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Infectious Disease Clinics of North America

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https://www.readbyqxmd.com/read/28366224/management-of-prosthetic-joint-infection
#1
REVIEW
Aaron J Tande, Eric O Gomez Urena, Elie F Berbari, Douglas R Osmon
Although uncommon, prosthetic joint infection is a devastating complication. This challenging condition requires a coordinated management approach to achieve good patient outcomes. This review details the general principles to consider when managing patients with prosthetic joint infection. The different medical/surgical treatment strategies and how to appropriately select a strategy are discussed. The data to support each strategy are presented, along with discussion of antimicrobial strategies in specific situations...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28366223/radiologic-approach-to-musculoskeletal-infections
#2
REVIEW
Claus S Simpfendorfer
Imaging is often used to establish a diagnosis of musculoskeletal infections and evaluate the full extent and severity of disease. Imaging should always start with radiographs, which provide an important anatomic overview. MRI is the test of choice in most musculoskeletal infections because of its superior soft tissue contrast resolution and high sensitivity for pathologic edema. However, MRI is not always possible. Alternative imaging modalities including ultrasound scan, computed tomography, and radionuclide imaging may be used...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28366222/infections-of-the-spine
#3
REVIEW
Maja Babic, Claus S Simpfendorfer
Pyogenic infections of the bony spinal column and the intervertebral discs are on a steady rise in an aging western population. Despite advanced medical imaging, this clinical entity of devastating consequences if missed, still presents a diagnostic conundrum and is plagued by an unacceptably long diagnostic delay. The aim of this article is to raise awareness of the heterogeneity of spinal infections paralleling the complex structure of the spinal column and neighboring soft tissues. Emphasis is placed on the clinical presentation and management of septic facet joints and psoas muscle abscesses associated with lumbar spondylodiscitis...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28366221/septic-arthritis-of-native-joints
#4
REVIEW
John J Ross
Septic arthritis is a rheumatologic emergency that may lead to disability or death. Prompt evacuation of the joint, either by arthrocentesis at the bedside, open or arthroscopic drainage in the operating room, or imaging-guided drainage in the radiology suite, is mandatory. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of septic arthritis in the United States. MRSA joint infection seems to be associated with worse outcomes. Antibiotic courses of 3 to 4 weeks in duration are usually adequate for uncomplicated bacterial arthritis...
March 30, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28292542/prevention-of-infection-in-open-fractures
#5
REVIEW
Charalampos G Zalavras
Open fractures are complex injuries that are associated with increased risk for complications, such as infection and nonunion. The goals of open fracture management are prevention of infection, fracture union, and restoration of function. These goals are best achieved by careful patient and injury assessment, early administration of systemic antibiotics supplemented by local delivery of antibiotics in severe injuries, thorough surgical debridement, wound management with soft tissue coverage if needed, and stable fracture fixation...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28292541/mycobacterial-musculoskeletal-infections
#6
REVIEW
John I Hogan, Rocío M Hurtado, Sandra B Nelson
Although less common as causes of musculoskeletal infection than pyogenic bacteria, both Mycobacterium tuberculosis and nontuberculous mycobacteria can infect bones and joints. Although tuberculous arthritis and osteomyelitis have been recognized for millennia, infections caused by nontuberculous mycobacteria are being identified more often, likely because of a more susceptible host population and improvements in diagnostic capabilities. Despite advances in modern medicine, mycobacterial infections of the musculoskeletal system remain particularly challenging to diagnose and manage...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28292540/reactive-arthritis
#7
REVIEW
Steven K Schmitt
Reactive arthritis is classified as a spondyloarthropathy. Current concepts of disease suggest an infectious trigger, followed by inflammatory arthritis. Several mechanisms have been proposed to explain the interaction of host susceptibility and microorganism. Diagnosis relies on a compatible clinical syndrome and microbiologic confirmation of the pathogen. Antibiotic therapy seems useful in Chlamydia-triggered arthritis. The role of antibiotics in arthritis triggered by enteric pathogens is less clear. The role of tumor necrosis factor alpha inhibitors in therapy is evolving...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28292539/prevention-of-infection-in-orthopedic-prosthetic-surgery
#8
REVIEW
Ioana Chirca, Camelia Marculescu
Total joint arthroplasty is a generally safe orthopedic procedure; however, infection is a potentially devastating complication. Multiple risk factors have been identified for development of prosthetic joint infections. Identification of patients at risk and preoperative correction of known risk factors, such as smoking, diabetes mellitus, anemia, malnutrition, and decolonization of Staphylococcus carriers, represent well-established actions to decrease the infection risk. Careful operative technique, proper draping and skin preparation, and appropriate selection and dosing of antimicrobials for perioperative prophylaxis are also very important in prevention of infection...
