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Osteomyelitis, septic arthritis

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https://www.readbyqxmd.com/read/29777344/arthroscopic-debridement-for-septic-arthritis-of-the-shoulder-joint-post-infectious-arthritis-is-an-inevitable-consequence
#1
Sung-Jae Kim, Yun-Rak Choi, Wonyong Lee, Woo-Seok Jung, Yong-Min Chun
PURPOSE: The purpose of this study was to compare clinical outcomes and development of post-infectious arthritis of the shoulder joint after single (Group S) or repeated (Group R) arthroscopic debridement surgeries. We hypothesized that (1) repeated surgeries might be attributable to initial subchondral involvement resulting from septic arthritis and (2) the repeated surgery group would exhibit a higher incidence of post-infectious arthritic changes and inferior clinical outcomes due to prolonged resolution of the infection...
May 18, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29773450/acromioclavicular-joint-septic-arthritis-in-an-immunocompetent-child-a-case-report
#2
Saurabh Dutt, Jeetendra Lodhi, Vinod Kumar, Abhishek Kashyap
Septic arthritis of acromioclavicular (AC) joint is a rare entity. It is generally seen in patients who are immunocompromised. Only 15 cases have been reported till now, with only one case series of 6 patients. We report a case of septic arthritis of AC joint in an immunocompetent child. A 9 years old girl presented with history of pain in left shoulder for 4 days associated with fever. No history suggestive of any immunocompromised state was complained. On local examination, a swelling of around 3 cm in diameter was found over left AC joint region with raised local temperature, tenderness on palpation and positive response in fluctuation test...
March 23, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29728840/evaluation-of-the-current-use-of-imaging-modalities-and-pathogen-detection-in-children-with-acute-osteomyelitis-and-septic-arthritis
#3
Nora Manz, Andreas H Krieg, Ulrich Heininger, Nicole Ritz
Diagnostic tools for the management of acute osteomyelitis (OM) and septic arthritis (SA) have improved over the last decade. To investigate the influence and availability of magnetic resonance imaging (MRI) and nucleic acid testing (NAT), a retrospective cohort study was done. Patients admitted with acute OM or SA between 2005 and 2014 were identified using ICD-10 discharge codes. Ninety-six children were identified: OM, n = 45; SA, n = 42; and OM + SA, n = 9. Diagnostic imaging was performed in 100% of OM or OM + SA and 95% of SA patients...
May 4, 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29727410/improved-diagnosis-and-treatment-of-bone-and-joint-infections-using-an-evidence-based-treatment-guideline
#4
Rachel D Quick, John Williams, Marisol Fernandez, Hilton Gottschalk, Peter Cosgrove, Kyle Kahlden, Kathryn Merkel, Lynn Thoreson, Patrick Boswell, Sarmistha B Hauger
BACKGROUND: Our institution created a multidisciplinary guideline for treatment of acute hematogenous osteomyelitis (AHO) and septic arthritis (SA) in response to updates in evidence-based literature in the field and existing provider variability in treatment. This guideline aims to improve the care of these patients by standardizing diagnosis and treatment and incorporating up to date evidence-based research into practice. The primary objective of this study is to compare cases before versus after the implementation of the guideline to determine concrete effects the guideline has had in the care of patients with AHO and SA...
May 2, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29718310/clinical-features-and-outcomes-of-children-with-culture-negative-septic-arthritis
#5
Evangelos Spyridakis, Jeffrey S Gerber, Emily Schriver, Robert W Grundmeier, Eric A Porsch, Joseph W St Geme, Kevin J Downes
Background: Septic arthritis is a serious infection, but the results of blood and joint fluid cultures are often negative in children. We describe here the clinical features and management of culture-negative septic arthritis in children at our hospital and their outcomes. Methods: We performed a retrospective review of a cohort of children with septic arthritis who were hospitalized at Children's Hospital of Philadelphia between January 2002 and December 2014. Culture-negative septic arthritis was defined as a joint white blood cell count of >50000/μL with associated symptoms, a clinical diagnosis of septic arthritis, and a negative culture result...
