detected increased bacterial load and abscess formation from day 3 to day 10. Antibiotic treatment significantly reduced kidney signals, correlating with decreased bacterial counts and IL-6 levels, indicating effective infection control. In the local infection model, early-phase bioluminescent signals from joints were correlated with macroscopic arthritis and bacterial burden. Thus, signal detection from kidneys using IVIS is useful for monitoring S. aureus sepsis and assessing antibiotic efficacy, though it may only be effective for early-phase monitoring of local septic arthritis. [ABSTRACT FROM AUTHOR]
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- 2024
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14. The accuracy and diagnostic value of gram staining joint aspirates in suspected joint infections.
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Zhang, James, Stevenson, Anna, Zhou, Andrew Kailin, Khan, Faris, Geetala, Rahul, and Krkovic, Matija
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ANTIBIOTICS , *DIABETES complications , *RISK assessment , *ARTHROCENTESIS , *PROSTHESIS-related infections , *INFECTIOUS arthritis , *LOGISTIC regression analysis , *HYPERTENSION , *DIAGNOSTIC errors , *RETROSPECTIVE studies , *TREATMENT effectiveness , *TRAUMA centers , *ODDS ratio , *ARTHRITIS , *STAINS & staining (Microscopy) , *TREATMENT delay (Medicine) , *CONFIDENCE intervals , *SENSITIVITY & specificity (Statistics) , *CULTURES (Biology) , *EVALUATION , *DISEASE complications - Abstract
Background: Septic arthritis is a debilitating condition with prolonged treatment and adverse outcomes. A gram stain is often performed from the joint aspirate sample, followed by a definitive culture. In our study, we assessed the accuracy of gram staining for suspected septic arthritis and explored factors associated with positive culture growth and false negatives in the gram stain. Methods: We retrospectively reviewed joint aspirates performed from 2015-2021 at a major trauma centre. Aspirates not cultured for septic arthritis were excluded. Data collected included aspirate site, gram stain and culture result delay, patient demographics, orthopaedic/rheumatological history, and comorbidities. Outcomes measured were gram stain sensitivity and specificity. Factors influencing positive cultures and false negative gram stain results were analysed using logistic regression. Results: Of 408 joint aspirates meeting the criteria, 37 did not undergo initial gram staining. Gram stain sensitivity was 30.4%, specificity was 97.6%. The delay from aspirate to definitive gram stain and culture results was 1.1 and 5.4 days, respectively Logistic regression identified that prosthetic joint(p = 0.007), past joint infections(p = 0.006), arthritis(p < 0.001), hypertension(p = 0.007), diabetes(p = 0.019) were positively associated with positive cultures. Past joint infections(p = 0.004) were positively associated with false negative gram stain results. Patients on antibiotics during the aspirate had a higher risk of false negative gram stain results (OR = 5.538, 95%CI, 2.802–10.948; p < 0.001). Conclusions: In conclusion, the initial gram stain has limited sensitivity and caution should be exercised when interpreting negative results. Vigilance is crucial when the highlighted comorbidities or antibiotic use are present, to assess patients with potential joint infections. [ABSTRACT FROM AUTHOR]
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- 2024
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15. Infective endocarditis and septic arthritis caused by Corynebacteriumstriatum.
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Umemoto, Daichi, Hara, Shigeo, and Nishioka, Hiroaki
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INFECTIVE endocarditis , *INFECTIOUS arthritis , *MICROBIAL sensitivity tests , *NOSOCOMIAL infections , *SHOULDER joint , *JOINT diseases , *TRANSESOPHAGEAL echocardiography - Abstract
Corynebacterium striatum occasionally causes nosocomial infections, such as catheter-related bloodstream infection and pneumonia; however, C. striatum- related infective endocarditis or septic arthritis is uncommon. We present the case of an 85-year-old woman with infective endocarditis at the native valve and septic arthritis at the native shoulder joint caused by C. striatum. The patient was admitted for a 10-day history of fever and right shoulder pain. She had no history of artificial device implantation, injury, arthrocentesis, or hospitalization. A physical examination revealed conjunctival petechiae, a systolic heart murmur, and right shoulder joint swelling. C. striatum was observed in two blood culture sets. Transesophageal echocardiography revealed vegetation in the right aortic coronary cusp. Arthrocentesis at the right shoulder aspirated pyogenic fluid and C. striatum was detected in the culture. The patient was diagnosed with infective endocarditis and septic arthritis caused by C. striatum, and ampicillin was administered based on antimicrobial susceptibility test results. The patient's condition was initially stable; however, she developed pulmonary congestion on day 56 and eventually died. An autopsy demonstrated perforation of the aortic left coronary cusp with vegetation. C. striatum may cause native valve endocarditis and native joint septic arthritis. [ABSTRACT FROM AUTHOR]
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- 2024
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16. A prospective multicentre evaluation of BioFire® Joint Infection Panel for the rapid microbiological documentation of acute arthritis.
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Gaillard, Tiphaine, Dupieux-Chabert, Céline, Roux, Anne-Laure, Tessier, Eve, Boutet-Dubois, Adeline, Courboulès, Camille, Corvec, Stéphane, Bémer, Pascale, Lavigne, Jean-Philippe, El Sayed, Faten, Marchandin, Hélène, Munier, Clément, Chanard, Emmanuel, Gazzano, Vincent, Loiez, Caroline, and Laurent, Frédéric
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JOINT infections , *PROSTHESIS-related infections , *ARTHRITIS , *SYNOVIAL fluid , *INFECTIOUS arthritis , *DRUG resistance in bacteria - Abstract
To assess the performance of the rapid syndromic BioFire® Joint Infection Panel (BF-JIP) to detect bacterial and fungal pathogens, as well as antibiotic resistance genes, directly in synovial fluid specimens collected from patients with acute arthritis. The study was conducted in six French bacteriological laboratories. To assess the performances of BF-JIP, results were compared with those of synovial fluid 14-day culture and, in case of discrepancy, with those of complementary molecular methods and intraoperative samples. A total of 308 synovial fluid specimens were tested after collection from 308 adults and children presenting with clinical and biological suspicion of acute arthritis; patients presenting with acute periprosthetic joint infection were included according to the European Bone and Joint Infection Society 2021 criteria. Only one specimen failed (no result). On the basis of the consolidated data, the BF-JIP was concordant with the 14-day culture in 280 (91.2%) of the 307 specimens finally included in the study. The positive percentage agreement was 84.9% (95% CI, 78.8–89.8%) and the negative percentage agreement was 100% (95% CI, 97.2–100%). The positive predictive value was extremely high (100%; 95% CI, 97.6–100%), whereas the negative predictive value was lower (82.6%; 95% CI, 75.7–88.2%), partially explained by the missing target species in the panel. The BF-JIP showed high performances to detect pathogens involved in acute arthritis. [ABSTRACT FROM AUTHOR]
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- 2024
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17. Simultaneous Salmonella septic arthritis and naïve tricuspid valve endocarditis: A case report.
