Neisseria meningitidis serogroup C causing primary polyarthritis in an octogenarian

2020 ◽  
Vol 13 (6) ◽  
pp. e233378 ◽  
Author(s):  
Thomas William Noteman ◽  
Taegyeong Tina Ha ◽  
Elan Micha Tsarfati
Keyword(s):  
Septic Arthritis ◽  
Neisseria Meningitidis ◽  
Blood Cultures ◽  
Joint Fluid ◽  
Age Group ◽  
Edta Blood Sample ◽  
History Of ◽  
The Impact ◽  
Intensive Physiotherapy ◽  
Edta Blood

A man in his 80s presented to the hospital with a 36-hour history of fever, myalgia, bilateral shoulder and right knee pain. Joint fluid aspirates from his shoulders and right knee isolated Gram-negative diplococci. After failing to grow on standard and selective media, Neisseria meningitidis was identified by 16s PCR and subsequently typed as serogroup C. He had no clinical features of meningitis or meningococcaemia. Blood cultures were negative and an EDTA blood sample was negative for meningococcal ctrA gene. Urine PCR was negative for Neisseria gonorrhoeae. He was treated successfully with two arthroscopic joint washouts of his right knee, aspirates of both shoulders, 40 days of intravenous ceftriaxone and intensive physiotherapy as both an inpatient and outpatient. In the literature, we have not found any previously documented cases of serogroup C meningococcus causing polyarticular primary septic arthritis in this age group or guidance on duration of antibiotic treatment. Literature on the impact of rehabilitation to baseline function was also found to be lacking. Although rare, primary meningococcal arthritis (PMA) should be considered as a differential diagnosis in cases of acute polyarticular septic arthritis. Polyarticular PMA in older adults may require prolonged rehabilitation before one might expect to return to premorbid function.

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 GAMBARAN PENGGUNAAN KONTRASEPSI HORMONAL PADA PASIEN STROKE ISKEMIK DI RSUD Dr. SOETOMO SURABAYA

2021 ◽  
Vol 3 (1) ◽  
pp. 37
Author(s):  
Virna Safira Puspaningtyas ◽  
Baksono Winardi ◽  
Sulistiawati Sulistiawati
Keyword(s):  
Ischemic Stroke ◽  
Hormonal Contraception ◽  
Hormonal Contraceptive ◽  
Hereditary Disease ◽  
Hereditary Diseases ◽  
Coagulation System ◽  
Age Group ◽  
Consecutive Sampling ◽  
History Of ◽  
The Impact