April 30, 2018: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/29705992/outpatients-with-acute-osteoarticular-infections-had-favourable-outcomes-when-they-received-just-oral-antibiotics-without-intravenous-antibiotics
#6
Rosa Alcobendas, Agustín Remesal, Sara Murias, Esmeralda Nuñez, Cristina Calvo
AIM: The traditional approach for acute paediatric osteoarticular infections (OAI) has comprised initial intravenous antibiotics followed by prompt oral antibiotics. We assessed how providing just oral antibiotics compared to the traditional two-step approach. METHODS: This prospective study was performed at the Hospital La Paz, Madrid, Spain, from September 2015 to September 2016. We compared 25 outpatients, with good general health and a mean age of 25 months who received just oral antibiotics, with 228 hospitalised children of a similar age who received intravenous and oral antibiotics from other hospitals in the Spanish Network of Osteoarticular Infections...
April 29, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29643731/childhood-pyogenic-osteomyelitis-in-abakaliki-south-east-nigeria
#7
Njoku Isaac Omoke
Background: Pyogenic osteomyelitis is an important child health problem in developing countries. It is a one-disease state with a spectrum of pathological features and clinical forms ranging from acute to chronic presentation. Its pattern of presentation varies from and within subregions. The aim of this study was to determine the pattern and outcome of childhood pyogenic osteomyelitis in a low-resource environment. Materials and Methods: This was a retrospective study of all the children aged 18 years and under seen with pyogenic osteomyelitis in Federal Teaching Hospital Abakaliki between January 2005 and December 2015...
January 2018: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29626020/bone-and-joint-infection
#8
Julia Colston, Bridget Atkins
Bone and joint infections include septic arthritis, prosthetic joint infections, osteomyelitis, spinal infections (discitis, vertebral osteomyelitis and epidural abscess) and diabetic foot osteomyelitis. All of these may present through the acute medical take. This article discusses the pathogenesis of infection and highlights the importance of taking a careful history and fully examining the patient. It also emphasises the importance of early surgical intervention in many cases. Consideration of alternative diagnoses, appropriate imaging and high-quality microbiological sampling is important to allow appropriate and targeted antimicrobial therapy...
March 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29620718/kingella-kingae-as-the-main-cause-of-septic-arthritis-importance-of-molecular-diagnosis
#9
María Belén Hernández-Rupérez, María Del Carmen Suárez-Arrabal, Ángel Villa-García, Sara Zarzoso-Fernández, Marisa Navarro-Gómez, Mar Santos-Sebastián, Azucena García-Martín, Mercedes Marín, Felipe González-Martínez, Javier Narbona-Cárceles, Paloma Cervera-Bravo, José Luis González-López, Teresa Hernández-Sampelayo, Jesús Saavedra-Lozano
BACKGROUND: Kingella kingae is an emergent pathogen causing septic arthritis (SA) in children. OBJECTIVES: To analyze the etiology of SA in children before and after the implementation of universal 16S rRNA gene polymerase chain reaction and sequencing (16SPCR) in synovial fluid. METHODS: Children ≤ 14 years with acute SA from a Madrid cohort (2002-2013), were reviewed. Differences in etiology were analyzed before (Period 1) and after (Period 2) the implementation of bacterial 16SPCR in 2009...
March 31, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29600201/femoral-head-stress-fracture-in-children-a-case-report
#10
Mourad Zaraa, Heithem Sahli, Imene Yeddes, Sabri Mahjoub, Mondher Mbarek
Introduction: The stress fracture of the femoral head rarely occurs; but, it is generally encountered in case of bone insufficiency, and it is exceptional in younger individuals. The main differential diagnosis may include several diseases, namely, slipped upper femoral epiphysis, septic arthritis, osteomyelitis, and Perthes' disease. Bone scintigraphy is very sensitive but lacks specificity. Nowadays, the magnetic resonance imaging (MRI) is the gold standard for an accurate diagnosis...