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Arian, Mahnaz, Sarvari, Farideh Najm, Mohebbi, Moein, and Kazerani, Marzieh
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TRICUSPID valve ,INFECTIOUS arthritis ,SALMONELLA ,ENDOCARDITIS ,DELAYED diagnosis ,SALMONELLA diseases - Abstract
Background: Salmonella osteoarticular involvement is a rare complication, occurring in about 2% of the cases. Septic arthritis is exceedingly rare, involving only 0.2 % of all salmonellosis patients. Endocarditis is another complication that occurs in less than 0.8 % of cases. These complications are more likely to happen among immunocompromised patients. Case Presentation: We report a previously healthy 25-year-old man who presented with left limb pain. He had been treated for brucellosis ten days earlier by his primary care physician. Arthrocentesis and subsequent hip-joint biopsy confirmed septic arthritis due to Salmonella. However, he was unresponsive to the treatment. We found no underlying immunosuppression. A trans-esophageal echo was performed due to the continued fever and positive blood cultures. It revealed Salmonella endocarditis of the naïve tricuspid valve. He was treated via arthrotomy and antimicrobials for four weeks. Follow-up after 20 months showed no underlying immunosuppression. Conclusion: This case highlights that in patients with positive Salmonella blood cultures and a focus of infection compatible with Salmonellosis but unresponsive to treatment, searching for other foci of infection is necessary. Furthermore, physicians in endemic areas of brucellosis should consider other differential diagnoses in patients with fever and limping because any delay in diagnosing Salmonella septic arthritis can destroy the joint space with lifelong discomfort. [ABSTRACT FROM AUTHOR]
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- 2024
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18. Native Joint Septic Arthritis.
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Wu, Kevin A., Kugelman, David N., Seidelman, Jessica L., and Seyler, Thorsten M.
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JOINT infections ,SYNOVITIS ,SYMPTOMS ,ARTHROPLASTY ,TREATMENT duration - Abstract
Native joint septic arthritis (NJSA) is a severe and rapidly progressing joint infection, predominantly bacterial but also potentially fungal or viral, characterized by synovial membrane inflammation and joint damage, necessitating urgent and multidisciplinary management to prevent permanent joint damage and systemic sepsis. Common in large joints like knees, hips, shoulders, and elbows, NJSA's incidence is elevated in individuals with conditions like rheumatoid arthritis, diabetes, immunosuppression, joint replacement history, or intravenous drug use. This review provides a comprehensive overview of NJSA, encompassing its diagnosis, treatment, antibiotic therapy duration, and surgical interventions, as well as the comparison between arthroscopic and open debridement approaches. Additionally, it explores the unique challenges of managing NJSA in patients who have undergone graft anterior cruciate ligament (ACL) reconstruction. The epidemiology, risk factors, pathogenesis, microbiology, clinical manifestations, diagnosis, differential diagnosis, antibiotic treatment, surgical intervention, prevention, and prophylaxis of NJSA are discussed, highlighting the need for prompt diagnosis, aggressive treatment, and ongoing research to enhance patient outcomes. [ABSTRACT FROM AUTHOR]
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- 2024
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19. Clinical characteristics of neonatal and infant osteomyelitis and septic arthritis: a multicenter retrospective study.
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Keming Sun, Chunxu Zhang, Ziwen Mao, Chen Wang, Hua Zhu, Huiqing Sun, Kang Wang, and Weyland Cheng
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INFECTIOUS arthritis ,NEWBORN infants ,STAPHYLOCOCCUS aureus infections ,OSTEOMYELITIS ,INFANTS ,AGE groups - Abstract
Objective: Signs and symptoms of osteomyelitis or septic arthritis in neonates and infants are often nonspecific and early-stage bone infections in infants may often go unnoticed. The objective of this study was to analyze the clinical characteristics of newborns and infants with osteomyelitis and septic arthritis to improve understanding of the disorder and to assist clinicians with diagnosis. Methods: A retrospective multicenter study was conducted on neonates (0-28 days old, n = 94) and infants (1-12 months old, n = 415) with osteoarticular infections. Data consisting of clinical characteristics, complications, laboratory outcomes, and the pathogenic microorganisms causing osteomyelitis were tabulated. The statistics were further broken down into two regions and the significant differences between neonates and infants were evaluated and compared to the literature. Results: Compared to infants, neonates had significantly lower incidences of fever (p < 0.0001), higher incidences of localized swelling (p = 0.0021), higher rate of infection at the humerus (p = 0.0016), higher percentage of Escherichia coli (p < 0.0001) and Klebsiella pneumoniae (p = 0.0039) infections, lower percentage of Staphylococcus aureus infections (p < 0.0001) and were more likely to develop septic arthritis (p < 0.0001). Conclusion: Distinct differences were found between neonatal and infants with osteoarticular infections. Future studies should focus on improving diagnosis and subsequent treatment regimens for younger age groups. [ABSTRACT FROM AUTHOR]
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- 2024
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20. Putative mRNA Biomarkers for the Eradication of Infection in an Equine Experimental Model of Septic Arthritis.
