scholarly journals Spontaneous Septic Arthritis of Pubic Symphysis in an Elite Athlete

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
F. Jasmijn Smits ◽  
Herman Frima ◽  
Christoph Schaeffeler ◽  
Christoph Sommer
Keyword(s):  
Septic Arthritis ◽  
Groin Pain ◽  
Severe Disease ◽  
Pubic Symphysis ◽  
Pubic Bone ◽  
Reactive Protein ◽  
Image Guided ◽  
First Case ◽  
Additional Image ◽  
Invasive Intervention

Septic arthritis of the pubic symphysis is a potentially severe disease. Athletes are at risk of this form of spontaneous arthritis, as inflammation of the pubic bone due to muscular stress is relatively common. Oedema due to inflammation might predispose to infection through bacteraemia or local bacterial translocation. Suspicion should be raised when an athlete complains of groin pain and has signs of infection (i.e., fever, elevated white blood cell count, and elevated C-reactive protein). Diagnosis is made by imaging showing signs of inflammation combined with positive (blood) cultures. Broad spectrum antibiotics should be started upon suspicion and adjusted according to cultures. An abscess causing clinical deterioration under antibiotic treatment is an indication for invasive intervention (i.e., surgical or image-guided drainage). This is the first case of spontaneous septic arthritis of the pubic symphysis in an athlete requiring surgical and additional image-guided drainage.

scholarly journals 64-year-old male with septic arthritis of the pubic symphysis

2011 ◽  
Vol 1 (3) ◽  
pp. 76 ◽  
Author(s):  
Ewa Konik ◽  
Brent Bauer ◽  
Mark Lee
Keyword(s):  
Risk Factors ◽  
Staphylococcus Aureus ◽  
Pseudomonas Aeruginosa ◽  
Septic Arthritis ◽  
Groin Pain ◽  
Pubic Symphysis ◽  
Pelvic Malignancy ◽  
Incontinence Surgery ◽  
Streptococcus Anginosus ◽  
Hip Motion

Septic arthritis of the pubic symphysis is a rare disease. Typical clinical features include fever, pubic or groin pain, pain with hip motion, and painful or waddling gait. Identified predisposing factors to develop an infection in pubic joint include female incontinence surgery or postpartum period; sports, especially soccer; pelvic malignancy; and intravenous drug abuse. The most often identified microorganisms were Staphylococcus aureus and Pseudomonas aeruginosa. Osteomyelitis complicates the majority of cases, and about half of the patients require surgical debridement along with a prolonged antibiotic treatment. We report a case of Streptococcus anginosus septic arthritis of the pubic symphysis. The patient did not have any of the above risk factors.

scholarly journals Osteomyelitis of the pubic symphysis caused by methicillin-resistant Staphylococcus aureus after vaginal delivery: a case report and literature review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Stefano Cosma ◽  
Fulvio Borella ◽  
Andrea Carosso ◽  
Agata Ingala ◽  
Federica Fassio ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Pubic Symphysis ◽  
Joint Effusion ◽  
Pubic Bone ◽  
Oral Antibiotic ◽  
X Rays ◽  
Methicillin Resistant ◽  
Orthopedic Procedure ◽  
First Case ◽  
Bone Edema

Abstract Background Osteomyelitis of the pubic symphysis is a rare cause of pelvic pain after delivery, mainly caused by Staphylococcus aureus and Pseudomonas aeruginosa. The clinical context is the same as the more common diastasis of the pubic bone, but the presence of intense local pain in association with fever should prompt further clinical work-up based on blood chemistry, microbiology and diagnostic imaging. We report the first case of methicillin-resistant Staphylococcus aureus osteomyelitis of the pubic symphysis occuring after the delivery. Case presentation A 39-year-old woman developed pain over the pubic bone 12 h after the delivery. After 72 h fever rose and laboratory examination showed elevation of C-reactive protein and procalcitonin levels. Pelvic x-rays and magnetic resonance showed pubic diastasis, joint effusion, tiny irregularities of articular surfaces and, severe bone edema. The patient was started on broad spectrum intravenous (IV) antibiotics (piperacillin-tazobactam) and then replaced to IV vancomycin and oral levofloxacin based on antibiogram result. She was then discharged with oral antibiotic therapy and fully recovered. Conclusions Due to the rarity of this disease, we compared our experience with the other cases of osteomyelitis of pubic symphysis occurring in peri-postpartum reported in the literature. The course of osteomyelitis was favourable in all patients, and only in one case an additional orthopedic procedure for symphysis fixation was necessary. Knowledge of this rare condition is important to enable prompt diagnosis and treatment.

scholarly journals Long-standing groin pain in contact sports: a prospective case–control and MRI study

2019 ◽  
Vol 5 (1) ◽  
pp. e000507 ◽  
Author(s):  
Hannu Paajanen ◽  
Heikki Hermunen ◽  
Leena Ristolainen ◽  
Sonia Branci
Keyword(s):  
Groin Pain ◽  
Pubic Symphysis ◽  
Case Control ◽  
Ice Hockey ◽  
Pubic Bone ◽  
Mri Findings ◽  
Pelvic Mri ◽  
Contact Sports ◽  
Annual Prevalence ◽  
Significant Difference