AbstrakLatar Belakang : Kontrasepsi hormonal berfungsi untuk mencegah terjadinya kehamilan yang mengandung preparat estrogen dan progesteron. Esterogen diketahui dapat menginduksi perubahan signifikan dalam sistem koagulasi yang dapat menyebabkan terjadinya tromboembolik seperti stroke. Sementara pada beberapa penelitian, kontrasepsi progesterone-only, dampaknya pada penyakit kardiovaskular belum dapat dijelaskan secara pasti. Penelitian bertujuan untuk mengetahui gambaran pengguna kontrasepsi hormonal pada pasien stroke iskemik di RSUD Dr. Soetomo Surabaya. Metode : Penelitian deskriptif observasional. Teknik sampling secara consecutive sampling. Variabel penelitian meliputi usia, pekerjaan, riwayat penyakit, jenis dan lama penggunaan kontrasepsi hormonal, serta jarak berhenti penggunaan kontrasepsi hormonal sampai terjadinya stroke. Untuk mengetahui gambaran dan distribusi frekuensi variabel dilakukan analisis univariat atau deskriptif. Hasil :. Didapatkan kelompok usia tertinggi yakni 40% adalah masa lansia awal (46 – 55 tahun), sebanyak 42% responden berprofesi sebagai ibu rumah tangga. Didapati 40% responden pernah menderita hipertensi dan juga mayoritas 50% memiliki riwayat penyakit keturunan hipertensi. Sebesar 54% responden menggunakan alat kontrasepsi hormonal ≥5 tahun dengan jenis kontrasepsi hormonal terbanyak adalah suntik 3 bulan (progesterone-only) yaitu 42%. Sebanyak 68% responden menyatakan jangka waktu berhentinya menggunakan kontrasepsi hormonal sampai terjadinya stroke iskemik rata - rata <12 tahun.  Kesimpulan : Usia responden pada penelitian ini mayoritas pada kelompok umur lansia awal (46 - 55 tahun) dengan jenis pekerjaan terbanyak ibu rumah tangga. Hipertensi merupakan riwayat penyakit terdahulu dan penyakit keturunan yang banyak diderita oleh responden. Sebagian kecil responden menggunakan kontrasepsi hormonal lamanya ≤5 tahun dengan jenis penggunaan terbanyak adalah suntik 3 bulan (progesterone-only). Rata-rata responden berhenti menggunakan kontrasepsi hormonal <12 tahun sebelum terjadinya stroke iskemik. AbstractBackground : Hormonal contraception serves to prevent pregnancy from it contains estrogen and progesterone preparations. Esterogens are known to induce significant changes in the coagulation system that can cause thromboembolic events such as stroke. While in some studies, progesterone-only contraception, the impact on cardiovascular disease has not been clearly explained. This study aims to determine the description of hormonal contraceptive users in ischemic stroke patients at Dr. Soetomo Surabaya. Method : Observational descriptive study. In addition, researcher applied consecutive sampling in this study. Research variables included age, occupation, disease history, type and duration of hormonal contraceptive use, as well as the distance to stop using hormonal contraception until the occurrence of stroke. Univariate or descriptive analysis is applied to perceive the representation and frequency distribution of variables. Result : The highest age group of 40% was obtained from the early elderly (46 - 55 years), as many as 42% of respondents worked as housewives. In the amount of 40% respondents had suffered from hypertension and also 50% had a history of hypertensive hereditary disease. 54% of respondents used hormonal contraception in ≥5 years with the most types of hormonal contraception were injections of progesterone-only, which is 42%. As many as 68% of respondents stated that the duration of cessation of using hormonal contraception until the occurrence of ischemic stroke was on average <12 years. Conclusion : The majority of the respondent were in the age group of the early elderly (46 - 55 years) with the most respondents worked as housewives. Hypertension is a history of previous illnesses and hereditary diseases that were mostly suffered by respondents. A small proportion of respondents used hormonal contraception for ≤5 years with the most type of use being injected progesterone-only. On average respondents stopped using hormonal contraception in <12 years before the occurrence of ischemic stroke.  

scholarly journals Predictive value of the usual clinical signs and laboratory tests in the diagnosis of septic arthritis

CJEM ◽  
2015 ◽  
Vol 17 (4) ◽  
pp. 403-410 ◽  
Author(s):  
Marion Couderc ◽  
Bruno Pereira ◽  
Sylvain Mathieu ◽  
Jeannot Schmidt ◽  
Olivier Lesens ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Univariate Analysis ◽  
Clinical Signs ◽  
University Hospital ◽  
Joint Fluid ◽  
Radiological Findings ◽  
Bacteriological Test ◽  
History Of ◽  
Wbc Count ◽  
Crystal Induced Arthritis

AbstractObjectiveTo determine the sensitivity and specificity of clinical and laboratory signs for the diagnosis of septic arthritis (SA).Patients and methodsThis prospective study included all adult patients with suspected SA seen in the emergency department or rheumatology department at the University Hospital, Clermont-Ferrand, France, over a period of 18 months.ResultsIn total, 105 patients with suspected SA were included, 38 (36%) presenting with SA (29 [28%] with bacteriologically documented SA). In the univariate analysis, chills (p=0.015), gradual onset (p=0.04), local redness (p=0.01), as well as an entry site for infection (p=0.01) were most often identified in SA. A history of crystal-induced arthritis (p=0.004) was more frequent in non-SA cases. An erythrocyte sedimentation rate (ESR)>50 mm (p=0.005), a C-reactive protein (CRP) level >100 mg/L (p=0.019), and radiological signs suggestive of SA (p=0.001) were more frequent in the SA cases. Synovial fluid appearance: purulent (p<0.001) and clear (p=0.007), synovial white blood cell (WBC) count >50,000/μL (p < 0.001), differentiated between SA and non-SA.In multivariate analysis, only chills (odds ration [OR]=4.7, 95% confidence interval [CI] 1.3–17.1), a history of crystal-induced arthritis (OR=0.09, 95% CI 0.01–0.9), purulent appearance of the joint fluid (OR=8.4, 95% CI 2.4–28.5), synovial WBC count >50,000/mm3 (OR=6.8, 95% CI 1.3–36), and radiological findings (OR=7.1, 95% CI 13–37.9) remained significant.ConclusionNo clinical sign or laboratory test (excluding bacteriological test), taken alone, is conclusive for the differentiation between SA and non-SA, but the association of several signs, notably chills, history of crystal-induced arthritis, radiological findings, and the appearance and cellularity of joint fluid may be suggestive.

