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https://www.readbyqxmd.com/read/29756282/acute-arthritis-predictive-factors-and-current-practice-in-the-approach-to-diagnosis-and-management-across-two-hospitals-in-sydney
#1
Katrina Pavic, Jay Pandya, Sophie Sebak, Amith Shetty, David Spencer, N Nicholas Manolios
BACKGROUND: Literature pertaining to the predictive factors for septic arthritis is limited. AIMS: The primary objective was to investigate the predictive factors for septic arthritis. The secondary objectives were to investigate the predictive factors for crystal arthritis and to explore current practises in the management of acute arthritis. METHODS: A retrospective analysis was undertaken. All patients with an acute arthritis who underwent a joint aspiration for diagnostic and management purposes were considered for inclusion...
May 14, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29707061/the-efficacy-of-16s-ribosomal-dna-sequencing-in-the-diagnosis-of-bacteria-from-blood-bone-and-synovial-fluid-samples-of-children-with-musculoskeletal-infections
#2
S Hashavya, I Gross, A Michael-Gayego, N Simanovsky, R Lamdan
Background: Musculoskeletal infections are among the most common bacterial infections in children leading to hospitalization, invasive procedures and prolonged antibiotic administration. Blood, synovial and sometimes tissue cultures are essential for the diagnosis and treatment of musculoskeletal infections; 16S ribosomal DNA (rDNA) sequencing is a novel diagnostic tool for the detection of bacteria.While the yield of 16S rDNA sequencing in synovial fluid was previously assessed, data regarding the efficacy of this method from blood samples or partially treated children with suspected musculoskeletal infections is lacking...
April 1, 2018: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29666092/a-rare-cause-of-oligoarthritis-with-septic-presentation
#3
Patrick Hoversten, Joel Beachey, Michael Pham, Anjali Bhagra
A 33-year-old man presented with new-onset, asymmetric, migratory oligoarthritis in the setting of several weeks of nausea and vomiting, diarrhoea, fevers and dysuria. He was initially treated in the inpatient setting with broad-spectrum antibiotics due to concern for an evolving sepsis presentation. Arthrocentesis of a large right knee effusion revealed inflammatory synovial fluid without findings suggestive of septic arthritis. Human leucocyte antigen B27 was positive and, taken together with the antecedent history of gastroenteritis, dysuria and inflammatory oligoarthritis, the clinical diagnosis was most consistent with reactive arthritis...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29623279/-clostridium-difficile-colitis-leading-to-reactive-arthritis-a-rare-complication-associated-with-a-common-disease
#4
Asghar Marwat, Hassan Mehmood, Ali Hussain, Muzammil Khan, Asad Ullah, Medha Joshi
The relationship between reactive arthritis and enteric infections caused by Yersinia enterocolitica, Campylobacter jejuni , and Salmonella typhimurium is well documented. Clostridium difficile colitis is a less recognized cause of reactive arthritis. We present a case of a 58-year-old woman with Clostridium difficile colitis complicated by reactive arthritis. A 58-year-old woman with no significant past medical history presented to our hospital with complaints of nonbloody watery diarrhea, abdominal pain for the past 1 week, and right knee pain starting 1 day prior...
January 2018: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29549470/development-and-evaluation-of-a-culture-free-microbiota-profiling-platform-mycrobiota-for-clinical-diagnostics
#5
Stefan A Boers, Saskia D Hiltemann, Andrew P Stubbs, Ruud Jansen, John P Hays
Microbiota profiling has the potential to greatly impact on routine clinical diagnostics by detecting DNA derived from live, fastidious, and dead bacterial cells present within clinical samples. Such results could potentially be used to benefit patients by influencing antibiotic prescribing practices or to generate new classical-based diagnostic methods, e.g., culture or PCR. However, technical flaws in 16S rRNA gene next-generation sequencing (NGS) protocols, together with the requirement for access to bioinformatics, currently hinder the introduction of microbiota analysis into clinical diagnostics...