March 11, 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159180/legionnaire-s-disease-and-its-protean-clinical-manifestations-the-ongoing-challenges-of-the-most-interesting-atypical-pneumonia
#9
EDITORIAL
Cheston B Cunha, Burke A Cunha
No abstract text is available yet for this article.
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159179/legionnaire-s-disease-and-its-mimics-a-clinical-perspective
#10
REVIEW
Burke A Cunha, Cheston B Cunha
Whenever the cardinal manifestations of a disorder occur in similar disorders, there is potential for a disease mimic. Legionnaire's disease has protean manifestations and has the potential to mimic or be mimicked by other community acquired pneumonias (CAPs). In CAPs caused by other than Legionella species, the more characteristic features in common with legionnaire's disease the more difficult the diagnostic conundrum. In hospitalized adults with CAP, legionnaire's disease may mimic influenza or other viral pneumonias...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159178/legionnaire-s-disease-a-clinical-diagnostic-approach
#11
REVIEW
Burke A Cunha, Cheston B Cunha
Legionnaire's disease is a nonzoonotic atypical pneumonia caused by Legionella sp that occurs sporadically or in outbreaks. Legionnaire's disease pneumonia is accompanied by several extrapulmonary clinical and laboratory findings. Rather than testing all pneumonias for Legionnaire's disease, the clinical challenge is to recognize the diagnostic significance of Legionnaire's disease's. The pretest probability of Legionnaire's disease is increased if several characteristic extrapulmonary findings are present...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159177/microbiology-and-epidemiology-of-legionnaire-s-disease
#12
REVIEW
Almudena Burillo, María Luisa Pedro-Botet, Emilio Bouza
Legionnaire's disease (LD) is the pneumonic form of legionellosis caused by aerobic gram-negative bacilli of the genus Legionella. Individuals become infected when they inhale aerosolized water droplets contaminated with Legionella species. Forty years after the identification of Legionella pneumophila as the cause of the 1976 pneumonia outbreak in a hotel in Philadelphia, we have non-culture-based diagnostic tests, effective antibiotics, and preventive measures to handle LD. With a mortality rate still around 10%, underreporting, and sporadic outbreaks, there is still much work to be done...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159176/legionnaire-s-disease-cardiac-manifestations
#13
REVIEW
John L Brusch
Most cardiac infections with Legionella are secondary to bacteremias arising from a pulmonary focus. Other possible sites of origin are infected sternotomy wounds or equipment contaminated by Legionella spp. Legionella endocarditis is truly a "stealth" infection, with almost no hallmarks of bacterial endocarditis. The key step in making the diagnosis of Legionella endocarditis is for the physician to be aware of the clinical causes of culture-negative infective endocarditis and to include Legionella cardiac involvement in this differential...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159175/thoracic-imaging-features-of-legionnaire-s-disease
#14
REVIEW
Sameer Mittal, Ayushi P Singh, Menachem Gold, Ann N Leung, Linda B Haramati, Douglas S Katz
Imaging examinations are often performed in patients with Legionnaires' disease. The literature to date has documented that the imaging findings in this disorder are relatively nonspecific, and it is therefore difficult to prospectively differentiate legionella pneumonia from other forms of pneumonia, and from other noninfectious thoracic processes. Through a review of clinical cases and the literature, our objective is for the reader to gain a better understanding of the spectrum of radiographic manifestations of Legionnaires' disease...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159174/antimicrobial-therapy-for-legionnaire-s-disease-antibiotic-stewardship-implications
#15
REVIEW
Cheston B Cunha, Burke A Cunha
