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synovial fluid AND antibiotics

Michael G Ficklin, Michael P Kowaleski, Kevin A R Kunkel, Jonathan T Suber
A two-year-old, 44 kg dog with a right Helica cementless total hip replacement (THR) was radiographically diagnosed with implant loosening eight months after the index total hip replacement procedure. Subsequent synoviocentesis and synovial fluid culture revealed a methicillin-resistant coagulase-negative Staphylococcus spp infection of the right THR. A one-stage revision using a hybrid BFX cementless acetabular cup and CFX cemented femoral stem was performed. Vancomycin and micro-silver antimicrobial powder impregnated cement were used in the revision...
October 20, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Jared M Newman, Jaiben George, Alison K Klika, Stephen F Hatem, Wael K Barsoum, W Trevor North, Carlos A Higuera
BACKGROUND: Periprosthetic joint infection is a serious complication after THA and commonly is treated with a two-stage revision. Antibiotic-eluting cement spacers are placed for local delivery of antibiotics. Aspirations may be performed before the second-stage reimplantation for identification of persistent infection. However, limited data exist regarding the diagnostic parameters of synovial fluid aspiration with or without saline lavage from a hip with an antibiotic-loaded cement spacer...
September 26, 2016: Clinical Orthopaedics and related Research
N Jung, S Vossen
Septic arthritis and spondylodiscitis are relatively rare but severe diseases with increasing incidence. Septic arthritis is an emergency situation with high morbidity (40 %) and fatality rates (11 %). The infection occurs via a hematogenous route by direct inoculation or per continuitatem. Patients with pre-existing destructive joint diseases or under immunosuppressive treatment are particularly at risk. It is mandatory to sample synovial fluid for isolation of the relevant pathogen and quantification of leucocytes before starting antibiotic therapy...
September 15, 2016: Zeitschrift Für Rheumatologie
Elizabeth M Pinder, Joshua Cy Ong, R Stephen Bale, Ian A Trail
Prosthetic shoulder infection can cause significant morbidity secondary to pain and stiffness. Symptoms may be present for years before diagnosis because clinical signs are often absent and inflammatory markers may be normal. An emerging common culprit, Propionibacterium acnes, is hard to culture and so prolonged incubation is necessary. A negative culture result does not always exclude infection and new synovial fluid biochemical markers such as α defensin are less sensitive than for lower limb arthroplasty...
July 2016: Shoulder & Elbow
R Razzaghi, R Rastegar, M Momen-Heravi, M Erami, M Nazeri
UNLABELLED: Structured to Purpose: Human brucellosis is one of the most common zoonotic infections worldwide, which remains one of the major problems for public health. Despite the World Health Organization's recommendation for human brucellosis treatment, sporadic cases of relapse have been reported. The aim of this study was to assess the susceptibility of Brucella isolates to common antibiotics that are prescribed by the physician for the treatment of brucellosis and also to determine the minimum inhibitory concentration 50% (MIC 50 ) and MIC 90 for these antibiotics...
July 2016: Indian Journal of Medical Microbiology
Jorge E Nieto, Jan Trela, Scott D Stanley, Sawsan Yamout, Jack R Snyder
The aim of this study was to determine the pharmacokinetics of amikacin and penicillin G sodium when administered in combination as an intravenous regional limb perfusion (IVRLP) to horses. Seven healthy adult horses underwent an IVRLP in the cephalic vein with 2 g of amikacin sulfate and 10 mill IU of penicillin G sodium diluted to 60 mL in 0.9% saline. A pneumatic tourniquet set at 450 mmHg was left in place for 30 min. Synovial fluid was collected from the metacarpophalangeal joint 35 min and 2, 6, 12, and 24 h after infusion of the antimicrobials...
July 2016: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
Kaisa Huotari, Jarkko Leskinen
Successful replacement arthroplasty enhances the patient's functional capacity, alleviates pain and improves the quality of life. Prosthetic joint infection is one of the most dangerous complications following replacement arthroplasty. In cases of suspected prosthetic joint infection it is essential to consult with the prosthetic joint unit and abstain from starting antibiotics before the appropriate microbiological samples. The diagnosis is made on the basis of history, clinical picture, levels of inflammatory markers, synovial fluid cells and microbiological findings...
2016: Duodecim; Lääketieteellinen Aikakauskirja
P Lehmann, B Ehrenstein, W Hartung, C Dragonas, U Reischl, M Fleck
OBJECTIVES: The diagnosis of Whipple's disease (WD) is commonly confirmed by histology demonstrating Periodic Acid Schiff (PAS)-positive macrophages in the duodenal mucosa. Analysis of intestinal tissue or other specimens using polymerase chain reaction (PCR) is a more sensitive method. However, the relevance of positive PCR findings is still controversial. Therefore, we evaluated the relevance of histology and PCR findings to establishing the diagnosis of WD in a series of WD patients initially presenting with suspected rheumatic diseases...
