1/21. Update: allograft-associated bacterial infections--united states, 2002.Tissue allografts are commonly used in orthopedic surgical procedures; in 1999, approximately 650,000 musculoskeletal allografts were distributed by tissue processors (1). A rare complication of musculoskeletal allografts is bacterial infection (2,3). After the reported death of a recipient of an allograft contaminated with clostridium spp. (an anaerobic spore and toxin-forming organism) (3), CDC investigated this case and solicited additional reports of allograft-associated infections; 26 cases have been identified. This report summarizes the investigation of these cases and describes additional steps given to a tissue processor to enhance tissue transplant safety.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
2/21. mycobacterium tuberculosis and mycobacterium fortuitum osteomyelitis of the foot and septic arthritis of the ankle in an immunocompetent patient.Mycobacteria, both tuberculous and nontuberculous, are recognized as a cause of chronic bone and joint infection. However, the diagnosis of mycobacterial infection is easily missed because of the absence of systemic involvement. Moreover, specific microbiologic techniques are required to detect mycobacteria in clinical specimens. Infections due to uncommon pathogens such as mycobacteria are more likely to occur in the immunocompromised host. A case of septic arthritis of the ankle and osteomyelitis of the foot due to both tuberculous and nontuberculous mycobacteria in an immunocompetent host is reported here.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
3/21. Posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection.BACKGROUND: We report a rare complication of posterior dislocation of a cruciate-retaining total knee arthroplasty following an acute bacterial infection. The mechanism of dislocation proved to be septic loosening of the femoral component and a tear of the posterior cruciate ligament near to the femoral insertion site. The tear arose during the treatment of acute septic arthritis following total knee arthroplasty when the patient attempted full weight-bearing with the affected limb in a semiflexion position and twisted the knee. methods AND RESULTS: Successful treatment was provided with subsequent surgical debridement, removal of the loosened prosthesis, the application of systemic antibiotics, and a revision total knee arthroplasty utilizing a posteriorly stabilized prosthesis after adequate control of the infection. CONCLUSION: Soft-tissue protection from full weight-bearing of the knee during the treatment of an acute infection following total knee arthroplasty and timely removal of the loosened total knee prosthesis are recommended in order to prevent such a complication.- - - - - - - - - - ranking = 1keywords = bacterial infection (Clic here for more details about this article) |
4/21. AIDS-related ankle arthropathy: mycobacterium avium-intracellulare infection.We present a case of Mycobacterium avium-intracellulare (MAI) infection of the ankle joint in a patient with hiv infection. The patient presented with a painful, destructive arthropathy of the ankle. Initial microbiological studies were negative but infection with MAI was later identified from biopsies taken during hindfoot fusion. Antibiotic triple therapy was given and the patient remains pain-free without evidence of active infection. To our knowledge, this is the first case of MAI infection of the ankle reported in the literature. A high index of suspicion of (atypical) Mycobacterial infection should be maintained in patients with hiv infection presenting with an indolent but destructive arthropathy of the ankle joint.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
5/21. Septic arthritis caused by nocardia asteroides in a renal transplant recipient.Although articular complications are common following renal transplantation, septic arthritis is not frequent. Previous bacterial infection in an another site is a consistent finding and the knee is the most often affected joint. We present a 30-year-old female renal transplant recipient with recurrent pulmonary infiltrates preceding septic arthritis of her left knee. Cultures of the aspirated synovial fluid yielded a gram-positive, rod-shaped bacterium later identified as nocardia asteroides. The patient was treated with oral trimethoprim-sulfamethoxazole without any side effect. Nocardia is a rare but serious cause of infection in renal transplant recipients but there is no well-known predisposing factor. Recently mycophenolate mofetil has been implicated as a factor associated with nocardia infections. Prolonged courses of treatment with sulphonamides are recommended.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