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Koziy, Roman V., Bracamonte, José L., Katselis, George S., Udenze, Daniel, Hayat, Shahina, Hammond, S. Austin, and Simko, Elemir
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JOINT infections ,MESSENGER RNA ,HORSE diseases ,GENE expression ,SYNOVIAL fluid ,INFECTIOUS arthritis ,HORSE breeding ,SEPTIC shock - Abstract
Simple Summary: Joint infection, or septic arthritis, is an important disease in horses and requires aggressive treatment to eradicate the infection. Using current diagnostic methods, it is difficult to determine when the infection has been eliminated following treatment, leading to often prolonged antimicrobial therapy, which may be unnecessary and is associated with side effects and antimicrobial resistance. Thus, better markers of eradication of joint infection are needed. In this study, a class of molecules called messenger ribonucleic acid (mRNA) in synovial fluid was investigated for potential biomarkers of the eradication of infection in an experimental model of equine septic arthritis using transcriptomics methods. Transcriptomics data were also compared to our previously published data on putative protein biomarkers of the eradication of joint infection and to an mRNA biomarker panel used to differentiate septic from non-septic shock in humans. Eight mRNAs were identified that were at least three times increased in horses with active septic arthritis compared to horses post-eradication of infection after treatment and horses with non-septic synovitis. The presence of mRNAs corresponding to our previously reported protein markers of eradication of joint infection and to the validated mRNA biomarker panel detecting sepsis in humans was also confirmed. Further investigation of mRNAs as a source of potential markers of the eradication of joint infection in horses is needed. Septic arthritis (SA) in horses has long-term health implications. The success of its resolution hinges on the implementation of early, aggressive treatment, which is often sustained over a prolonged period. Common diagnostic methods do not allow for the reliable detection of the eradication of joint infection. A potential alternative is the discovery and characterization of mRNA biomarkers. The purpose of this study was to identify potential mRNA biomarkers for the eradication of joint infection in equine SA and to compare their expression with our previously published proteomics data. In addition, the transcriptomics data were compared to the mRNA biomarker panel, SeptiCyte Lab, used to distinguish sepsis from non-septic shock in humans. A comparative transcriptomics analysis of synovial fluid from the SA joints of five horses with active infection and subsequent post-treatment eradicated infection in the same joints and five horses with non-septic synovitis was performed. Eight novel mRNA transcripts were identified that were significantly upregulated (>3-fold) in horses with active SA compared to horses post-eradication of infection after treatment and horses with non-septic synovitis. Two proteins in our proteomics data corresponded to these mRNA transcripts, but were not statistically different. The transcripts used in the SeptiCyte test were not differentially expressed in our study. Our results suggest that mRNA may be a useful source of biomarkers for the eradication of joint infection in horses and warrants further investigation. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Determining the accuracy of the leukocyte esterase reagent strip test in the rapid diagnosis of adult septic arthritis
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Peyman Mirghaderi, Mohammad-Taha Pahlevan-Fallahy, Jamil Mahmoudi, and S.M. Javad Mortazavi
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Septic arthritis ,Leukocyte esterase ,Joint infection ,Urine strip test ,Diagnostic test ,Acute hot joint ,Diseases of the musculoskeletal system ,RC925-935 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Backgrounds Septic arthritis is a dangerous disease that occurs when microorganisms enter synovial fluid. It needs fast and accurate management; otherwise, it can harm the patient’s life. Currently, the tests measure WBC and PMN in SF, so we hypothesized to use a proxy that is easier and faster to measure. Leukocyte esterase is an enzyme secreted by neutrophils that can be found in the synovial fluid of SA patients. In this study, we tried to investigate the sensitivity and specificity of leukocyte esterase in diagnosing septic arthritis. Methods We obtained synovial fluid samples from forty-six patients suspected of having septic arthritis and fifty-eight healthy individuals and measured the WBCs, ESR, CRP, PMN, glucose, and protein of SF in 2021. We also used the leukocyte esterase dipstick test to investigate the level of LE in synovial fluid for one minute. Results Based on clinical and paraclinical criteria, sixteen out of the forty-six patients were diagnosed with SA. When (++) was considered positive, the sensitivity and specificity of the LE dipstick test for the diagnosis of SA were 93.7% (95% CI: 81.8–100%) and 60% (95% CI: 42.4–77.5%, P = 0.000), respectively. When both (+) and (++) were considered positive, they were 100% and 43.3% (95% CI: 25.6–61.0% P = 0.000), respectively. All the patients in the control group had negative cultures and LE test readings (specificity = 100%). Conclusion The LE dipstick test can be a valuable diagnostic tool in the initial diagnosis of SA since it is affordable, fast, and reliable.
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- 2024
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22. Pathogenesis and modern methods for treatment of hip infectious arthritis: a review
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Denis I. Astakhov and Vasily A. Artyukh
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infectious arthritis ,septic arthritis ,coxitis ,hip joint ,Orthopedic surgery ,RD701-811 - Abstract
Background. One of the little-studied but long-known problems is determining the optimal treatment regimen for patients with infectious arthritis of the hip joint. Existing studies offer various methods of conservative and surgical treatment, which, however, do not have a fundamental evidence base. The polyetiology and variability of the clinical manifestations of infectious arthritis of the hip joint and the severity of the consequences in case of incorrectly chosen tactics require a differentiated approach to treatment and development of certain diagnostic and treatment algorithms. The aim of the review – to identify pathogenesis factors that are significant for the choice of treatment tactics and to analyze modern methods of treating infectious arthritis of the hip joint based on the data from available medical literature. Methods. For analysis, we selected 90 foreign and domestic sources published between 1997 and 2023. Inclusion criteria were: clinical studies, analytical reviews and meta-analyses of the literature. The search was performed in eLIBRARY, PubMed and Google Scholar databases. Results. The analysis showed that, despite the comparable effectiveness and advantages of individual treatment methods, their use is limited to certain indications, and the choice of the optimal one for a particular patient should take into account many etiopathogenetic factors, clinical, laboratory and instrumental data, the role of which is still insufficiently studied. Currently, throughout the world the “gold standard” for radical surgical treatment remains the technique of two-stage hip arthroplasty using an antibacterial spacer. However, encouraging results of alternative treatment methods require continued search for ways to optimize diagnostic and therapeutic tactics.
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- 2024
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23. Sternoclavicular septic arthritis, a late complication after surgical tracheostomy: A case report
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Pedro Marques Gomes, Diogo Cabral, Joana Barreto, Fátima Hierro, Delfim Duarte, and José Ferreira Penêda
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Septic arthritis ,sternoclavicular joint ,suppurative arthritis ,surgical management ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Septic arthritis of the sternoclavicular joint is a rare condition. The diagnosis of sternoclavicular septic arthritis as a late complication of surgical tracheostomy is extremely uncommon. A case study is presented of a man in his 70s who experienced painful swelling of the right sternoclavicular joint three months after elective surgical tracheostomy. The diagnosis was made based on clinical history and examination. The patient achieved a full recovery following antibiotic treatment and surgical drainage. This report is the second documented case of sternoclavicular septic arthritis resulting from surgical tracheostomy.
