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Septic arthritis

Robert P Runner, Amanda Mener, Thomas L Bradbury
A 58-year-old male presented with native joint septic arthritis of the hip and osteomyelitis. After treatment with an articulating antibiotic spacer, he developed acute renal failure requiring dialysis. He continued to have elevated serum tobramycin levels exclusively from the antibiotic spacer elution as no intravenous tobramycin was used. Subsequent explantation was required to correct his renal failure. Although renal failure after antibiotic impregnated cement placement is rare, the risk of this potential complication should be considered preoperatively and in the postoperative management of these patients...
March 2018: Arthroplasty Today
Anahy M Brandy-García, Daniel Clemente Garulo, Juan Carlos López Robledillo
No abstract text is available yet for this article.
March 17, 2018: Reumatología Clinica
Philipp Schuster, Markus Geßlein, Philipp Mayer, Michael Schlumberger, Raul Mayr, Jörg Richter
PURPOSE: The purpose of this study was to determine the incidence of septic arthritis following arthroscopic posterior cruciate ligament (PCL) and multi-ligament reconstructions, and to evaluate a treatment regime with sequential arthroscopic irrigation and debridement procedures combined with antibiotic therapy that is focused on retention of the graft. METHODS: Between 2004 and 2016 a total of 866 PCL reconstructions and multi-ligament reconstructions were performed at our institution (408 isolated PCL reconstructions, 458 combined reconstructions)...
March 20, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Sarel R van Amstel, David E Anderson, Ricardo Videla
CASE DESCRIPTION 3 Angus bulls, aged 2 to 3 years, with severe lameness of 2 to 4 weeks' duration and swelling proximal to the coronary band of the affected limb were evaluated after failing to respond to antimicrobial treatment. CLINICAL FINDINGS Septic arthritis of a distal interphalangeal joint (DIPJ) was diagnosed in all 3 bulls on the basis of results of a physical examination, radiographic and ultrasonographic evaluations of the affected foot, and cytologic evaluation of synovial fluid from the affected DIPJ...
April 1, 2018: Journal of the American Veterinary Medical Association
Brian R Waterman, William Arroyo, Eric J Cotter, Michael A Zacchilli, E'Stephan J Garcia, Brett D Owens
Background: There remains a debate over whether to retain the index anterior cruciate ligament (ACL) graft in the setting of septic arthritis. Purpose: To evaluate and compare clinical outcomes for the treatment of septic arthritis after ACL reconstruction (ACLR) in those with and without early graft retention. Study Design: Case series; Level of evidence, 4. Methods: The Military Health System was queried for all ACLR procedures performed between 2007 and 2013...
March 2018: Orthopaedic Journal of Sports Medicine
Simond Jagernauth, Reece Alexander James Clough, Ali Noorani, Muaaze Ahmad
We present a rare case of a subscapularis pyomyositis in a 38-year-old woman and examine the diagnostic and surgical challenges posed. History and examination features were similar to that of septic shoulder arthritis without overlying features of warmth or erythema. Serological markers revealed a C-reactive protein of 221 mg/L and white cell count of 11.1×109 /L. A dry shoulder aspirate was obtained. Contrast-enhanced MRI demonstrated a peripheral rim-enhancing lesion within the subscapularis muscle belly with lack of central enhancement...
March 16, 2018: BMJ Case Reports
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
Scott A Weisenberg
A 78-year-old man developed right knee pain and swelling without other systemic symptoms. He had travelled frequently to the Central Valley of California. He was diagnosed with coccidioidomycosis based on joint fluid culture. Coccidioidal complement fixation antibody titres were extremely elevated. Arthroscopic debridement and fluconazole therapy did not lead to satisfactory improvement. Subsequent open debridement and change to itraconazole was followed by resolution of clinical signs of infection.
March 13, 2018: BMJ Case Reports
Costansia Bureta, Hiroyuki Tominaga, Takuya Yamamoto, Takao Setoguchi, Hideki Kawamura, Satoshi Nagano, Ichiro Kawamura, Masahiko Abematsu, Hironori Kakoi, Yasuhiro Ishidou, Setsuro Komiya
BACKGROUND: Here we report a rare case of lumbar spine epidural abscess and facet joint septic arthritis caused by Streptococcus agalactiae, which had spread to the iliopsoas muscles, leading to urine retention. CASE PRESENTATION: A 68-year-old woman with low back pain experienced a sudden onset of bilateral lower limb weakness, it was followed 14 days later by urine retention. At consultation, magnetic resonance imaging and identification of serum β-hemolytic streptococci provided a diagnosis of Streptococcus agalactiae infection...
March 13, 2018: BMC Surgery
Maurizio Pacilli, Catherine J Bradshaw, Simon A Clarke
INTRODUCTION: Medium-term intravenous access in children is normally achieved by means of repeated multiple peripheral intravenous cannula insertions or peripherally inserted central catheters. Long peripheral cannulas might offer an alternative to these devices in children. Our aim was to clarify whether long peripheral cannulas provide reliable medium-term intravenous access avoiding the need for multiple peripheral intravenous cannulations or peripherally inserted central catheter insertion in children undergoing surgery...
March 1, 2018: Journal of Vascular Access
E Laurent, G Gras, J Druon, P Rosset, S Baron, A Le-Louarn, E Rusch, L Bernard, L Grammatico-Guillon
OBJECTIVES: French reference centers for bone and joint infections (BJI) were implemented from 2009 onwards to improve the management of complex BJIs. This study compared BJI burden before and after the implementation of these reference centers. PATIENTS AND METHODS: BJI hospital stays were selected from the 2008 and 2013 national hospital discharge database using a validated algorithm, adding the new complex BJI code created in 2011. Epidemiology and economic burden were assessed...