July 11, 2016: Scandinavian Journal of Rheumatology
Ronald W B Wyatt, Gregory B Maletis, Liisa L Lyon, Joan Schwalbe, Andrew L Avins
PURPOSE: To determine the association between the use of preoperative antibiotics and the risk of postoperative infection after simple knee arthroscopy. METHODS: The electronic medical records of a large integrated health care organization were used to identify patients who underwent simple knee arthroscopy between 2007 and 2012. Patient demographics, potential infection risk factors, and antibiotic administration data were extracted. Simple knee arthroscopy included debridement, meniscectomy, meniscus repair, synovectomy, microfracture, and lateral release...
June 30, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Daniel Pérez-Prieto, Andrej Trampuz, Raúl Torres-Claramunt, María Eugenia Portillo, Lluís Puig-Verdié, Joan C Monllau
Arthroscopic debridement has proven to be the optimal surgical treatment for infections of the anterior cruciate ligament reconstruction (ACLR). Nevertheless, there are no reported data for the best antibiotic treatment option and its duration. The purpose of this article is to assess the usefulness of oral levofloxacin and rifampicin for the treatment of acute infections of an ACLR. This is a retrospective observational cohort study of patients operated on for ACLR over 4 years. A diagnosis of septic arthritis was based on patients' anamnesis and physical examination, laboratory parameters, and cultures of synovial fluid and/or joint tissue...
July 1, 2016: Journal of Knee Surgery
Tommaso Bonanzinga, Akos Zahar, Michael Dütsch, Christian Lausmann, Daniel Kendoff, Thorsten Gehrke
BACKGROUND: A key issue in the treatment of periprosthetic joint infection (PJI) is the correct diagnosis. The main problem is lack of diagnostic tools able to diagnose a PJI with high accuracy. Alpha-defensin has been proposed as a possible solution, but in the current literature, there is a lack of independent validation. QUESTIONS/PURPOSES: We performed a prospective study to determine (1) what is the sensitivity, specificity, and positive and the negative predictive values of the alpha-defensin immunoassay test in diagnosing PJI; and (2) which clinical features may be responsible for false-positive and false-negative results? METHODS: Preoperative aspiration was performed in all patients presenting with a painful hip/knee arthroplasty, including both primary and revision implants...
June 24, 2016: Clinical Orthopaedics and related Research
Annet Heuvelink, Constance Reugebrink, Jet Mars
Control of Mycoplasma bovis infections depends on good husbandry practices and antibiotic treatment. To allow more prudent use of antimicrobial drugs, there is a need for information on the susceptibility profile of this pathogen. The objective of the present study was to analyse the in vitro antimicrobial susceptibility of clinical M. bovis isolates in the Netherlands. The collection comprised 95 bovine isolates, originating from lungs (n=56), mastitis milk (n=27), and synovial fluid (n=12), collected between 2008 and 2014...
June 30, 2016: Veterinary Microbiology
Sean I Tracy, Sherry-Ann Brown, John T Ratelle, Anjali Bhagra
A 59-year-old man was admitted with a 3-month history of daily fevers as well as bilateral knee pain and swelling. Medical history was significant for bilateral knee arthroplasties 4 years prior to admission. Two sets of peripheral blood cultures as well as bilateral knee synovial fluid grew Enterococcus faecalis within 10 hours. Transoesophageal echocardiography revealed aortic and mitral valve vegetations suggestive of infectious endocarditis, with severe regurgitation secondary to large size. The patient's hospitalisation was complicated by acute heart failure, necessitating emergent mitral valve repair and aortic valve replacement, followed shortly thereafter by bilateral total knee arthroplasty resection with placement of antibiotic spacers...
2016: BMJ Case Reports
M Alrehaili, A Harless, L Bateman
Pseudoseptic arthritis is an acute inflammatory arthritis found in association with a sterile synovial fluid culture despite white blood cell (WBC) counts >100,000 and >75% polymorph neutrophils. This arthritis occurs most frequently in patients with underlying inflammatory or immune disorders. Early distinction from true septic arthritis can decrease the need for unnecessary antibiotics and improve patient outcomes.