Mycoplasma hominis septic arthritis in a patient with hypogammaglobinaemia and rheumatoid arthritis

2021 ◽  
Vol 14 (1) ◽  
pp. e237798
Author(s):  
Naila Bozo ◽  
Christen Ravn ◽  
Ulrik Stenz Justesen ◽  
Line Dahlerup Rasmussen
Keyword(s):  
Rheumatoid Arthritis ◽  
Septic Arthritis ◽  
Mycoplasma Hominis ◽  
Joint Fluid ◽  
Pcr Analysis ◽  
Predisposing Factor ◽  
Correct Treatment ◽  
Increased Risk ◽  
History Of ◽  
Anti Cd20

We describe the case of Mycoplasma hominis septic arthritis in a 58-year-old woman with a history of rheumatoid arthritis and ulcerative colitis on immunosuppressive therapy with rituximab. Treatment with anti-CD20 antibodies (eg, rituximab) leads to an immediate depletion of B cells and hence risk of reductions in immunoglobulins and increased risk of infections. This effect may last long after drug cessation. M. hominis is commensal to the genitourinary tract in sexually active adults. Extragenital M. hominis infections including septic arthritis are rare, but hypogammaglobulinaemia is a predisposing factor. As M. hominis requires extended culture, special media or PCR analysis, it is not tested routinely, which in many cases delays diagnosis and correct treatment. In our case, a diagnosis of M. hominis septic arthritis was made after 9 weeks by PCR analysis and culture of joint fluid. The patient responded well to an 8-week treatment course of moxifloxacin and doxycycline.

scholarly journals Clinico-Epidemiological Profile of Patients with COVID-19 in a Tertiary Care Centre of Mid-Western Nepal

2021 ◽  
Vol 4 (1) ◽  
pp. 429-432
Author(s):  
Shravya Singh Karki ◽  
Pragya S Basnet ◽  
Sauharda S Karki ◽  
Basant Lamichhane ◽  
Damodar Sharma ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Age Group ◽  
Tertiary Care Centre ◽  
Travel History ◽  
Young Males ◽  
Targeted Testing ◽  
History Of ◽  
Epidemiological Profile ◽  
The Impact

Introduction: With little to no research done that sheds light on the COVID-19 pandemic in the Mid-Western region of Nepal, this study attempts to educate the general populace and concerned authorities on the impact of the pandemic in the region.Materials and Methods: Patients presenting at Rapti Academy of Health Sciences between 14 May 2020 to December 21, 2020, diagnosed with COVID-19 were included in the study. These patients were reviewed for age, sex, address, recent travel history, and presenting symptoms.Results: A total of 3895 COVID -19 positive individuals were included in the study. The mean age of the patients was 33.6 ± 13.8 years, a majority (49.5%) of the cases were in the 20-29 years age group. 73.7% were male. 82.9% of the patients were from Dang, 86% of the cases of Dang were from urban areas, and the districts bordering India accounted for 88.5% of cases. Most of the positive patients were asymptomatic (97.1%), Amongst the symptomatic cases, the most frequent clinical manifestation was both fever and cough. 8.5% of the patients also reported travel history, of which a majority had returned from India.Conclusions: The patients were mostly young males belonging to the economically active age group who were mostly affected by COVID-19 in Mid-Western Nepal. It is important to carry out age-group targeted testing to flatten the infection curve. Testing must be done irrespective of observable symptoms to overcome this public health emergency.

scholarly journals Yersinia pseudotuberculosis: an unexpected cause of fever and a hot joint