March 8, 2018: Médecine et Maladies Infectieuses
Karthikeyan E Ponnusamy, Jacquelyn D Marsh, Lyndsay E Somerville, Richard W McCalden, Edward M Vasarhelyi
BACKGROUND: We compared 90-day costs and outcomes for primary total knee arthroplasty patients among nonobese (body mass index [BMI] 18.5-24.9), overweight (25-29.9), obese (30-34.9), severely obese (35-39.9), morbidly obese (40-49.9), and super-obese (50+) cohorts. METHODS: We conducted a retrospective review of an institutional database of total knee arthroplasty patients from 2006 to 2013 with a minimum of 3-year follow-up. Sixty-five super-obese patients were identified, and five other cohorts were randomly selected in a 2:1 ratio (total, n = 715)...
February 15, 2018: Journal of Arthroplasty
Elizabeth Wilson, Peter Cox, Karen Greaves, Siba Prosad Paul
Children with acute onset non-traumatic limp often present to emergency departments (EDs). The limp can occasionally be associated with medical emergencies such as septic arthritis and slipped upper femoral epiphysis but is often due to less severe conditions. This article discusses the common and self-limiting causes of acute onset of non-traumatic limp in children, such as transient synovitis, reactive arthritis, and benign acute childhood myositis. It also discusses more severe conditions, including septic arthritis, osteomyelitis, slipped upper femoral epiphysis, Perthes disease, malignancies and non-accidental injury...
March 9, 2018: Emergency Nurse: the Journal of the RCN Accident and Emergency Nursing Association
Bennet A Butler, David W Fitz, Cort D Lawton, Daniel D Li, Earvin S Balderama, Michael D Stover
OBJECTIVES: Septic arthritis results in rapid joint destruction if not properly diagnosed and treated. A work up for septic arthritis includes a peripheral white blood cell count, inflammatory markers, and a joint aspiration. In the general population, the interpretation of these labs has been well-defined by prior studies. To this point, no study has determined how immunosuppressive states affect this work up. METHODS: Patients with immunosuppressive conditions who received a joint aspiration for a painful joint were retrospectively identified...
March 5, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Khalid Gafoor, Shalin Patel, Francis Girvin, Nishant Gupta, David Naidich, Stephen Machnicki, Kevin K Brown, Atul Mehta, Bryan Husta, Jay Ryu, George Sarosi, Tomas Franquet, Johny Verschakelen, Takeshi Johkoh, William Travis, Suhail Raoof
Cavities are occasionally encountered on thoracic imaging. Their differential diagnosis is large and includes, among others, various infections, autoimmune conditions and primary and metastatic malignancies. We offer an algorithmic approach to their evaluation by initially excluding mimics of cavities then broadly classifying them according to the duration of clinical symptoms and radiological abnormalities.. An acute or subacute process (<12 weeks) suggests common bacterial and uncommon nocardial and fungal causes of pulmonary abscesses, necrotizing pneumonias, and septic emboli...
March 5, 2018: Chest
Anne-Cécile Debrach, Ilias Lazarou, Cem Gabay, Ilker Uçkay
Native joint septic arthritis is a medical emergency requiring urgent joint drainage and antibiotic therapy. In the absence of an artificial joint or a foreign body, the « rheumatological approach » with repetitive arthrocentesis yields similar outcomes in the literature when compared to surgical drainage. Arthrocentesis could therefore be viewed as the preferential method of joint drainage as it is associated both with reduced morbidity for patients and decreased costs for the healthcare system. In case of failure with arthrocentesis, surgical arthroscopic drainage becomes necessary...
March 7, 2018: Revue Médicale Suisse
Stéphanie D'Incau, Stéphane Emonet
Septic arthritis is a medical and surgical emergency. It is therefore essential to promptly differentiate an infectious from a non-infectious origin in order to improve the prognostic (mortality and morbidity). To do so the clinician needs not only to know which tests are available but also how to adequately use them and interpret their results. In this article, we review the various tests in use for the evaluation of acute arthritis, highlighting the most useful ones for the diagnosis of septic arthritis. We will also have a quick look at the use of intra-articular injection of corticosteroid...
March 7, 2018: Revue Médicale Suisse
Philipp Schuster, Markus Geßlein, Michael Schlumberger, Philipp Mayer, Hermann Josef Bail, Jörg Richter
PURPOSE: No systematic studies on optimal treatment of postoperative septic arthritis following arthroscopic meniscus repair are available. The purpose of this study was to retrospectively evaluate the fate of repaired menisci in cases of postoperative septic arthritis, with treatment for infection focused on arthroscopic irrigation and debridement (I&D) and intention to maintain the meniscus. METHODS: Data of two sports orthopedics centers of the last 10 years were pooled (approximately 25,000 arthroscopic procedures of the knee)...
March 6, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
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
Yoshihiro Katsuura, Brandon Cincere, Garrick Cason, James Osborn
Here, we present a rare case of metastatic methicillin sensitive Staphylococcus aureus (MSSA) infection arising from an unknown focus and spreading throughout the lumbar spine with associated pyomyositis of the paraspinal musculature, and septic arthritis of the knee, ankle and sternoclavicular joint. This case highlights the potential for missed aspects and delay in diagnosis in the care of metastatic S. aureus and the need for multispecialty intervention. Treatment of S. aureus infections requires a high index of suspicion and careful examination of multiple organ systems to identify the full extent of the disease...
March 5, 2018: BMJ Case Reports
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