6/21. Relapsing oligoarticular septic arthritis during etanercept treatment of rheumatoid arthritis.Septic arthritis is a commonly reported complication of rheumatoid arthritis (RA). Tumor necrosis factor alpha (TNF-alpha) plays an important role in host defense against infection. Inhibition of its activity could therefore be anticipated to augment the risk of infection. Both opportunistic and bacterial infections have been described in patients with RA treated with anti-TNF-alpha therapy. We describe a patient who experienced 2 episodes of septic arthritis. Both occurred while the patient was on etanercept. recurrence developed despite prolonged parenteral antibiotic. To our knowledge, this is the first report of relapsing oligoarticular methicillin-sensitive staphylococcus aureus septic arthritis despite prolonged antibiotic treatment in a patient receiving etanercept therapy. Our case underscores the advisability of discontinuing TNF-alpha blockade in patients with septic arthritis during prolonged antimicrobial therapy.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
7/21. Increased risk of neisserial infections in systemic lupus erythematosus.survival in systemic lupus erythamatosus (SLE) continues to improve because of better ancillary care, earlier diagnosis, and earlier treatment. However, infection remains a leading cause of morbidity and mortality in this disease. Although corticosteroids and immunosuppresives increase the risk of opportunistic infection, the SLE patient is still most at risk from common bacterial pathogens. As the prototypic immune-complex disease, patients with active SLE have low circulating complement as well as a reticuloendothelial system (RES) saturated with immune complexes. It seems intuitive that SLE patients should be most at risk for organisms dependent for their removal on the RES or complement for opsonization or bacteriolysis. The current series presents four patients with SLE and disseminated neisseria infection and brings to 14 the number of patients in the literature with disseminated neisserial infection. They are typically young, female, with renal disease, and either congenital or acquired hypocomplementemia, and may present with all features of a lupus flare. Surprisingly, they are not all on corticosteroids or immunosuppressives and have some features that are unusual for non-SLE patients with these infections. There seems to be an over-representation of Nisseria meningitidis (despite potential reporting bias), and there ironically may be better tolerance with fewer fulminant complications in patients who have complement deficiencies. The best approach for the physician treating SLE is to immunize all SLE patients with available bacterial vaccines to N meningitidis and streptococcus pneumonia, have a low threshold of suspicion for the diagnosis of disseminated neisserial or other encapsulated bacterial infection in the SLE patient who is sick, and to treat empirically with third generation cephalosporins after appropriate cultures.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
8/21. Mixed gonococcal and mycobacterial sepsis of the wrist.Mycobacterial infections of the hand and wrist are rare. Concurrent infection of a joint by more than one organism is also unusual. A 25-year-old man developed wrist sepsis caused by neisseria gonorrhoeae and Mycobacterium avium intracellularis. The infection was successfully treated by wrist drainage, carpal debridement, and intravenous antibiotics. Secondary carpal reconstruction was accomplished by delayed bone grafting and internal fixation to preserve radiocarpal motion.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
9/21. Cryptococcal pyarthrosis complicating gouty arthritis.Cryptococcal arthritis remains a rare entity. Crystalline arthropathy has been described in association with bacterial infection, but no similar association has been described for crystalline joint disease and fungal infection. We have described a renal transplant patient with concurrent gout and cryptococcal arthritis that responded favorably to treatment. joints with crystalline arthropathy should be cultured for both bacteria and fungi.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
10/21. A transient granulocyte killing defect secondary to a varicella infection.A varicella infection in a previously healthy young girl was complicated by bacterial sepsis, arthritis, and osteomyelitis in multiple locations. This secondary complication caused by staphylococcus aureus was associated with a transient defect in granulocyte function and an alteration in the representation of CD4 and CD8 positive lymphocyte subpopulation. The mechanism responsible for secondary bacterial infections following varicella may be due to transient defects in granulocyte function.- - - - - - - - - - ranking = 0.2keywords = bacterial infection (Clic here for more details about this article) |
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