Bone and joint infections

2016 ◽  
Author(s):  
M. Estée Török ◽  
Fiona J. Cooke ◽  
Ed Moran
Keyword(s):  
Diabetes Mellitus ◽  
Septic Arthritis ◽  
Diabetic Foot ◽  
Bone Destruction ◽  
Joint Space ◽  
Joint Infections ◽  
Diabetic Foot Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Knee Replacements

This chapter provides an overview of inflammations of the joint space and bones, such as arthritis and bursitis, including osteomyelitis and bone destruction and formation of sequestra. The chapter also includes prosthetic joint infections such as hip and knee replacements. It also describes diabetic foot infections, defined as any inframalleolar infection in a patient with diabetes mellitus. Infections include paronychia, cellulitis, myositis, abscesses, necrotizing fasciitis, septic arthritis, tendonitis, and osteomyelitis.

Rare case of Ureaplasma parvum septic arthritis in an immunocompetent patient

2020 ◽  
Vol 13 (9) ◽  
pp. e236396
Author(s):  
Abuzar Ali Asif ◽  
Moni Roy ◽  
Sharjeel Ahmad
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Immunocompetent Patient ◽  
Next Generation ◽  
Ureaplasma Parvum ◽  
Urogenital Infections ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Diagnostic Modalities

Mycoplasmatacea family comprises two genera: Mycoplasma and Ureaplasma. Ureaplasma parvum (previously known as U. urealyticum biovar 1) commonly colonises the urogenital tract in humans. Although Ureaplasma species have well-established pathogenicity in urogenital infections, its involvement in septic arthritis has been limited to prosthetic joint infections and immunocompromised individuals. We present a rare case of native right knee infection due to U. parvum identified using next-generation sequencing of microbial cell-free DNA testing and confirmed with PCR assays. This rare case of Ureaplasma septic arthritis was diagnosed using newer next-generation DNA sequencing diagnostic modalities and a literature review of prior cases, antibiotic coverage and antimicrobial resistance is incorporated as part of the discussion.

scholarly journals The difference between native septic arthritis and prosthetic joint infections: A review of literature

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986046 ◽  
Author(s):  
Ramon Lucas Roerdink ◽  
Henricus Johannus Theodorus Antoniu Huijbregts ◽  
Antoine Willy Tonny van Lieshout ◽  
Martijn Dietvorst ◽  
Babette Corine van der Zwaard
Keyword(s):  
Septic Arthritis ◽  
Current Literature ◽  
Treatment Strategies ◽  
Review Of Literature ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
The Difference

Current literature occasionally considers septic arthritis in native joints and prosthetic joint infections as equal pathologies. However, significant differences can be identified. The aim of this review of literature is to describe these differences in definitions, pathology, diagnostic workups, treatment strategies, and prognosis.

Epidemiology, Management, and Outcomes of Large and Small Native Joint Septic Arthritis in Adults

2019 ◽  
Vol 70 (2) ◽  
pp. 271-279 ◽  
Author(s):  
Stephen McBride ◽  
Jessica Mowbray ◽  
William Caughey ◽  
Edbert Wong ◽  
Christopher Luey ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Septic Arthritis ◽  
Surgical Procedures ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Total Incidence ◽  
Large Joint ◽  
Prosthetic Joint Infections ◽  
Small Joint ◽  
Antibiotic Duration

Abstract Background Native joint septic arthritis (NJSA) is poorly studied. We describe the epidemiology, treatment, and outcomes of large joint NJSA (LNJSA) and small joint NJSA (SNJSA) in adults at Middlemore Hospital, Auckland, New Zealand. Methods This was a coding-based retrospective study of patients ≥16 years old admitted between 2009 and 2014. Prosthetic joint infections were excluded. Results Five hundred forty-three NJSA episodes were included (302 LNJSA, 250 SNJSA). Only 40% had positive synovial fluid culture. Compared to SNJSA, LNJSA has higher incidence (13 vs 8/100 000 person-years [PY]), occurs in older, more comorbid patients, and is associated with greater rates of treatment failure (23% vs 12%) and mortality, despite longer antibiotic treatment. Total incidence is higher than previously reported (21/100 000 PY), with marked interethnic variation. Incidence rises with age (LNJSA only) and socioeconomic deprivation (LNJSA and SNJSA). Tobacco smokers and males are overrepresented. The most commonly involved joints were knee (21%) and hand interphalangeal (20%). Staphylococcus aureus was the most common pathogen (53%). Mean antibiotic duration was 25 days for SNJSA and 40 days for LNJSA, and the mean number of surgical procedures was 1.5 and 1.6, respectively. Treatment failure was independently associated with LNJSA, age, intra-articular nonarthroplasty prosthesis, and number of surgical procedures. Conclusions This is the largest contemporary series of adult NJSA. SNJSA has better outcomes than LNJSA and may be able to be safely treated with shorter antimicrobial courses. Incidence is high, with significant ethnic and socioeconomic variation. Microbiological NJSA case ascertainment underestimates case numbers as it frequently excludes SNJSA.