Legionnaire's disease is a common cause of community-acquired pneumonia (CAP). Although no single clinical feature is diagnostic, if characteristic extrapulmonary findings are present a presumptive clinical syndromic diagnosis is possible. Depending on geographic location, season, and physician awareness, Legionnaire's disease may be included in the differential diagnosis of CAP. Some antibiotics effective against Legionella sp are also effective in treating the typical bacterial causes of CAP. From an antimicrobial stewardship program (ASP) perspective, monotherapy is preferred to double-drug therapy...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159173/legionnaire-s-disease-and-influenza
#16
REVIEW
Eleni E Magira, Sryros Zakynthinos
Legionella pneumophila and influenza types A and B viruses can cause either community-acquired pneumonia with respiratory failure, or Legionella infection could attribute to influenza infection with potentially fatal prognosis. Copathogenesis between pandemic influenza and bacteria is characterized by complex interactions between coinfecting pathogens and the host. Understanding the underlying reason of the emersion of the secondary bacterial infection during an influenza infection is challenging. The dual infection has an impact on viral control and may delay viral clearance...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159172/legionnaire-s-disease-in-compromised-hosts
#17
REVIEW
Fanny Lanternier, Florence Ader, Benoit Pilmis, Emilie Catherinot, Sophie Jarraud, Olivier Lortholary
Legionnaire's disease (LD) is mainly reported in apparently immunocompetent patients. Among them, risk factors include chronic lung disease and smoking. However, LD is also well reported among immunocompromised patients, particularly those treated with anti-tumor necrosis factor alpha therapy, patients with hematological malignancy, and transplant patients. This article discusses the available data on immunity against Legionella spp, epidemiology, clinical presentation, diagnosis, and treatment of LD in immunocompromised patients...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/28159171/severe-pneumonia-caused-by-legionella-pneumophila-differential-diagnosis-and-therapeutic-considerations
#18
REVIEW
Abdullah Chahin, Steven M Opal
Severe legionella pneumonia poses a diagnostic challenge and requires early intervention. Legionnaire's disease can have several presenting signs, symptoms, and laboratory abnormalities that suggest that Legionella pneumophila is the pathogen, but none of these are sufficient to distinguish L pneumophila pneumonia from other respiratory pathogens. L pneumophila is primarily an intracellular pathogen and needs treatment with antibiotics that efficiently enter the intracellular space.
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/27979687/legionnaire-s-disease-since-philadelphia-lessons-learned-and-continued-progress
#19
REVIEW
Cheston B Cunha, Burke A Cunha
Legionnaire's disease has been recognized as a cause of severe community-acquired pneumonia (CAP). Legionnaire's disease has characteristic extrapulmonary findings that are the basis for a presumptive clinical diagnosis. The widespread use of Legionella culture, sputum DFA, serology, urinary antigen testing, and polymerase chain reaction have allowed earlier diagnosis of Legionnaire's disease. Excluding common source outbreaks, CAP caused by Legionnaire's disease is manifested as sporadic cases. In contrast, nosocomial Legionnaire's disease occurs in clusters or outbreaks from common Legionella species-contaminated water sources...
March 2017: Infectious Disease Clinics of North America
https://www.readbyqxmd.com/read/27979683/nosocomial-health-care-associated-legionnaire-s-disease
#20
REVIEW
Shanu Agarwal, Virginia Abell, Thomas M File
Nosocomial Legionnaire's disease is most frequently associated with presence of the organism in hospital water systems. Patients are often susceptible as a result of age, underlying comorbidities, or immunosuppression. Prevention focuses on reducing the reservoir within water systems and includes super heating, ultraviolent light, chlorination, silver-copper ionization, and distal filtration. This article reviews the epidemiology of health care-associated Legionnaire's disease, reviews characteristics of several health care-associated outbreaks, and discusses strategies to prevent health care-associated infection...
March 2017: Infectious Disease Clinics of North America
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