Cases reported "Arthritis, Infectious"

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1/627. Septic arthritis following arthroscopic meniscus repair: a cluster of three cases.

    Three cases of staphylococcus epidermidis septic arthritis following inside-out arthroscopic meniscus repair within a 4-day period at the same facility are described. All three patients responded to surgical debridement and 4 to 6 weeks of intravenous antibiotics. In each instance, the meniscus and repair sutures were left intact; 12- to 38-month follow-up revealed no evidence of infection or meniscal symptoms. Epidemiological investigation implicated the meniscus repair cannulas as one of the few factors common to all three cases. molecular typing of bacterial dna revealed that two of the three isolated organisms showed identical pulsed-field gel electrophoretic patterns, implying a common source of inoculation. Experimental contamination of the cannulas revealed that only sterilization involving ultrasonification, lumen washing by water jet, and steam sterilization resulted in clean and sterile cannulas.
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2/627. arthritis due to mycobacterium fortuitum.

    mycobacterium fortuitum is classified as a rapidly growing mycobacterium (RGM) according to the Runyon classification. RGM are increasingly being recognized as human pathogens. Joint infection due to M. fortuitum is a rare, but serious disease. This report describes a patient with acquired immunodeficiency syndrome (AIDS) and septic arthritis of the knee due to M. fortuitum in a previously normal joint with no history of surgery or intra-articular injections.
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3/627. Septic arthritis and osteomyelitis of the wrist: reconstruction with a vascularized fibular graft.

    A case of spontaneous staphylococcus arthritis of the wrist with associated carpal and distal radius osteomyelitis is reported. Following sequential debridements and a 6-week course of parenteral antibiotics, an extensive defect was bridged with a vascularized fibular autograft to achieve a successful fusion. There was no donor site morbidity or recurrent infection. Follow-up radiographs 41 months later demonstrated complete incorporation and hypertrophy of the graft.
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4/627. Pneumococcal arthritis.

    Twelve patients with pneumococcal arthritis are described. Seven of the 12 patients had underlying diseases which predisposed them to pneumococcal infections; five were alcoholics and two had hypogammaglobulinemia. Five patients had pre-existing joint disease prior to the onset of septic arthritis. Seven patients had co-existent pneumococcal infection, including meningitis and/or endocarditis in five. The other five patients had pneumococcal arthritis without evidence of other foci of pneumococcal infection. With penicillin therapy and drainage of the purulent joint fluid (by needle aspiration in four and surgical drainage in seven), the function of the involved joint returned to normal or to the previous baseline level in all but one patient.
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5/627. Acute inflammatory (non-purulent) arthritis concomitant with a developing breast abscess.

    A 34 year old female presented 7 weeks post-partum with acute diffuse arthritic manifestations and pyrexia. Extensive investigations (grossly raised erythrocyte sedimentation rate [ESR], c-reactive protein [CRP], normal serology and others) were performed to pursue a diagnosis. Subsequently a breast abscess was diagnosed. Surgical treatment of this led to almost immediate resolution of the joint complaints and return of ESR/CRP to normal levels. This was considered a hitherto unreported case of acute non-purulent inflammatory arthritis concomitant to an existing infection elsewhere in the body. The pathogenic mechanism is unclear but speculatively toxin-mediated.
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6/627. pasteurella multocida meningitis and septic arthritis secondary to a cat bite.

    Animal bites are seen almost daily in the emergency department, and the majority heal without complication. pasteurella multocida is frequently the causative organism of localized wound infections and cellulitis in this patient population. P. multocida infection is usually associated with close contact with pets, such as dogs and cats, that harbor this organism as normal oral flora. meningitis and septic arthritis are very rare sequelae of P. multocida infection. This case report presents a patient with P. multocida bacteremia, meningitis, and septic arthritis developing together as a complication of a cat bite.
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7/627. Group G streptococcus sacroilitis with sepsis in a 15-y-old adolescent.

    Group G streptococci cause invasive infections of different tissues. Most infected patients have underlying diseases and are of adult age. Invasive group G streptococcal infections rarely occur in childhood and adolescence. A 15-y-old boy with a beta-haemolytic group G streptococcus sacroiliitis, sepsis and secondary pulmonary manifestations resembling an acute respiratory distress syndrome is described.
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8/627. Pneumococcal polyarticular septic arthritis in a patient with rheumatoid arthritis.

    Rheumatoid arthritis is the most commonly reported host-related risk factor for septic arthritis. This risk is highest in severe, seropositive, long-standing (mean, 10 years) rheumatoid arthritis responsible for extraarticular symptoms and treated with systemic glucocorticoids. The clinical presentation of the joint infection is often atypical, leading to diagnostic wanderings. In 25% of cases, the infection is polyarticular, with 3.5 involved joints on average. staphylococcus aureus is the most common causative organism. streptococcus pneumoniae causes 5% of all cases of septic arthritis and is more often responsible for polyarticular infections than other organisms. Polyarticular septic arthritis carries a poor prognosis, with a mortality rate of 50% in rheumatoid arthritis patients. Despite its low incidence, polyarticular septic arthritis should be routinely considered in the differential diagnosis of rheumatoid flares. We report a case of pneumococcal septic arthritis involving five joints in a patient with known rheumatoid arthritis. Three other cases with involvement of more than four joints have been published.
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9/627. Varicella arthritis diagnosed by polymerase chain reaction.

    We report a 2-year-old girl who developed acute arthritis of the left knee 4 days after the onset of a typical varicella infection. She was first thought to have pyogenic arthritis caused by staphylococcus aureus. Accordingly, oxacillin was administered upon hospitalization. On the third day after hospitalization, bacterial cultures of the synovial fluid and blood showed no growth and oxacillin was discontinued. Although a viral culture of the synovial fluid for varicella-zoster virus (VZV) was negative, varicella dna was identified by means of polymerase chain reaction (PCR) with VZV-specific primers. The patient recovered spontaneously. To differentiate this condition from septic arthritis is important. PCR is a sensitive technique that can demonstrate the presence of VZV dna in synovial fluid, even if viral cultures are negative.
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10/627. candida glabrata arthritis: case report and review of the literature of Candida arthritis.

    We report a case of arthritis due to Candida (Torulopsis) glabrata in two different joints at different times in the same patient. The first episode of arthritis was situated in the right ankle and lasted more than 1 year before the patient agreed to the proposed treatment. Therapy with intravenous amphotericin b and oral fluconazole failed. A cure was achieved with weekly intra-articular administration of amphotericin b, which was continued for more than 20 weeks and combined with oral itraconazole. Several weeks later the patient developed candida glabrata arthritis of the left knee while still taking itraconazole. Immediately, intravenous amphotericin b therapy was started and was successful. Because there were no previous invasive point manipulations or trauma, the infections were considered to be haematogenously disseminated. Chronic corticosteroid and repeated antibiotic therapy for infectious exacerbations of chronic obstructive pulmonary disease and alcohol abuse are the presumed risk factors in this otherwise immunocompetent patient.
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