March 16, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29545432/carpal-synovitis-with-capitate-bone-tuberculosis-in-a-child
#6
André Grenho, Joana Arcângelo, Pedro Jordão, Catarina Gouveia
We present a 10-year-old boy with 2-month duration non-traumatic wrist pain and inflammatory signs. Due to elevated inflammatory markers on blood tests, with an increase in radiocarpal and intercarpal joints synovial fluid and no bony lesions, the patient was submitted to wrist arthrocentesis for the suspicion of septic arthritis. The patient did not improve on conventional treatment, however. An MRI showed synovitis around the carpus and a lytic lesion of the capitate bone due to osteomyelitis. A biopsy was able to identify the causative agent as Mycobacterium tuberculosis , and the patient was treated with antibiotics...
March 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29509649/presentation-and-investigation-of-pediatric-bone-and-joint-infections-in-the-pediatric-emergency-department
#7
Olugbenga Akinkugbe, Charles Stewart, Caoimhe McKenna
OBJECTIVE: The objective of this study was to evaluate the presenting features of bone and joint infections with a view to identify distinguishing trends that will be useful for pediatric emergency departments. METHODS: We performed a retrospective review of patient records over a 12-year period in the pediatric emergency department of a large regional pediatric teaching center serving a diverse population. RESULTS: There were 88 cases of osteoarticular infections during the study period...
March 5, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29505515/persistent-fever-and-destructive-arthritis-caused-by-dialysis-related-amyloidosis-a-case-report
#8
Kotaro Matsumoto, Jun Kikuchi, Yuko Kaneko, Hidekata Yasuoka, Kazuko Suzuki, Hirobumi Tokuyama, Kaori Kameyama, Kunihiro Yamaoka, Tsutomu Takeuchi
RATIONALE: Dialysis-related amyloidosis (DRA) can present rheumatic manifestations in patients on long-term hemodialysis. Typical articular symptoms with DRA involve carpal-tunnel syndrome, effusion in large joints, spondyloarthropathy, or cystic bone lesions, which are usually with non-inflammatory processes. PATIENT CONCERNS: A 64-year-old man on hemodialysis for >30 years was admitted because of intermittent fever, polyarthritis, and elevated serum C-reactive protein (CRP) level, which was continuous for 2 years...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29464173/temporomandibular-joint-septic-arthritis
#9
Gianfranco Frojo, Kashyap Komarraju Tadisina, Vilaas Shetty, Alexander Y Lin
Infection of the temporomandibular joint (TMJ) is a rare pediatric condition resulting from the introduction of pathogens into the joint by hematogenous seeding, local extension, or trauma. Early recognition of the typical signs and symptoms including fever, trismus, preauricular swelling, and TMJ region tenderness are critical in order to initiate further evaluation and prevent feared complications of fibrosis, ankylosis, abnormal facial structure, or persistence of symptoms. Contrast-enhanced computed tomography with ancillary laboratory analysis including erythrocyte sedimentation rate, C-reactive protein, and white blood cell count are beneficial in confirming the suspected diagnosis and monitoring response to therapy...
January 2018: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/29437053/can-next-generation-sequencing-play-a-role-in-detecting-pathogens-in-synovial-fluid
#10
M Tarabichi, N Shohat, K Goswami, J Parvizi
AIMS: The diagnosis of periprosthetic joint infection can be difficult due to the high rate of culture-negative infections. The aim of this study was to assess the use of next-generation sequencing for detecting organisms in synovial fluid. MATERIALS AND METHODS: In this prospective, single-blinded study, 86 anonymized samples of synovial fluid were obtained from patients undergoing aspiration of the hip or knee as part of the investigation of a periprosthetic infection...
February 2018: Bone & Joint Journal
https://www.readbyqxmd.com/read/29398463/coexistence-of-septic-and-crystal-induced-arthritis-a-diagnostic-challenge-a-report-of-25-cases
#11
Águeda Prior-Español, Yaiza García-Mira, Sonia Mínguez, Melania Martínez-Morillo, Laia Gifre, Lourdes Mateo
OBJECTIVE: Septic arthritis is a medical emergency and crystal-induced arthritis is a risk factor for its development. If both occur simultaneously, crystal-induced arthritis may mask the diagnosis of infection and delay antibiotic therapy. METHOD: Retrospective analysis of patients with coexistence of septic and crystal-induced arthritis. We included only patients with isolation of crystals in synovial fluid analysis and positive culture of synovial fluid and/or blood culture...