2020 ◽  
Vol 13 (2) ◽  
pp. e233125
Author(s):  
Emily Martyn ◽  
Jack Heward ◽  
Rachel Herbert
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Septic Arthritis ◽  
Yersinia Pseudotuberculosis ◽  
Blood Cultures ◽  
Pcr Analysis ◽  
Gram Negative ◽  
Contaminated Food ◽  
History Of ◽  
Or History

Yersinia pseudotuberculosis is a Gram-negative zoonosis which occasionally infects humans via ingestion of contaminated food and water, and typically causes a self-limiting gastrointestinal tract infection. Patients who are immunocompromised, have haemochromatosis or liver cirrhosis are more likely to develop serious complications such as bacteraemia. We present the case of a 76-year-old man with fever and an acutely tender, swollen right knee. Blood cultures were positive for Y. pseudotuberculosis, and 16s ribosomal PCR analysis of his knee aspirate confirmed septic arthritis. He was treated with intravenous ceftriaxone and made an excellent recovery following knee washout. Interestingly, our patient did not have any of the classic risk factors described in the literature, or history of exposure to the pathogen to explain his diagnosis. To our knowledge, this is only the second confirmed case of Y. pseudotuberculosis bacteraemia with septic arthritis, and the first to involve the knee joint.

Impact of preheparinization and sample volume on routine hematology findings in healthy cats

2020 ◽  
pp. 1098612X2092635
Author(s):  
Gary D Norsworthy ◽  
Audrey K Cook ◽  
Christopher J Lanier
Keyword(s):  
Blood Count ◽  
Complete Blood Count ◽  
Hemoglobin Concentration ◽  
Sample Volume ◽  
Mean Cell Volume ◽  
Edta Blood Sample ◽  
Patient Stress ◽  
The Impact ◽  
Specific Volumes ◽  
Edta Blood

Objectives It can be challenging to collect sufficient blood from feline patients for both a biochemical profile and a complete blood count (CBC). The ability to generate accurate hematologic and biochemical data from a single, small (<2 ml) sample could reduce patient stress and improve clinical efficiency. The objective of this study was to determine the impact of preheparinization and/or sample size on routine hematology findings in cats. Methods Blood was collected from 20 healthy cats; measured aliquots were placed directly into tubes containing either EDTA or lithium–heparin (Hep). Within 2 mins, specific volumes were removed from the Hep tubes and placed in additional EDTA tubes. Four distinct sample sizes/types were created from each cat: (1) 1.3 ml EDTA (criterion standard); (2) 0.5 ml EDTA; (3) 1.3 ml Hep + EDTA; and (4) 0.5 ml Hep + EDTA. Three CBCs were performed on each sample using an automated bench-top hematology analyzer. Drops of blood were contemporaneously used to create three air-dried stained slides from each tube. Triplicate results were averaged for statistical analysis; results were compared across all sample types and against the criterion standard. Significance was set at P <0.05. Results Preheparinization did not significantly impact determinations of erythrocyte number, hematocrit, hemoglobin concentration, mean cell volume and neutrophil count. Platelet counts for the non-traditional samples correlated poorly with the criterion standard, although numbers could be effectively estimated using stained slides. Cell morphology was well preserved across all sample types. Conclusions and relevance These results indicate that a 0.5 ml preheparinized EDTA blood sample can generate clinically useful hematologic data (excluding platelet count) in cats, using a bench-top analyzer. Our findings support the collection of a single small (<2 ml) sample that can be used for both biochemical and hematologic analyses. Further studies are needed to verify these findings using other hematology machines and in diseased cats.

Investigating the Relationship Between Self-Esteem and Stigma Among Young Adults With History of Suicide Attempts

Crisis ◽  
2016 ◽  
Vol 37 (4) ◽  
pp. 265-270 ◽  
Author(s):  
Meshan Lehmann ◽  
Matthew R. Hilimire ◽  
Lawrence H. Yang ◽  
Bruce G. Link ◽  
Jordan E. DeVylder
Keyword(s):  
Young Adults ◽  
Suicide Attempts ◽  
Self Esteem ◽  
High Risk Population ◽  
High Functioning ◽  
People With Mental Illness ◽  
History Of ◽  
The Individual ◽  
The Impact ◽  
The Relationship