scholarly journals A Real Pain: Diagnostic Quandaries and Septic Arthritis

2017 ◽  
Vol 56 (2) ◽  
Author(s):  
Cristina Costales ◽  
Susan M. Butler-Wu
Keyword(s):  
Septic Arthritis ◽  
Laboratory Tests ◽  
Joint Infection ◽  
Rapid Diagnosis ◽  
Accurate Diagnosis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
The Many ◽  
Future Utility

ABSTRACT Rapid diagnosis and treatment of an infected joint are paramount in preserving orthopedic function. Here, we present a brief review of the many challenges associated with the diagnosis of both septic arthritis and prosthetic joint infections. We also discuss the many laboratory tests currently available to aid in the accurate diagnosis of joint infection, as well as emerging diagnostics that may have future utility in the diagnosis of these challenging clinical entities.

scholarly journals Cutibacterium acnes Septic Arthritis of the Nonoperated Knee: A Case Report

2017 ◽  
Vol 03 (03) ◽  
pp. e107-e109 ◽  
Author(s):  
Kelechi Okoroha ◽  
Michael Gabbard ◽  
Jamal Fitts ◽  
Trevor Banka
Keyword(s):  
Septic Arthritis ◽  
Clinical Judgment ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Cutibacterium Acnes ◽  
Antibiotic Management ◽  
Uncommon Case ◽  
Selection For ◽  
Septic Knee Arthritis

Abstract Cutibacterium (Propionibacterium) acnes, a gram-positive bacillus with low pathogenicity, is an uncommon but known cause of prosthetic joint infections, particularly related to shoulder surgery. C. acnes, however, is an extremely rare pathogen in the nonoperated knee joint. This report details an uncommon case of C. acnes septic knee arthritis after multiple intra-articular steroid injections in a 56-year-old male patient. After an indolent presentation and late diagnosis, the patient underwent surgical debridement with IV antibiotic management. This case illustrates that intra-articular corticosteroid injections for the management of osteoarthritis are not without risk. Literature supporting their use remains limited and clinicians should use proficient clinical judgment for appropriate patient selection for these injections. Vigilance following injections or aspirations of the knee should be maintained to identify the indolent clinical presentation of C. acnes septic arthritis.

scholarly journals Clinical features and outcome of Streptococcus agalactiae bone and joint infections over a 6-year period in a French university hospital

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248231
Author(s):  
Paul Loubet ◽  
Yatrika Koumar ◽  
Catherine Lechiche ◽  
Nicolas Cellier ◽  
Sophie Schuldiner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Features ◽  
Streptococcus Agalactiae ◽  
Treatment Success ◽  
University Hospital ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Prosthetic Joint ◽  
Device Infection ◽  
Prosthetic Joint Infections

Background Bone and joint infections (BJIs) due to Streptococcus agalactiae are rare but has been described to increase in the past few years. The objective of this study was to describe clinical features and outcomes of cases of S. BJIs. Methods We conducted a retrospective analysis of adult cases of S. agalactiae BJIs that occurred between January 2009 and June 2015 in a French university hospital. The treatment success was assessed until 24 months after the end of antibiotic treatment. Results Among the 26 patients included, 20 (77%) were male, mean age was 62 years ± 13 and mean Charlson comorbidity index score was 4.9 ± 3.2. Diabetes mellitus was the most common comorbidity (n = 14, 54%). Six had PJI (Prosthetic Joint Infections), five osteosynthesis-associated infections, 11 osteomyelitis and four native septic arthritis. Eleven patients had a delayed or late infection: six with a prosthetic joint infection and five with an internal fixation device infection. Sixteen patients (62%) had a polymicrobial BJI, most commonly with Gram-positive cocci (75%) notably Staphylococcus aureus (44%). Polymicrobial infections were more frequently found in foot infections (90% vs 44%, p = 0.0184). During the two-year follow-up, three patients died (3/25, 12%) and seven (7/25, 28%) had treatment failure. Conclusion Diabetes mellitus was the most common comorbidity. We observed an heterogenous management and a high rate of relapse.