February 1, 2018: Reumatología Clinica
https://www.readbyqxmd.com/read/29383856/detecting-the-presence-of-bacterial-dna-and-rna-by-polymerase-chain-reaction-to-diagnose-suspected-periprosthetic-joint-infection-after-antibiotic-therapy
#12
Xin-Yu Fang, Wen-Bo Li, Chao-Fan Zhang, Zi-da Huang, Hui-Yi Zeng, Zheng Dong, Wen-Ming Zhang
OBJECTIVE: To explore the diagnostic efficiency of DNA-based and RNA-based quantitative polymerase chain reaction (qPCR) analyses for periprosthetic joint infection (PJI). METHODS: To determine the detection limit of DNA-based and RNA-based qPCR in vitro, Staphylococcus aureus and Escherichia coli strains were added to sterile synovial fluid obtained from a patient with knee osteoarthritis. Serial dilutions of samples were analyzed by DNA-based and RNA-based qPCR...
February 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29349980/-clinical-analysis-on-arthroscopic-debridement-for-the-treatment-of-early-infection-after-total-knee-replacement
#13
Hai-Bo Song, Jie Chen, Liu Hong Liux, Zhao-Hui Zhou, Jian-Feng Wang, Hao-Jie Gu
OBJECTIVE: To compare the clinical effects of arthroscopic debridement versus open debridement on controlling and treatment of infection after total knee replacement. METHODS: From October 2009 to September 2016 in three hospitals, 11 patients with 11 joints which were infected after total knee replacement were randomly divided into two groups:5 cases in arthroscopy group and 6 cases in routine group. Patients in arthroscopy group were treated with arthroscopic debridement to remove the necrotic tissues, then closed-type irrigation with sensitive antibiotics by using two sebific ducts were performed continuously for 2 or 3 weeks until the flushing fluid became clear for 3 or 5 days;other 6 patients in routine group were treated with open surgical debridement and the following procedures in keeping with those in the arthroscopy group...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29243060/synovial-aspiration-and-serological-testing-in-two-stage-revision-arthroplasty-for-prosthetic-joint-infection-evaluation-before-reconstruction-with-a-mean-follow-up-of-twenty-seven-months
#14
Heinrich M L Mühlhofer, C Knebel, Florian Pohlig, Susanne Feihl, Norbert Harrasser, Johannes Schauwecker, Rüdiger von Eisenhart-Rothe
INTRODUCTION: The two-stage revision protocol is the gold standard for controlling and treating low-grade prosthetic joint infections of total hip and total knee arthroplasty. The antibiotic pause for diagnostic reasons before reconstruction (stage two) is discussed in relation to the persistence of the infection and the development of resistant bacterial strains. Serological markers and a synovial analysis are commonly used to exclude the persistence of infection. Therefore, we asked (1) is the serological testing of C-reactive protein and leucocytes a valuable tool to predict a persistence of infection? and (2) what is the role of synovial aspiration of Plymethylmethacrylat (PMMA) spacers in hip and knee joints? MATERIALS AND METHODS: One hundred twelve patients who were MSIS criteria-positive for a prosthetic joint infection were studied, including 45 total hip arthroplasties (THA) and 67 total knee artrhoplasties (TKA) patients...
February 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29208200/-primary-septic-arthritis-is-a-rare-atypical-manifestation-of-invasive-meningococcal-disease
#15
Anne Katrine Bisgaard, Steen Kåre Fagerberg, Ulla Hjort
We present a case report of a 50-year-old man diagnosed with a primary septic arthritis with invasive Neisseria meningitidis serogroup W (MenW) clonal complex 11 identified with culture in blood and synovial fluid. The patient recovered from rapidly instituted relevant antibiotics and synovectomy, but there may be a risk of fatal delayed diagnosis and treatment by an atypical manifestation of invasive meningococcal disease. Invasive MenW disease has been increasing in recent years and has been described with atypical presentations...