May 2015: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Tyler A Luthringer, Yale A Fillingham, Kamil Okroj, Edward J Ward, Craig Della Valle
Periprosthetic joint infection is among the most common modes of failure of a total hip or knee arthroplasty and can be a common concern when patients present to the emergency department for care. The initial evaluation for periprosthetic joint infection includes a history and physical examination, followed by radiographs (to rule out other causes of pain or failure) and then serum erythrocyte sedimentation rate and C-reactive protein testing. If the erythrocyte sedimentation rate and C-reactive protein level are elevated or if the clinical suspicion for infection is high, the joint should be aspirated and the fluid sent for culture, as well as for a synovial WBC count and differential, with optimal threshold values of 3,000 WBC/μL and 80% polymorphonuclear cells, respectively...
September 2016: Annals of Emergency Medicine
Salim Ahmed Yahia, Valérie Zeller, Nicole Desplaces, Pascal Chazerain, Luc Lhotellier, Simon Marmor, Jean-Marc Ziza
OBJECTIVES: To describe the occurrence in prosthetic joints of crystal-induced arthritis (CIA) defined as the deposition within the synovial membrane and/or joint cavity of calcium pyrophosphate dehydrate (CPPD) (chondrocalcinosis), sodium urate (gout), or hydroxyapatite. METHODS: We retrospectively reviewed the 7 cases of prosthetic-joint CIA seen between 1993 and 2013 at a medical-surgical center specialized in the management of osteoarticular infections. RESULTS: The 4 females and 3 males ranged in age from 67 to 79 years...
October 2016: Joint, Bone, Spine: Revue du Rhumatisme
Shimon Takada, Sho Fujiwara, Toshiya Inoue, Yuki Kataoka, Yoshiro Hadano, Kentaro Matsumoto, Kyoko Morino, Taro Shimizu
We mainly refer to the acute setting of meningococcemia. Meningococcemia is an infection caused by Neisseria meningitidis, which has 13 clinically significant serogroups that are distinguishable by the structure of their capsular polysaccharides. N. meningitidis, also called meningococcus, is a Gram-negative, aerobic, diplococcus bacterium. The various consequences of severe meningococcal sepsis include hypotension, disseminated intravascular coagulation (DIC), multiple organ failure, and osteonecrosis due to DIC...
2016: Internal Medicine
Chaofan Zhang, Chun Hoi Yan, Ping Keung Chan, Fu Yuen Ng, Kwong Yuen Chiu
This study aims to report our experience of managing acute periprosthetic joint infection (PJI) following total knee arthroplasty (TKA) with surgical debridement and prostheses retention. A review of patients in our prospective joint replacement register from 1998 to 2013 was performed. In this study, 34 patients with 35 TKAs were included; 25 were infections after primary TKA and 10 were after revision TKA. For primary TKA infections, after a mean follow-up of 53.8 ± 42.6 months, 11 were successfully treated, while 14 failed, including 10 required reoperations and 4 needed lifelong antibiotic suppression...
March 10, 2016: Journal of Knee Surgery
Sergiu Straticiuc, Ancuta Ignat, Elena Hanganu, Vasile Valeriu Lupu, Alexandru Bogdan Ciubara, Roxana Cretu
INTRODUCTION: Neisseria meningitidis (N. meningitidis) is associated with severe invasive infections such as meningitis and fulminant septicemia. Septic arthritis due to N. meningitidis is rare and bone infections have been reported exceptionally. We report the case of a 1-year old girl who presented with a painful, swollen right knee, accompanied by fever and agitation. Arthrocentesis of the right knee, while patient was under anesthesia, yielded grossly purulent fluid, so we made arthrotomy and drainage...
February 2016: Medicine (Baltimore)
Salvatore J Frangiamore, Marcelo B P Siqueira, Anas Saleh, Thomas Daly, Carlos A Higuera, Wael K Barsoum
BACKGROUND: Diagnosing periprosthetic joint infection (PJI) requires a combination of clinical and laboratory parameters, which may be expensive and difficult to interpret. Synovial fluid cytokines have been shown to accurately differentiate septic from aseptic failed total knee (TKA) and hip (THA) arthroplasties. However, after first-stage explantation, there is still no reliable test to rule out PJI before a second-stage reimplantation procedure. QUESTIONS/PURPOSES: (1) Which synovial fluid cytokines have the highest diagnostic accuracy for PJI? (2) Which cytokine shows the greatest decrease associated with the resolution of infection in the same patient between explantation and subsequent reimplantation of an infected arthroplasty? (3) What is the accuracy of synovial fluid cytokines and the Musculoskeletal Infection Society (MSIS) criteria to rule out PJI after first-stage explantation? (4) What are the most studied synovial fluid cytokines for diagnosing PJI as reported in the literature and what are their cumulative diagnostic accuracy? METHODS: Between May 2013 and March 2014, 104 patients with painful THA and TKA evaluated for possible PJI were included in our study...
July 2016: Clinical Orthopaedics and related Research
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