scholarly journals Optimal microbiological sampling for the diagnosis of osteoarticular infection

2021 ◽  
Vol 6 (6) ◽  
pp. 390-398
Author(s):  
Ricardo Sousa ◽  
André Carvalho ◽  
Ana Cláudia Santos ◽  
Miguel Araújo Abreu
Keyword(s):  
Clinical Laboratory ◽  
Basic Principles ◽  
Specific Patient ◽  
Osteoarticular Infection ◽  
Joint Infections ◽  
Diabetic Foot Infections ◽  
Prosthetic Joint ◽  
Clinical Scenarios ◽  
Prosthetic Joint Infections ◽  
Processing Techniques

Infection is a dire complication afflicting every field of orthopaedics and traumatology. If specific clinical, laboratory and imaging parameters are present, infection is often assumed even in the absence of microbiological confirmation. However, apart from confirming infection, knowing the exact infecting pathogen(s) and their antimicrobial susceptibility patterns is paramount to help guide treatment. Every effort should therefore be undertaken with that goal in mind. Not all microbiological findings carry the same relevance, and knowing exactly how and where a sample was collected is key. Several different sampling techniques are available, and one must be aware of both advantages and limitations. Microbiological sampling alternatives in some of the most common clinical scenarios such as native and prosthetic joint infections, osteomyelitis and fracture-related infections, spinal and diabetic foot infections will be discussed. Orthopaedic surgeons should also be aware of basic laboratory sample processing techniques as they have a direct impact on the way specimens should be dealt with and transported to the laboratory. Only by knowing these basic principles will surgeons be able to participate in the multidisciplinary discussion and decision making around how to interpret microbiological findings in each specific patient. Cite this article: EFORT Open Rev 2021;6:390-398. DOI: 10.1302/2058-5241.6.210011

Septic Arthritis and Prosthetic Joint Infections in Older Adults

2017 ◽  
Vol 31 (4) ◽  
pp. 715-729 ◽  
Author(s):  
Rajeshwari Nair ◽  
Marin L. Schweizer ◽  
Namrata Singh
Keyword(s):  
Older Adults ◽  
Septic Arthritis ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

Diabetes Mellitus, Hyperglycemia, Hemoglobin A1C and the Risk of Prosthetic Joint Infections in Total Hip and Knee Arthroplasty

2015 ◽  
Vol 30 (3) ◽  
pp. 439-443 ◽  
Author(s):  
Hilal Maradit Kremers ◽  
Laura W. Lewallen ◽  
Tad M. Mabry ◽  
Daniel J. Berry ◽  
Elie F. Berbari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Knee Arthroplasty ◽  
Hemoglobin A1c ◽  
Total Hip ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Hip And Knee Arthroplasty

scholarly journals Using Nuclear Medicine Imaging Wisely in Diagnosing Infectious Diseases

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
Andrea Censullo ◽  
Tara Vijayan
Keyword(s):  
Infectious Disease ◽  
Nuclear Medicine ◽  
Diagnostic Testing ◽  
Vertebral Osteomyelitis ◽  
Nuclear Imaging ◽  
Nuclear Medicine Imaging ◽  
Joint Infections ◽  
Diabetic Foot Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections

AbstractIn recent years, there has been an increasing emphasis on efficient and accurate diagnostic testing, exemplified by the American Board of Internal Medicine’s “Choosing Wisely” campaign. Nuclear imaging studies can provide early and accurate diagnoses of many infectious disease syndromes, particularly in complex cases where the differential remains broad.This review paper offers clinicians a rational, evidence-based guide to approaching nuclear medicine tests, using an example case of methicillin-sensitive Staphylococcus aureus (MSSA) bacteremia in a patient with multiple potential sources. Fluorodeoxyglucose-positron emission tomography (FDG-PET) with computed tomography (CT) and sulfur colloid imaging with tagged white blood cell (WBC) scanning offer the most promise in facilitating rapid and accurate diagnoses of endovascular graft infections, vertebral osteomyelitis (V-OM), diabetic foot infections, and prosthetic joint infections (PJIs). However, radiologists at different institutions may have varying degrees of expertise with these modalities.Regardless, infectious disease consultants would benefit from knowing what nuclear medicine tests to order when considering patients with complex infectious disease syndromes.

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