November 27, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29114643/analytical-evaluation-of-a-vancomycin-immunoassay-in-synovial-fluid
#16
REVIEW
Francesca Luceri, Fiamma Balboni, Giovanni Balato, Paola Pezzati, Nicoletta Cini, Gianni Virgili, Andrea Baldini
In clinical laboratories performing routine activities, the need to answer the burning clinical question in emerging field may be limited by lack of technology support or assays accessibility. Commercially available methods, although originally validated for specific biological matrices, may be employed for other matrices, following appropriate guidelines such as Clinical and Laboratory Standards Institute (CLSI) EP 19. We investigated the use of a vancomycin assay with synovial fluid samples, in view of a possible employment in vancomycin release study...
June 2017: Joints
https://www.readbyqxmd.com/read/29109168/risk-factors-and-outcomes-for-ineffective-empiric-treatment-of-sepsis-caused-by-gram-negative-pathogens-stratification-by-onset-of-infection
#17
Scott T Micek, Nicholas Hampton, Marin Kollef
Sepsis and septic shock remain serious consequences of infections, with reported mortality rates in excess of 40 percent. Timely antibiotic therapy in cases of sepsis and septic shock is recognized as an important determinant of outcome. However, the administration of ineffective empirical treatment (IET) (an initial antibiotic regimen that is not active against the identified pathogen[s] based on in vitro susceptibility testing results) is associated with excess mortality compared to effective empirical treatment (EET)...
January 2018: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29091212/penetration-of-linezolid-into-synovial-fluid-and-muscle-tissue-after-elective-arthroscopy
#18
R Schwameis, S Syré, K Sarahrudi, A Appelt, D Marhofer, D Burau, C Kloft, M Zeitlinger
Objectives: Penetration of antibiotics into synovial fluid is crucial to combat septic arthritis efficiently. Since linezolid may be used for treatment of septic arthritis when methicillin-resistant bacterial strains are suspected, we investigated its target-site concentrations in synovial fluid. Patients and methods: Ten patients undergoing elective knee arthroscopy were included in this study. Subjects received a single dose of 600 mg of linezolid intravenously and linezolid concentrations were measured in plasma and by using microdialysis in muscle tissue and synovial fluid...
October 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28926460/peripheral-bacterial-septic-arthritis-review-of-diagnosis-and-management
#19
Ahmed S Hassan, Allison Rao, Augustine M Manadan, Joel A Block
Septic arthritis refers to an infection in a joint due to a bacterial, mycobacterial, or fungal cause. Joint infections are a serious cause of morbidity and mortality and constitute a true musculoskeletal emergency. The estimated incidence of septic arthritis in the general population is between 2 and 6 cases per 100,000 people per year. The most common presentation is an acute monoarthritis. Identification of organisms in the synovial fluid is the criterion standard for diagnosis. Synovial fluid aspiration should be performed prior to initiating antibiotics...
December 2017: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
https://www.readbyqxmd.com/read/28918656/diagnosing-kingella-kingae-infections-in-infants-and-young-children
#20
Pablo Yagupsky
Kingella kingae is currently recognized as the prime etiology of skeletal system infections in children aged 6-48 months. The organism is notoriously fastidious, its growth is inhibited by synovial fluid and bone exudates, and its presence in clinical specimens is commonly missed by traditional culture methods. Areas covered: The present review discusses the use of improved laboratory methods to detect the organism in normally sterile body fluids, exudates, and upper respiratory tract specimens. Expert commentary: While inoculation of joint and bone exudates into blood culture vials dilutes the concentration of detrimental factors and significantly improves the isolation of the organism, novel PCR-based assays have enhanced sensitivity, shortened the time-to-detection of K...
October 2017: Expert Review of Anti-infective Therapy
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