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- 2024
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24. Septic arthritis of the wrist: A case of Parona space abscess in a rheumatoid arthritis patient with Charcot wrist
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Zainab Mashaalla Ahmed, MB, BCh, BAO, Huda Alsahlawi, MD, and Rola Husain, MB, BCh, BAO
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Parona space ,Wrist infection ,Tenosynovitis ,Septic arthritis ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Closed-space hand infections are considered an emergency requiring prompt management to avoid debilitating consequences and potential morbidity. Septic arthritis of the wrist is particularly uncommon in comparison to the large joints that are usually affected. We report a case of a 64-year-old female with known rheumatoid arthritis and neuropathic wrist, with superimposed septic arthritis of the wrist, complicated by abscess formation. Ultrasound and Magnetic resonance imaging revealed spread of infection to the midpalmar region and the space of Parona. Although collections in this space are extremely rare, if left untreated, they may lead to permanent disability. Incision and drainage of the abscess along with synovectomy of the affected wrist joint was performed. Streptococcus pneumoniae was the causative organism, despite the fact that Non-gonococcal and Staphylococcus aureus bacteria are the main causative agents of septic arthritis in adults.
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- 2024
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25. Hematogenous Osteomyelitis and Septic Arthritis in Children
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Fenlon, Edward P., III, Karmazyn, Boaz, Kim, John Y., Jaramillo, Diego, Medina, L. Santiago, Series Editor, Applegate, Kimberly E., Series Editor, Blackmore, C. Craig, Series Editor, Otero, Hansel J., editor, and Kaplan, Summer L., editor
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- 2024
- Full Text
- View/download PDF
26. Postinfectious Deformities of the Lower Limb
- Author
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Choi, In Ho, Shin, Chang Ho, Sabharwal, Sanjeev, editor, and Iobst, Christopher A., editor
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- 2024
- Full Text
- View/download PDF
27. Infections About the Hand
- Author
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Rojas-Neira, Juliana A., Slullitel, Pablo, editor, Rossi, Luciano, editor, and Camino-Willhuber, Gastón, editor
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- 2024
- Full Text
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28. Possibilities and Limitations of Total Ankle Arthroplasty
- Author
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Hintermann, Beat, Ruiz, Roxa, Hintermann, Beat, and Ruiz, Roxa
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- 2024
- Full Text
- View/download PDF
29. Basic Considerations for Total Ankle Arthroplasty
- Author
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Hintermann, Beat, Ruiz, Roxa, Hintermann, Beat, and Ruiz, Roxa
- Published
- 2024
- Full Text
- View/download PDF
30. Surgical Management of Knee Septic Arthritis
- Author
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Matthew Wells, Principal Investigator
- Published
- 2023
31. Next-Generation Sequencing for Pathogen Detection and Quantification in Children With Musculoskeletal Infections (KDG-002)
- Author
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Karius, Inc. and Jack Schneider, Assistant Professor of Clinical Medicine and Clinical Pediatrics
- Published
- 2023
32. Dalbavancin For The Treatment of Gram Positive Osteoarticular Infections
- Author
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Johns Hopkins University
- Published
- 2023
33. Arthrocentesis of suspected septic sternoclavicular arthritis: microbial yield and predictors of culture positivity.
- Author
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Symanski, John S., Arnold, Joshua, Buchanan, Mary E., Punathil, Ritika, Tuite, Michael J., and Ross, Andrew B.
- Subjects
- *
INFECTIOUS arthritis , *LEUKOCYTE count , *ARTHROCENTESIS , *BLOOD sedimentation , *SYNOVIAL fluid , *ELECTRONIC health records - Abstract
Objective: Evaluate the microbial yield and factors predicting culture positivity for image-guided arthrocentesis of suspected septic sternoclavicular (SC) arthritis. Materials and methods: An electronic health record search identified image-guided SC joint aspirations for suspected septic arthritis. Data was extracted by retrospective chart review including patient demographics, procedure characteristics, pre-procedure lab testing, joint culture results, final SC joint diagnoses and any effect of positive synovial cultures on subsequent antibiotic therapy. Factors associated with positive joint fluid cultures were assessed using a Chi-squared test for categorical predictors and logistic regression for continuous predictors. Results: A total of 31 SC arthrocenteses met inclusion criteria with most (81%) performed using ultrasound guidance. Synovial fluid was successfully aspirated in 19/31 (61%) of cases, and in all other cases lavage fluid was successfully obtained. Synovial cultures were positive in 9/31 (29%) of cases. A final diagnosis of septic arthritis was assigned to 20/31 cases (65%) in which 9/20 (45%) had positive synovial cultures. There was no statistically significant association between synovial culture positivity and risk factors for septic arthritis, positive blood cultures, pre-aspiration antibiotics and whether synovial fluid or lavage fluid was cultured. Serum white blood cell count (WBC) and erythrocyte sedimentation rate (ESR) demonstrated statistically significant positive correlation with positive synovial cultures. Conclusion: Arthrocentesis is effective for microbial speciation in SC septic arthritis, and diagnostic yield may be increased with lavage when encountering a dry tap. Normal serum WBC and ESR values indicate an extremely low likelihood of positive synovial cultures. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
34. Lower extremity infections: Essential anatomy and multimodality imaging findings.
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Matcuk Jr., George R., Skalski, Matthew R., Patel, Dakshesh B., Fields, Brandon K. K., Waldman, Leah E., Spinnato, Paolo, Gholamrezanezhad, Ali, and Katal, Sanaz
- Subjects
- *
SOFT tissue infections , *INFECTIOUS arthritis , *ANATOMY , *EXTREMITIES (Anatomy) , *INFECTION - Abstract
In modern practice, imaging plays an integral role in the diagnosis, evaluation of extent, and treatment planning for lower extremity infections. This review will illustrate the relevant compartment anatomy of the lower extremities and highlight the role of plain radiographs, CT, US, MRI, and nuclear medicine in the diagnostic workup. The imaging features of cellulitis, abscess and phlegmon, necrotizing soft tissue infection, pyomyositis, infectious tenosynovitis, septic arthritis, and osteomyelitis are reviewed. Differentiating features from noninfectious causes of swelling and edema are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
35. Imaging assessment of spine infection.
- Author
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Laur, Olga, Schonberger, Alison, Gunio, Drew, Minkowitz, Shlomo, Salama, Gayle, Burke, Christopher J., and Bartolotta, Roger J.
