Pseudoseptic Arthritis in a Patient With Psoriasis (original) (raw)
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Septic arthritis is the infection of joints and delay in treatment may lead to irrecoverable injuries such as joint destruction and dissemination of infection to other organs. The aims of this study were to evaluate synovial fluid cultures in patients with high suspicion for septic arthritis, their clinical and laboratory findings and to determine probable causes of true/false negative cultures. In this cross-sectional study, 25 patients with painful and swollen joint and high clinical suspicion for septic arthritis enrolled the study. Sterile synovial fluid aspiration was performed and specimens were evaluated direct smear for gram staining and 3 different cultures using chocolate agar, Mac-Conkey and blood agar for 24 hours. Blood samples were also obtained for culture. Data were analyzed using SPSS software (version 15). Fever, joint pain, swelling, warmth and tenderness were reported by all patients. Ten patients (40%) suffered from chilling and 24 patients (96%) from restricted...
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Two episodes of Pseudomonas septic arthritis occurred in an 84-year-old diabetic man separated by a 6 year interval. Pseudomonas is an unusual cause of septic arthritis requiring vigorous antibiotic therapy. The recurrence of the infection may be related to the inadequate response to treatment in the first episode, however, the long interval remains unexplained.
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To clinically and epidemiologically characterize a population diagnosed with and treated for septic arthritis of the knee, to evaluate the treatment results and to analyze the differences between patients with positive and negative culture results, patients with Gram-positive and Gram-negative bacterial isolates and patients with S. aureus- and non-S. aureus-related infections. One hundred and five patients with septic knee arthritis were included in this study. The clinical and epidemiological data were evaluated. Statistical analysis was performed to compare patients with and without an isolated causative agent, patients with Gram-positive and Gram-negative pathogens and patients with S. aureus-related and non S. aureus-related infections. Causative agents were isolated in 81 patients. Gram-positive bacteria were isolated in 65 patients and Gram-negative bacteria were isolated in 16 patients. The most commonly isolated bacterium was S. aureus. Comparing cases with an isolated path...
Annals of the Rheumatic Diseases, 2003
Objective: To investigate whether patients with acute septic arthritis (SA) diagnosed by positive synovial fluid (SF) culture (Newman grade A) have different clinical and serological features from those with sterile SF in whom there is nonetheless a high suspicion of SA (Newman grades B and C). Patients and methods: A prospective 12 month multicentre hospital based study of adult patients with SA recruited 47 patients with culture positive SA and 35 patients with clinically suspected SA but sterile SF. Results: Patient demography, clinical and laboratory features at presentation were similar irrespective of the underlying diagnosis, SF culture, and the presence of prosthetic joints. Medical and surgical treatment and outcome were comparable in the two patient groups. Patients with both suspected and proven SA were more likely to be from the more socially deprived areas of our community (p<0.0001). Conclusion: Patients in whom there is a high clinical suspicion of SA are comparable to those patients with SA with a positive SF culture and have similar morbidity and mortality on follow up. Therefore, if clinical suspicion of SA is high then it is correct to treat as SA in the absence of bacterial proof.
Septic arthritis in an unusual localization
Case Reports in Clinical Medicine, 2013
Septic arthritis is a rheumatological emergency due to its potential for rapid articular destruction and permanent functional loss. Its incidence ranges between 4 and 29 cases per 100,000 person-years, and depends on population variables and preexisting structural joint abnormalities. Clinical manifestations, severity, treatment and prognosis depend on the aetiologic agent, patient basal status and articulation involved. The sternoclavicular and condrosternal articulations are rarely affected. A 24 years old man presented with fever and right shoulder pain. Physical examination revealed swelling, redness, increased local heat, intense pain and functional impairment of the patient's right shoulder. Laboratory inflammatory markers were elevated. Right sternoclavicular articulation ultrasound, right sternoclavicular articulation X-ray, and galium bone scan have shown sternoclavicular arthritis and medial clavicular osteomyelitis. Blood cultures identified Staphylococcus aureus methicillin sensitive. The patient completed a six week antibiotic regimen and physical rehabilitation program. Herein, the authors report a case of sternoclavicular septic arthritis complicated with osteomyelitis and review aetiology, diagnosis, treatment and prognosis of this rare medical condition.
07.Recalcitrant septic knee arthritis due to adjacent osteomyelitis in adults
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We asked whether adjacent osteomyelitis with acute septic knee arthritis explained a lack of response to initial management, and whether patient comorbidities predisposed to the nonresponsiveness. From 147 adult patients (151 knees) with septic arthritis, we identified 29 patients (33 knees) who had persistence or recurrence of symptoms after surgical drainage. Adjacent osteomyelitis was present in 31 (94%) of the 33 knees (27 of 29 patients) with poor response to treatment. Patients with adjacent osteomyelitis had more comorbid conditions (23 of 27 patients, 85%) than patients without osteomyelitis (64 of 120, 53%). The most common comorbid conditions in patients with adjacent osteomyelitis were diabetes mellitus (10 patients, 37%) and intravenous drug use (eight patients, 30%). We identified Staphylococcus aureus in 19 of 31 knees (61%) with osteomyelitis, eight (26% of total cases) of which were methicillin-resistant. Persistence of clinical signs of infection after surgical management of septic knee arthritis in adults should raise the suspicion of adjacent osteomyelitis, especially in patients with comorbid conditions. Additional imaging studies may be necessary to evaluate the distal femur and proximal tibia. Level of Evidence: Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.