November 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29560396/renal-failure-after-placement-of-an-articulating-antibiotic-impregnated-polymethylmethacrlyate-hip-spacer
#11
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
https://www.readbyqxmd.com/read/29549135/subscapularis-pyomyositis-a-rare-presentation-of-shoulder-pain
#12
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
https://www.readbyqxmd.com/read/29545432/carpal-synovitis-with-capitate-bone-tuberculosis-in-a-child
#13
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/29521078/recognition-and-nursing-management-of-children-with-non-traumatic-limp
#14
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
https://www.readbyqxmd.com/read/29509649/presentation-and-investigation-of-pediatric-bone-and-joint-infections-in-the-pediatric-emergency-department
#15
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/29396671/endocarditis-associated-with-vertebral-osteomyelitis-and-septic-arthritis-of-the-axial-skeleton
#16
Oscar Murillo, Imma Grau, Joan Gomez-Junyent, Celina Cabrera, Alba Ribera, Fe Tubau, Carmen Peña, Javier Ariza, Roman Pallares
PURPOSE: The relationship between infective endocarditis (IE) and osteoarticular infections (OAIs) are not well known. We aimed to study the characteristics of patients with IE and OAIs, and the interactions between these two infections. METHODS: An observational study (1993-2014) which includes two cohorts: (1) patients with IE (n = 607) and (2) patients with bacteremic OAIs (n = 458; septic arthritis of peripheral and axial skeleton, and vertebral and peripheral osteomyelitis)...
April 2018: Infection
https://www.readbyqxmd.com/read/29389760/validating-an-algorithm-to-predict-adjacent-musculoskeletal-infections-in-pediatric-patients-with-septic-arthritis
#17
Benjamin D Welling, Lee S Haruno, Scott B Rosenfeld
BACKGROUND: Septic arthritis is frequently associated with adjacent infections including osteomyelitis and subperiosteal and intramuscular abscesses. While often clinically indiscernible from isolated septic arthritis, the diagnosis of adjacent infections is important in determining the need for additional surgical intervention. MRI has been used as the diagnostic gold standard for assessing adjacent infection. Routine MRI, however, can be resource-intensive and delay surgical treatment...
January 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29322903/difficult-to-treat-osteoarticulars-infections-focus-on-mycobacterial-and-fungal-infection
#18
REVIEW
J C Yombi, L Seyler, O Cornu, O Barbier, X Libouton, H Rodriguez-Villalobos, E Thienpont
Bone and joint infections are rare but often devastating. While bacteria are most commonly encountered organisms, mycobacteria and fungi are less frequent. Management of the latter is often more complex, especially in the presence of foreign material. We will increasingly be faced with mycobacterial and fungal bone infections, as medical conditions and newer therapeutics lead to more immunosuppression. In this article, we will review osteomyelitis, septic arthritis and peri-prosthetic joint infections related to mycobacteria and fungi...
March 2017: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29309293/orthopaedic-manifestations-of-sickle-cell-disease
#19
Kelly L Vanderhave, Crystal A Perkins, Brian Scannell, Brian K Brighton
Sickle cell disease (SCD) is an autosomal recessive disorder that results in hemolytic anemia related to abnormal hemoglobin and erythrocyte levels. SCD is characterized by vascular occlusive episodes, visceral sequestration, and aplastic or hemolytic crises. These crises most commonly occur in bone. The orthopaedic manifestations of SCD comprise much of the morbidity associated with this disorder. Osteonecrosis and osteomyelitis are among the most disabling and serious musculoskeletal complications in patients with SCD...
February 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29290233/antibiotic-therapy-of-bone-and-joint-infections-in-children-proposals-of-the-french-pediatric-infectious-disease-group
#20
M Lorrot, Y Gillet, C Gras Le Guen, E Launay, R Cohen, E Grimprel
Acute hematogenous bone and joint infections (osteomyelitis, septic arthritis, osteoarthritis, and spondylodiscitis) affect more frequently children younger than 5 years of age. Early diagnosis and prompt treatment are needed to limit the risk of complications. Children with suspected bone and joint infections (BJI) should be hospitalized at the beginning of treatment. Surgical drainage is indicated in patients with septic arthritis and in those with periosteal abscess. Staphylococcus aureus is involved in BJIs in children at all ages; Kingella kingae is a very common causative pathogen in children under 4 years of age...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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