- Subjects
- *
INFECTIOUS arthritis , *SPINE , *ZYGAPOPHYSEAL joint , *IMAGE analysis , *JOINT infections , *INFECTION , *RADIOGRAPHS , *OSTEITIS , *SPINAL surgery - Abstract
This article comprehensively reviews current imaging concepts in spinal infection with primary focus on infectious spondylodiscitis (IS) as well as the less common entity of facet joint septic arthritis (FSA). This review encompasses the multimodality imaging appearances (radiographs, CT, MRI, and nuclear imaging) of spinal infection—both at initial presentation and during treatment—to aid the radiologist in guiding diagnosis and successful management. We discuss the pathophysiology of spinal infection in various patient populations (including the non-instrumented and postoperative spine) as well as the role of imaging-guided biopsy. We also highlight several non-infectious entities that can mimic IS (both clinically and radiologically) that should be considered during image interpretation to avoid misdiagnosis. These potential mimics include the following: Modic type 1 degenerative changes, acute Schmorl's node, neuropathic spondyloarthropathy, radiation osteitis, and inflammatory spondyloarthropathy (SAPHO syndrome). [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
36. Imaging of MSK infections in the ER.
- Author
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Kompel, Andrew and Guermazi, Ali
- Subjects
- *
OSTEOMYELITIS , *INFECTION , *INFECTIOUS arthritis , *CELLULITIS , *FASCIAE (Anatomy) , *SKIN - Abstract
Musculoskeletal infections in the ER are not an uncommon presentation. The clinical context is critical in determining the suspicion for infection and degree of tissue involvement which can involve all layers from the skin to bones. The location, extent, and severity of clinically suspected infection directly relate to the type of imaging performed. Uncomplicated cellulitis typically does not require any imaging. Localized and superficial infections can mostly be evaluated with ultrasound. If there is a diffuse site (an entire extremity) or suspected deeper involvement (muscle/deep fascia), then CT is accurate in diagnosing, widely available, and performed quickly. With potential osseous involvement, MRI is the gold standard for diagnosing acute osteomyelitis; however, it has the drawbacks of longer scan times, artifacts including patient motion, and limited availability. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
37. De novo vesico-acetabular fistula presenting with septic arthritis: Case report and literature review
- Author
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Mohammad Danish Mangi, MBBS and WanYin Lim, MBChB, FRANZCR
- Subjects
Vesicoacetabular ,Fistula ,Arthroplasty ,Septic arthritis ,Pelvic fracture ,Calcium hydroxyapatite deposition disease ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Vesico-acetabular fistula formation is a rare condition typically associated with total hip arthroplasty. Clinical features can include pain of the hip and flank, haematuria, and dysuria. We report the case of a 67-year-old female with a past medical history of bilateral pelvic fractures and calcium hydroxyapatite deposition disease of the hip joint, who developed vesico-acetabular fistula in the absence of surgery. This was then complicated by septic arthritis. We highlight the ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI) findings of the case and review the previous case reports describing the vesico-acetabular fistula.
- Published
- 2024
- Full Text
- View/download PDF
38. Simultaneous Salmonella septic arthritis and naïve tricuspid valve endocarditis: A case report
- Author
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Mahnaz Arian, Farideh Najm Sarvari, Moein Mohebbi, and Marzieh Kazerani
- Subjects
salmonella ,septic arthritis ,infective endocarditis ,tricuspid valve ,Internal medicine ,RC31-1245 - Abstract
Background: Salmonella osteoarticular involvement is a rare complication, occurring in about 2% of the cases. Septic arthritis is exceedingly rare, involving only 0.2 % of all salmonellosis patients. Endocarditis is another complication that occurs in less than 0.8 % of cases. These complications are more likely to happen among immunocompromised patients. Case Presentation: We report a previously healthy 25-year-old man who presented with left limb pain. He had been treated for brucellosis ten days earlier by his primary care physician. Arthrocentesis and subsequent hip-joint biopsy confirmed septic arthritis due to Salmonella. However, he was unresponsive to the treatment. We found no underlying immunosuppression. A trans-esophageal echo was performed due to the continued fever and positive blood cultures. It revealed Salmonella endocarditis of the naïve tricuspid valve. He was treated via arthrotomy and antimicrobials for four weeks. Follow-up after 20 months showed no underlying immunosuppression. Conclusion: This case highlights that in patients with positive Salmonella blood cultures and a focus of infection compatible with Salmonellosis but unresponsive to treatment, searching for other foci of infection is necessary. Furthermore, physicians in endemic areas of brucellosis should consider other differential diagnoses in patients with fever and limping because any delay in diagnosing Salmonella septic arthritis can destroy the joint space with lifelong discomfort.
- Published
- 2024
39. Pharmacokinetics of amikacin after intravenous, intra‐articular, and combined intravenous and intra‐articular administration in healthy neonatal foals
- Author
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Jillian L. Paegelow, Mike J. Schoonover, Jenna M. Young, Lara K. Maxwell, Jared D. Taylor, Lyndi L. Gilliam, and Todd C. Holbrook
- Subjects
aminoglycoside ,antibiotic ,antimicrobial ,neonatology ,sepsis ,septic arthritis ,Veterinary medicine ,SF600-1100 - Abstract
Abstract Background Pharmacokinetics of amikacin administered IV to neonatal foals are described, but little data are available regarding the plasma concentrations contributed by concurrent intra‐articular (IA) administration. Hypothesis/Objectives Compare the pharmacokinetics of amikacin when the total dose is administered IV compared to being divided between IV and IA routes of administration in neonatal foals and predict the plasma concentrations from various combined IV and IA dosing regimens. Animals Eight healthy neonatal foals. Methods Foals received 3 amikacin treatment protocols: (1) IV‐only (25 mg/kg q24h IV), (2) concurrent IV and IA (16.7 mg/kg q24h IV and 8.3 mg/kg q24h into 1 tarsocrural joint), and (3) IA‐only (8.3 mg/kg q24h into 1 tarsocrural joint). Protocols were administered for 3 days beginning at 7, 14, and 21 days of age. Plasma concentrations ≥53 μg/mL at 30 minutes were considered therapeutic for isolates with intermediate susceptibility. Results Foal age was a significant variable. The IV‐only protocol met or exceeded the 30‐minute plasma concentrations considered therapeutic (mean μg/mL [95% confidence interval, CI]) in 7‐ to 9‐day‐old (54.0 [52.2‐56.9]), 14‐ to 16‐day‐old (58.1 [55.2‐61.0]), and 21‐ to 23‐day‐old (66.6 [63.7‐69.6]) foals. Concurrent IV and IA protocol did not reach the 30‐minute concentration considered therapeutic in 7‐ to 9‐day‐old foals (46.5 [43.6‐49.4]) but did in 14‐ to 16‐day‐old (62.9 [60.0‐65.8]) and 21‐to 23‐day‐old (62.6 [59.7‐65.6]) foals. Conclusions and Clinical Importance Concurrent IV and IA administration of amikacin produces 30‐minute plasma concentrations considered therapeutic in foals 14 to 23 days old, but concentrations observed in younger foals might be below those considered therapeutic for isolates with intermediate susceptibility to amikacin.
