Fluconazole concentration in joint fluid during successful treatment of Candida albicans septic arthritis

1990 ◽  
Vol 26 (4) ◽  
pp. 601-602 ◽  
Author(s):  
T. O'MEEGHAN ◽  
R. VARCOE ◽  
M. THOMAS ◽  
R. ELLIS-PEGLER
Keyword(s):  
Candida Albicans ◽  
Septic Arthritis ◽  
Successful Treatment ◽  
Joint Fluid

SEPTIC ARTHRITIS IN INFANTS AND CHILDREN: A REVIEW OF 117 CASES

PEDIATRICS ◽  
1966 ◽  
Vol 38 (6) ◽  
pp. 966-971 ◽  
Author(s):  
John D. Nelson ◽  
Wayne C. Koontz
Keyword(s):  
Antibiotic Therapy ◽  
Septic Arthritis ◽  
Age Groups ◽  
Infants And Children ◽  
Joint Fluid ◽  
Hemophilus Influenzae ◽  
In Infants And Children

A review of 117 cases of septic arthritis in infants and children revealed that the concept of staphylococci and streptococci as the major etiologic organisms should be modified to stress the frequency of Hemophilus influenzae in the 6-month to 2-year age bracket and to emphasize the variety of bacteria that must be anticipated in individual cases. Suggestions are made for increasing the frequency of bacteriologic diagnoses and for initiating the antibiotic therapy of patients with septic arthritis based upon age groups and observations of bacterial stains of joint fluid.

Septic Arthritis in an Infant Due to Clostridium ghoni and Hemophilus parainfluenzae

PEDIATRICS ◽  
1976 ◽  
Vol 57 (4) ◽  
pp. 573-574
Author(s):  
James W. Renne ◽  
Herbert B. Tanowitz ◽  
Jeffrey D. Chulay
Keyword(s):  
Case Report ◽  
Septic Arthritis ◽  
Otitis Media ◽  
Human Infection ◽  
Joint Fluid ◽  
Benzathine Penicillin ◽  
White Girl ◽  
History Of

Clostridium ghoni and Hemophilus parainfluenzae are uncommon causes of human infection. Both of these agents were isolated from joint fluid in a child with septic arthritis. CASE REPORT An 8-month-old white girl was admitted with a three-day history of irritability, fever, and inability to lie on her right side. Ten days prior to admission bilateral otitis media was treated with 600,000 units of benzathine penicillin intramuscularly and sulfisoxazole suspension (1 gm daily until admission). Fever and irritability from otitis abated by the fifth day of therapy. On admission the infant appeared acutely ill and had a temperature of 39.7 C.

scholarly journals Septic arthritis of the knee due to <i>Pantoea</i> <i>agglomerans</i>: look for the thorn

2020 ◽  
Vol 6 (3) ◽  
pp. 51-55
Author(s):  
Tobias Koester ◽  
Taro Kusano ◽  
Henk Eijer ◽  
Robert Escher ◽  
Gabriel Waldegg
Keyword(s):  
Septic Arthritis ◽  
Medical History ◽  
Successful Treatment ◽  
Black Locust ◽  
Pantoea Agglomerans ◽  
Source Control ◽  
Open Debridement

Abstract. We report on a patient with septic arthritis of the knee with Pantoea agglomerans after a penetrating black locust thorn injury. Antibiotics alone or in combination with an arthroscopy may be insufficient for achieving source control. Accurate medical history and open debridement with a search for a thorn fragment are key to successful treatment.

Bone and Joint Infections

2019 ◽  
Author(s):  
Jayshree Dave ◽  
Rohma Ghani
Keyword(s):  
Septic Arthritis ◽  
Group A Streptococcus ◽  
Clinical History ◽  
Liver Function Tests ◽  
Joint Disease ◽  
Joint Fluid ◽  
Response To Treatment ◽  
Range Of Movement ◽  
Joint Infections ◽  
Bone And Joint Infections