Abstract. Background: Self-esteem is a major contributor to risk for repeated suicide attempts. Prior research has shown that awareness of stigma is associated with reduced self-esteem among people with mental illness. No prior studies have examined the association between self-esteem and stereotype awareness among individuals with past suicide attempts. Aims: To understand the relationship between stereotype awareness and self-esteem among young adults who have and have not attempted suicide. Method: Computerized surveys were administered to college students (N = 637). Linear regression analyses were used to test associations between self-esteem and stereotype awareness, attempt history, and their interaction. Results: There was a significant stereotype awareness by attempt interaction (β = –.74, p = .006) in the regression analysis. The interaction was explained by a stronger negative association between stereotype awareness and self-esteem among individuals with past suicide attempts (β = –.50, p = .013) compared with those without attempts (β = –.09, p = .037). Conclusion: Stigma is associated with lower self-esteem within this high-functioning sample of young adults with histories of suicide attempts. Alleviating the impact of stigma at the individual (clinical) or community (public health) levels may improve self-esteem among this high-risk population, which could potentially influence subsequent suicide risk.

Hereditary Heparin Cofactor II Deficiency and the Risk of Development of Thrombosis

1987 ◽  
Vol 57 (02) ◽  
pp. 196-200 ◽  
Author(s):  
R M Bertina ◽  
I K van der Linden ◽  
L Engesser ◽  
H P Muller ◽  
E J P Brommer
Keyword(s):  
Liver Disease ◽  
Venous Thrombosis ◽  
Healthy Volunteers ◽  
Mean Value ◽  
Age Group ◽  
Normal Range ◽  
Heparin Cofactor Ii ◽  
History Of ◽  
Group 2 ◽  
Hereditary Nature

SummaryHeparin cofactor II (HC II) levels were measured by electroimmunoassay in healthy volunteers, and patients with liver disease, DIC, proteinuria or a history of venous thrombosis. Analysis of the data in 107 healthy volunteers revealed that plasma HC II increases with age (at least between 20 and 50 years). HC II was found to be decreased in most patients with liver disease (mean value: 43%) and only in some patients with DIC. Elevated levels were found in patients with proteinuria (mean value 145%). In 277 patients with a history of unexplained venous thrombosis three patients were identified with a HC II below the lower limit of the normal range (60%). Family studies demonstrated hereditary HC II deficiency in two cases. Among the 9 heterozygotes for HC II deficiency only one patient had a well documented history of unexplained thrombosis. Therefore the question was raised whether heterozygotes for HC II deficiency can also be found among healthy volunteers. When defining a group of individuals suspected of HC II deficiency as those who have a 90% probability that their plasma HC II is below the 95% tolerance limits of the normal distribution in the relevant age group, 2 suspected HC II deficiencies were identified among the healthy volunteers. In one case the hereditary nature of the defect could be established.It is concluded that hereditary HC II deficiency is as prevalent among healthy volunteers as in patients with thrombotic disease. Further it is unlikely that heterozygosity for HC II deficiency in itself is a risk factor for the development of venous thrombosis.

The Film World’s Cooperative Store: Institutions and Films of the 1930s and 1940s

2018 ◽  
Author(s):  
C. Claire Thomson
Keyword(s):  
World War Ii ◽  
Meat Products ◽  
Public Information ◽  
Early History ◽  
World War ◽  
International Context ◽  
German Occupation ◽  
History Of ◽  
The Uk ◽  
The Impact

This chapter traces the early history of state-sponsored informational filmmaking in Denmark, emphasising its organisation as a ‘cooperative’ of organisations and government agencies. After an account of the establishment and early development of the agency Dansk Kulturfilm in the 1930s, the chapter considers two of its earliest productions, both process films documenting the manufacture of bricks and meat products. The broader context of documentary in Denmark is fleshed out with an account of the production and reception of Poul Henningsen’s seminal film Danmark (1935), and the international context is accounted for with an overview of the development of state-supported filmmaking in the UK, Italy and Germany. Developments in the funding and output of Dansk Kulturfilm up to World War II are outlined, followed by an account of the impact of the German Occupation of Denmark on domestic informational film. The establishment of the Danish Government Film Committee or Ministeriernes Filmudvalg kick-started aprofessionalisation of state-sponsored filmmaking, and two wartime public information films are briefly analysed as examples of its early output. The chapter concludes with an account of the relations between the Danish Resistance and an emerging generation of documentarists.

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