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- 2024
- Full Text
- View/download PDF
40. Left knee septic monoarthritis in a pediatric patient due to shewanella putrefaciens: case report and literature review
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Nathalie Yepes Madrid, Luis Fernando Mejia, and José Fernando Gomez Urrego
- Subjects
Septic arthritis ,Shewanella putrefaciens ,Pediatrics ,Colombia ,Penetrating wound ,Therapeutics. Pharmacology ,RM1-950 ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,QR1-502 - Abstract
Abstract Background Shewanella putrefaciens is a gram-negative, nonfermenting, oxidase-positive, hydrogen sulfide-producing bacillus and a halophilic bacterium, known for causing unusual infections in humans and often regarded as an opportunistic pathogen. Its diverse symptoms have a significant impact on human health, with 260 documented disorders reported in the literature over the last 40 years, highlighting its potential danger. Case presentation We present the case of a previously healthy 15-year-old male patient who sustained a self-inflicted sharp-object injury while working in the field, resulting in secondary septic monoarthritis due to Shewanella putrefaciens. Conclusions This case highlights the bacteriological and clinical characteristics, as well as the antibiogram, of Shewanella spp. Given the recent increase in notifications of Shewanella infections, predominantly by S. algae and S. putrefaciens, it is essential to consider these pathogens in patients with a history of contact with bodies of water. Special attention must be paid to their resistance patterns in patient management to prevent the development of intrinsic antimicrobial resistance.
- Published
- 2024
- Full Text
- View/download PDF
41. Demonstrating antibiotic stewardship while diagnosing and treating bilateral pseudoseptic arthritis: a case report
- Author
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Rae Tarapore, Sierra Lindsey, Paige Strickland, and Robert McKinstry
- Subjects
Pseudoseptic arthritis ,Case report ,Antibiotic stewardship ,Septic arthritis ,Medicine - Abstract
Abstract Introduction Although viscosupplementation is a commonly used treatment for osteoarthritis and is widely regarded as a safe treatment option, it is associated with the rare complication of pseudoseptic arthritis. Most existing case reports that cite this rare complication employed the use of early broad-spectrum antibiotics. Case presentation In this case report, we present a 61-year-old African American female patient who presented with bilateral knee pseudoseptic arthritis in the setting of viscosupplementation. She presented 3 days after bilateral viscosupplementation injections with bilateral knee swelling, discomfort, and pain with micromotion. Her white blood cell count (WBC) was 12.83 (4.5–11 normal), her C-reactive protein (CRP) level was 159 mg/L (0–10 normal), and her erythrocyte sedimentation rate (ESR) was 79 mm/hour (0–40 normal). Her left knee aspirate yielded 38,580 WBC with a negative gram stain and negative cultures. Her right knee aspirate yielded 29,670 WBC with a negative gram stain and negative cultures. Through the utilization of careful clinical monitoring, ice therapy, and non-steroidal inflammatory medication, we were able to successfully treat this patient while maintaining proper antibiotic stewardship. Conclusion Pseudoseptic arthritis in the setting of viscosupplementation can be adequately treated and monitored without the use of antibiotics.
- Published
- 2024
- Full Text
- View/download PDF
42. Outcomes of paediatric septic arthritis patients: rates of re-admission, re-operation, and unplanned emergency room visits after discharge.
- Author
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Ng, Kelvin, Willegger, Madeleine, and Bouchard, Maryse
- Subjects
- *
EMERGENCY room visits , *INFECTIOUS arthritis , *REOPERATION , *PEDIATRICS , *SYNOVIAL fluid , *HIP joint - Abstract
Purpose: This study is aimed at determining the rates and predictors of re-operation and re-admission in children with septic arthritis treated at an institution without routine clinical practice guidelines. Methods: This is a retrospective cohort study of patients less than 18 years old who underwent surgery for septic arthritis between January 1, 2009, and January 1, 2019, at a single tertiary-care paediatric institution. Uni- and multivariate analysis was performed to identify any risk factors associated with re-operation or unplanned visits to the emergency department after hospital admission compared to patients who had an uncomplicated post-operative course. Results: One hundred and forty-four patients were included. The mean age was five years (range 1 month–17 years), and the most commonly affected joint was the hip. The re-admission rate was 1% (n = 2), and the re-operation rate was 8% (n = 12). Twenty percent of patients (n = 29) had unplanned presentations to the emergency department (ED) after discharge. Discharge CRP level was not significantly higher in patients with unplanned presentations to the ED or re-operation. Positive joint fluid culture and infection of any other joint than the hip increased the likelihood of re-operation. Patients who had septic arthritis of the hip were more likely to have an unplanned ED presentation. Conclusions: Rates of re-admission and re-operation were similar to literature despite lack of a standardized treatment pathway or discharge protocol. Outcomes of pediatric septic arthritis did not correlate with discharge CRP level. There was a high rate of unplanned ED visits after discharge. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
43. Early Intervention in Septic Arthritis of the Hand, Optimizing Patient Outcomes in Hand Infections—A Five-Year Retrospective Study.
- Author
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Hodea, Florin-Vlad, Grosu-Bularda, Andreea, Teodoreanu, Razvan Nicolae, Cretu, Andrei, Ratoiu, Vladut-Alin, Lascar, Ioan, and Hariga, Cristian-Sorin
- Subjects
INFECTIOUS arthritis ,DRUG resistance in bacteria ,TREATMENT effectiveness ,SYMPTOMS ,BACTERIAL growth ,RETROSPECTIVE studies - Abstract
Background and Objectives: Hand septic arthritis is a potentially debilitating condition that can significantly affect patient functionality and quality of life. Understanding the demographic, clinical, and microbiological characteristics of this condition is crucial for its effective treatment and management. This study aimed to analyze the demographic and clinical profiles of patients with hand septic arthritis, to identify common microbial pathogens, and to evaluate the impact of various factors on clinical course and treatment outcomes. Material and Methods: This cross-sectional retrospective study examined patients diagnosed with septic arthritis of the hand, focusing on their demographic data, clinical presentation, causative organisms, treatment methods, and outcomes. Data on age, sex, cause of infection, affected sites, surgical interventions, microbiological findings, and patient outcomes were also collected. Results: This study found a higher prevalence of septic arthritis in males and identified bite as the predominant cause. Staphylococcus aureus is the most common pathogen. A large number of patients did not exhibit bacterial growth, and bacterial resistance did not significantly affect the outcome. Outcomes were statistically influenced by the timing of medical presentation and the presence of comorbidities. Conclusions: Early diagnosis and intervention are critical for effective management of hand septic arthritis. This study underscores the need for a comprehensive approach that considers patient demographic and clinical characteristics to optimize treatment outcomes. Awareness and preventive measures are essential to reduce the incidence and severity of this condition. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
44. Septic arthritis of the cervical facet joint: Clinical report and review of the literature.
- Author
-
Quoilin, Melanie, Vu, Peter D., Bansal, Vishal, and Chen, Jason W.