Patients with bone and joint infections can present with native joint septic arthritis, osteomyelitis, or implant-associated bone and joint infections. Patients often present with an acute onset of hot, swollen, painful joint with restricted function in one or more joints over a couple of weeks. On examination the affected joint is painful with a limited range of movement, and fever is present. Risk factors for septic arthritis include an abnormal joint architecture due to pre-existing joint disease, e.g. patients with rheumatoid arthritis, or patients on haemodialysis, with diabetes mellitus, or older than 80 years of age. The differential diagnosis includes reactive arthritis, pre-patellar bursitis, gout, Lyme disease, brucellosis, and Whipples disease. Staphylococcus aureus is the most common cause of septic arthritis, followed by Group A streptococcus and other haemolytic streptococci including B, C and G. Gram-negative rods such as Escherichia coli are implicated in the elderly, immunosuppressed, or patients with comorbidities. Pseudomonas aeruginosa is implicated in intravenous (IV) drug users and patients post-surgery or intra-articular injections. Kingella kingae causes septic arthritis in children younger than four years of age. Neisseria gonorrhoeae, Neisseria meningitidis, and Salmonella species can also cause septic arthritis as part of a disseminated infection. Septic monoarthritis commonly occurs in patients with disseminated gonococcal infection. Blood cultures, white blood cell count, C reactive protein (CRP), electrolytes, and liver function tests are indicated. Serial CRP is useful in monitoring response to treatment. If there is a history of unprotected sexual intercourse, gonococcal testing is recommended. Brucella serology and Tropheryma whippei serology may be considered based on the clinical history. Joint fluid aspiration should be performed by a specialist within the hospital. Joint fluid aspirate is processed in the laboratory for microscopy, culture, and sensitivity. Gram stain can show an increase in neutrophils and presence of bacteria. The guidelines provided by the British Society for Rheumatology on the management of hot swollen joints in adults has provided advice for empirical treatment for suspected septic arthritis, but the local antibiotic policy should also be considered. Initial treatment is with intravenous flucloxacillin 2g four times daily, or 450– 600mg four times daily of intravenous clindamycin to cover S. aureus.

scholarly journals Salmonella entericaSerotype Choleraesuis Infection of the Knee and Femur in a Nonbacteremic Diabetic Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Alexander M. Sy ◽  
Jagbir Sandhu ◽  
Theodore Lenox
Keyword(s):  
United States ◽  
Septic Arthritis ◽  
Diabetic Patient ◽  
Salmonella Enterica ◽  
The United States ◽  
Joint Fluid ◽  
Highly Pathogenic ◽  
Osteoarticular Infection ◽  
Osteoarticular Infections ◽  
Intestinal Involvement

Osteoarticular infections caused bySalmonellaare rare. The rates of osteomyelitis and septic arthritis due toSalmonellaare estimated to be less than 1% and 0.1%-0.2%, respectively (Kato et al., 2012).Salmonella entericaserotype Choleraesuis is anontyphoidal Salmonella, highly pathogenic in humans, usually causing septicemic disease with little or no intestinal involvement. Serotype Choleraesuis accounts for a small percentage of published studies ofSalmonellainfections in the United States. It is not commonly reported in joint fluid and bones in contrast to serotype Enteritidis and Typhi, where a considerable number of cases have been published. Chen et al. in Taiwan found that 21% of bacteremic patients with this infection subsequently develop focal infections such as septic arthritis, pneumonia, peritonitis, and cutaneous abscess (Chen et al., 1999, Chiu et al., 2004). In contrast, our patient presented with localized osteoarticular infection withSalmonella enterica serotype Cholerasuis, but without evidence of bacteremia.

Clinical Features and Outcomes of Children with Culture-Negative Septic Arthritis

2018 ◽  
Vol 8 (3) ◽  
pp. 228-234 ◽  
Author(s):  
Evangelos Spyridakis ◽  
Jeffrey S Gerber ◽  
Emily Schriver ◽  
Robert W Grundmeier ◽  
Eric A Porsch ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Septic Arthritis ◽  
Clinical Features ◽  
Inflammatory Marker ◽  
Lyme Arthritis ◽  
Joint Fluid ◽  
Duration Of Symptoms ◽  
Empiric Antibiotics ◽  
Negative Culture ◽  
Culture Negative

Abstract 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. Children with pretreatment, an intensive case unit admission, Lyme arthritis, immunodeficiency, or surgical hardware were excluded. Treatment failure included a change in antibiotics, surgery, and/or reevaluation because of a lack of improvement/worsening. Results We identified 157 children with septic arthritis. The patients with concurrent osteomyelitis (n = 28) had higher inflammatory marker levels at presentation, had a longer duration of symptoms (median, 4.5 vs 3 days, respectively; P < .001), and more often had bacteremia (46.4% vs 6.2%, respectively; P < .001). Among children with septic arthritis without associated osteomyelitis, 69% (89 of 129) had negative culture results. These children had lower C-reactive protein levels (median, 4.0 vs 7.3 mg/dL, respectively; P = .001) and erythrocyte sedimentation rates (median, 39 vs 51 mm/hour, respectively; P = .01) at admission and less often had foot/ankle involvement (P = .02). Among the children with culture-negative septic arthritis, the inpatient treatment failure rate was 9.1%, and treatment failure was more common in boys than in girls (17.1% vs 3.8%, respectively; P = .03). We found no association between treatment failure and empiric antibiotics or patient age. No outpatient treatment failures occurred during the 6-month follow-up period, although 17% of the children discharged with a peripherally inserted central catheter line experienced complications, including 3 with bacteremia. Conclusions The majority of septic arthritis infections at our institution were culture negative. Among patients with culture-negative infection, empiric antibiotics failed for 9% and necessitated a change in therapy. More sensitive diagnostic testing should be implemented to elucidate the causes of culture-negative septic arthritis in children.

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