- Abstract
Background Objective Methods Results Conclusions Facet joint septic arthritis (FJSA) is an uncommon cause of neck pain, most frequently occurring in the lumbosacral spine. Cervical facet joint septic arthritis is particularly rare. Symptoms typically include spinal or paraspinal pain and tenderness, with severe infections potentially causing neurological impairments. This condition can progress to discitis and osteomyelitis. High clinical suspicion is required for accurate diagnosis and timely treatment.To present the first known case of cervical spine FJSA caused by Moraxella species and provide an updated narrative review of cervical spine FJSA.A case study of a 66‐year‐old male with cervical spine FJSA caused by Moraxella osloensis is detailed. Additionally, a librarian‐assisted literature search was conducted on MEDLINE Pubmed, filtering for adult human trials and including various study types, resulting in the inclusion of 9 relevant manuscripts.The patient’s symptoms included neck, right upper thoracic, and periscapular pain, with episodes of numbness and tingling. MRI revealed septic arthritis at the C7‐T1 facet joint and associated osteomyelitis. Cultures identified Moraxella osloensis as the causative agent. The patient was successfully treated with antibiotics and experienced significant symptom improvement. Literature review highlights that Staphylococcus aureus is the most common causative agent of cervical FJSA, with diagnosis typically involving MRI and culture tests. Treatment generally includes long‐term antibiotics, with some cases requiring surgical intervention.This report underscores the need for high clinical suspicion in diagnosing FJSA and highlights the importance of early intervention. It documents the first known case of cervical spine FJSA caused by Moraxella osloensis, contributing valuable information to the limited literature on this rare condition. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
45. Demonstrating antibiotic stewardship while diagnosing and treating bilateral pseudoseptic arthritis: a case report.
- Author
-
Tarapore, Rae, Lindsey, Sierra, Strickland, Paige, and McKinstry, Robert
- Subjects
- *
INFECTIOUS arthritis , *ANTIMICROBIAL stewardship , *LEUKOCYTE count , *GRAM-negative bacteria , *BLOOD sedimentation , *ARTHRITIS - Abstract
Introduction: Although viscosupplementation is a commonly used treatment for osteoarthritis and is widely regarded as a safe treatment option, it is associated with the rare complication of pseudoseptic arthritis. Most existing case reports that cite this rare complication employed the use of early broad-spectrum antibiotics. Case presentation: In this case report, we present a 61-year-old African American female patient who presented with bilateral knee pseudoseptic arthritis in the setting of viscosupplementation. She presented 3 days after bilateral viscosupplementation injections with bilateral knee swelling, discomfort, and pain with micromotion. Her white blood cell count (WBC) was 12.83 (4.5–11 normal), her C-reactive protein (CRP) level was 159 mg/L (0–10 normal), and her erythrocyte sedimentation rate (ESR) was 79 mm/hour (0–40 normal). Her left knee aspirate yielded 38,580 WBC with a negative gram stain and negative cultures. Her right knee aspirate yielded 29,670 WBC with a negative gram stain and negative cultures. Through the utilization of careful clinical monitoring, ice therapy, and non-steroidal inflammatory medication, we were able to successfully treat this patient while maintaining proper antibiotic stewardship. Conclusion: Pseudoseptic arthritis in the setting of viscosupplementation can be adequately treated and monitored without the use of antibiotics. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
46. Left knee septic monoarthritis in a pediatric patient due to shewanella putrefaciens: case report and literature review.
- Author
-
Madrid, Nathalie Yepes, Mejia, Luis Fernando, and Urrego, José Fernando Gomez
- Subjects
SHEWANELLA putrefaciens ,CHILD patients ,LITERATURE reviews ,GRAM-negative bacteria ,HALOBACTERIUM ,HALOMONAS (Bacteria) - Abstract
Background: Shewanella putrefaciens is a gram-negative, nonfermenting, oxidase-positive, hydrogen sulfide-producing bacillus and a halophilic bacterium, known for causing unusual infections in humans and often regarded as an opportunistic pathogen. Its diverse symptoms have a significant impact on human health, with 260 documented disorders reported in the literature over the last 40 years, highlighting its potential danger. Case presentation: We present the case of a previously healthy 15-year-old male patient who sustained a self-inflicted sharp-object injury while working in the field, resulting in secondary septic monoarthritis due to Shewanella putrefaciens. Conclusions: This case highlights the bacteriological and clinical characteristics, as well as the antibiogram, of Shewanella spp. Given the recent increase in notifications of Shewanella infections, predominantly by S. algae and S. putrefaciens, it is essential to consider these pathogens in patients with a history of contact with bodies of water. Special attention must be paid to their resistance patterns in patient management to prevent the development of intrinsic antimicrobial resistance. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
47. Pharmacokinetics of amikacin after intravenous, intra‐articular, and combined intravenous and intra‐articular administration in healthy neonatal foals.
- Author
-
Paegelow, Jillian L., Schoonover, Mike J., Young, Jenna M., Maxwell, Lara K., Taylor, Jared D., Gilliam, Lyndi L., and Holbrook, Todd C.
- Subjects
- *
FOALS , *INTRAVENOUS therapy , *AMIKACIN , *PHARMACOKINETICS , *MEDICAL protocols - Abstract
Background: Pharmacokinetics of amikacin administered IV to neonatal foals are described, but little data are available regarding the plasma concentrations contributed by concurrent intra‐articular (IA) administration. Hypothesis/Objectives: Compare the pharmacokinetics of amikacin when the total dose is administered IV compared to being divided between IV and IA routes of administration in neonatal foals and predict the plasma concentrations from various combined IV and IA dosing regimens. Animals: Eight healthy neonatal foals. Methods: Foals received 3 amikacin treatment protocols: (1) IV‐only (25 mg/kg q24h IV), (2) concurrent IV and IA (16.7 mg/kg q24h IV and 8.3 mg/kg q24h into 1 tarsocrural joint), and (3) IA‐only (8.3 mg/kg q24h into 1 tarsocrural joint). Protocols were administered for 3 days beginning at 7, 14, and 21 days of age. Plasma concentrations ≥53 μg/mL at 30 minutes were considered therapeutic for isolates with intermediate susceptibility. Results: Foal age was a significant variable. The IV‐only protocol met or exceeded the 30‐minute plasma concentrations considered therapeutic (mean μg/mL [95% confidence interval, CI]) in 7‐ to 9‐day‐old (54.0 [52.2‐56.9]), 14‐ to 16‐day‐old (58.1 [55.2‐61.0]), and 21‐ to 23‐day‐old (66.6 [63.7‐69.6]) foals. Concurrent IV and IA protocol did not reach the 30‐minute concentration considered therapeutic in 7‐ to 9‐day‐old foals (46.5 [43.6‐49.4]) but did in 14‐ to 16‐day‐old (62.9 [60.0‐65.8]) and 21‐to 23‐day‐old (62.6 [59.7‐65.6]) foals. Conclusions and Clinical Importance: Concurrent IV and IA administration of amikacin produces 30‐minute plasma concentrations considered therapeutic in foals 14 to 23 days old, but concentrations observed in younger foals might be below those considered therapeutic for isolates with intermediate susceptibility to amikacin. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
48. Infection after Anterior Cruciate Ligament Reconstruction: A Narrative Review of the Literature.
- Author
-
Cassano, Giuseppe Danilo, Moretti, Lorenzo, Vicenti, Giovanni, Buono, Claudio, Albano, Federica, Ladogana, Teresa, Rausa, Igor, Notarnicola, Angela, and Solarino, Giuseppe
- Subjects
ANTIBIOTICS ,PHYSICAL diagnosis ,MEDICAL history taking ,ARTHROCENTESIS ,ANTERIOR cruciate ligament injuries ,ANTERIOR cruciate ligament surgery ,INFECTIOUS arthritis ,ARTHROSCOPY ,SYNOVIAL fluid ,SURGICAL complications ,DEBRIDEMENT ,DISEASE risk factors ,DISEASE complications ,SYMPTOMS - Abstract
Infection is an uncommon side effect of arthroscopic surgery, and this percentage is higher in anterior cruciate ligament reconstruction (ACLR) surgery, where graft and fixation devices are used. Infections can not only lead to high re-admission rates and poor functional recovery of the knee but can also have a significant negative impact on the patient's psychological and economic health, especially in athletes, as it can affect their sports career. It is important to be aware of the many risk factors, especially the manifestation of symptoms. These may sometimes be non-specific to the infectious pathology and common to other situations, such as the presence of a significant intra-articular hematoma. Septic arthritis after ACLR can occur at any time after surgery but typically presents acutely, while late manifestation is relatively rare. Diagnosis of infection is based on patient history, physical examination, laboratory parameters, and analysis of synovial fluid after joint aspiration, which is the gold standard for diagnosing post-operative infection. Once symptoms appear and the diagnosis seems certain, it is necessary to intervene quickly with arthroscopic debridement and long-term antibiotic treatment to try to save the graft and resolve the infectious situation to avoid graft failure and arthrofibrotic sequelae. The aim of this paper is to provide an overview of the epidemiology, pathogenesis, risk factors, clinical presentation, diagnostic evaluation, and current treatment guidelines of septic arthritis after ACLR surgery by analyzing recent literature, in particular meta-analyses and systematic reviews. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
49. Septic Arthritis of the Manubriosternal Joint in an Adolescent: A Case Report.
- Author
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Soongang Park and Joon Kee Lee
- Subjects
- *
INFECTIOUS arthritis , *CHEST pain , *FEVER , *METHICILLIN-resistant staphylococcus aureus , *PATHOGENESIS - Published
- 2024
- Full Text
- View/download PDF
50. Clinical and radiological septic joint analysis of spontaneous sternoclavicular joint infections: achieving the best outcomes—a systems engineering approach.
- Author
-
Pothini, Tanushri, Wilmot, Charles D, Waters, John K, Wait, Michael A, Reznik, Scott I, Jordan, Kirk G, Caire, Jacqueline T, Ashworth, John M, Cady, Leah C, Lysikowski, Jerzy R, Yen, Christina F, Weinschenk, Robert C, Samade, Richard, Jessen, Michael E, Kusiak, Andrew, and Kernstine, Kemp H
- Subjects
- *
STERNOCLAVICULAR joint , *INDUSTRIAL engineers , *SYSTEMS engineering , *JOINT infections , *SURGICAL excision , *COMMUNICABLE diseases , *INFECTIOUS arthritis - Abstract
Open in new tab Download slide OBJECTIVES Spontaneous sternoclavicular joint infection (SSCJI) is a rare and poorly understood disease process. This study aims to identify factors guiding effective management strategies for SSCJI by using data mining. METHODS An Institutional Review Board-approved retrospective review of patients from 2 large hospitals (2010–2022) was conducted. SSCJI is defined as a joint infection without direct trauma or radiation, direct instrumentation or contiguous spread. An interdisciplinary team consisting of thoracic surgeons, radiologists, infectious disease specialists, orthopaedic surgeons, hospital information experts and systems engineers selected relevant variables. Small set data mining algorithms, utilizing systems engineering, were employed to assess the impact of variables on patient outcomes. RESULTS A total of 73 variables were chosen and 54 analysed against 11 different outcomes. Forty-seven patients [mean age 51 (22–82); 77% male] met criteria. Among them, 34 underwent early joint surgical resection (<14 days), 5 patients received delayed surgical intervention (>14 days) and 8 had antibiotic-only management. The antibiotic-only group had comparable outcomes. Indicators of poor outcomes were soft tissue fluid >4.5 cm, previous SSCJI, moderate/significant bony fragments, HgbA1c >13.9% and moderate/significant bony sclerosis. CONCLUSIONS This study suggests that targeted antibiotic-only therapy should be considered initially for SSCJI cases while concurrently managing comorbidities. Patients displaying indicators of poor outcomes or no symptomatic improvement after antibiotic-only therapy should be considered for surgical joint resection. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
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