ObjectivesWe aimed to prospectively evaluate the prevalence of long-standing groin pain and related MRI findings in contact sports.MethodsThis case–control study followed three male elite-level soccer, ice-hockey and bandy teams (102 players) for 2 years. All athletes with long-standing groin pain lasting >30 days and age-matched controls (1:3) from the same teams were examined clinically, using pelvic MRI and Hip and Groin Outcome Scores (HAGOS). Primary outcome measures were annual prevalence of groin pain and underlying MRI findings.ResultsThe annual prevalence of chronic groin pain was 7.5%. Training characteristics and pain scores of athletes were similar in all teams. On MRI, there was no significant difference in the percentage of pubic bone marrow oedema (p = 0.80) between symptomatic players (8/15; 53%) versus controls (20/43; 47%), but adductor tendinopathy and degenerative changes at the pubic symphysis were twice more common among players with pain. Rectus muscle or iliopsoas pathology were seldom observed. Lower HAGOS subscales (p < 0.01) were recorded in players who experienced groin pain compared with the controls.ConclusionLong-standing groin pain was observed annually in 1 of 14 athletes in contact sports. Abnormalities in the pubic symphysis were common MRI findings in both symptomatic and asymptomatic players.Trial registration numberNCT02560480

scholarly journals Symphysis Pubis Osteomyelitis with Bilateral Adductor Muscles Abscess

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Saad M. Alqahtani ◽  
Fan Jiang ◽  
Bardia Barimani ◽  
Marie Gdalevitch
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Septic Arthritis ◽  
Rare Condition ◽  
Pubic Symphysis ◽  
Symphysis Pubis ◽  
Definitive Treatment ◽  
Presenting Symptoms ◽  
First Case ◽  
Adductor Muscles ◽  
Pubis Symphysis

Osteomyelitis of the pubis symphysis is a rare condition. There have been various reports in the literature of inflammation and osteomyelitis as well as septic arthritis of pubic symphysis. However, due to the fact that these conditions are rare and that the usual presenting symptoms are very nonspecific, osteomyelitis of the pubic symphysis is often misdiagnosed, thus delaying definitive treatment. We present a case that to our knowledge is the first case in literature of osteomyelitis of the pubic symphysis in a 17-year-old boy with juvenile idiopathic arthritis (JIA), which was initially misdiagnosed and progressed to bilateral adductor abscesses. A high suspicion of such condition should be considered in a JIA patient who presents with symphysis or thigh pain.

scholarly journals Serum C-Reactive Protein and Interleukin-6 Levels as Biomarkers for Disease Severity and Clinical Outcomes in Patients with Idiopathic Granulomatous Mastitis

2021 ◽  
Vol 10 (10) ◽  
pp. 2077
Author(s):  
Yi-Min Huang ◽  
Chiao Lo ◽  
Chiao-Feng Cheng ◽  
Cheng-Hsun Lu ◽  
Song-Chou Hsieh ◽  
...  
Keyword(s):  
Disease Severity ◽  
Severe Disease ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Serum Biomarkers ◽  
Healthy Controls ◽  
Granulomatous Mastitis ◽  
C Reactive Protein ◽  
Idiopathic Granulomatous Mastitis ◽  
Reactive Protein

Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease mimicking breast cancer. Limited research has been conducted on the application of serum biomarkers. This study aims to investigate the association of serum biomarkers with disease severity in patients with IGM. From November 2011 to March 2020, medical records of patients with IGM were reviewed. Serum cytokine levels were measured in patients and healthy controls between July 2018 and March 2020. A total of 41 patients with histologically proven IGM were found. Serum interleukin (IL)-6 level was significantly higher in patients with IGM (n = 11) than healthy controls (n = 7). Serum IL-6 and C-reactive protein (CRP) levels were significantly higher in patients with severe disease than mild and moderate disease. Serum IL-6 (Spearman’s ρ = 0.855; p < 0.001) and CRP (Spearman’s ρ = 0.838; p = 0.001) levels were associated with time to resolution. A higher serum CRP level was associated with a longer time to resolution (B = 0.322; p < 0.001) in multiple linear regression analysis. Serum IL-6 and CRP levels can be used as biomarkers for the evaluation of disease severity in IGM. IL-6 may play a crucial role in the immunopathology of IGM.

Oxidative burst and phagocytic activity of phagocytes in canine parvoviral enteritis

2021 ◽  
pp. 104063872110255
Author(s):  
Kelly du Preez ◽  
Yolandi Rautenbach ◽  
Emma H. Hooijberg ◽  
Amelia Goddard
Keyword(s):  
Oxidative Burst ◽  
Phagocytic Activity ◽  
Severe Disease ◽  
Burst Activity ◽  
E Coli ◽  
Reactive Protein ◽  
Oxidative Burst Activity ◽  
Healthy Control ◽  
Complete Blood Counts ◽  
Serum Crp

Canine parvoviral enteritis (CPE) is a severe disease characterized by systemic inflammation and immunosuppression. The function of circulating phagocytes (neutrophils and monocytes) in affected dogs has not been fully investigated. We characterized the functional capacity of canine phagocytes in CPE by determining their oxidative burst and phagocytic activities using flow cytometry. Blood was collected from 28 dogs with CPE and 11 healthy, age-matched, control dogs. Oxidative burst activity was assessed by stimulating phagocytes with opsonized Escherichia coli or phorbol 12-myristate 13-acetate (PMA) and measuring the percentage of phagocytes producing reactive oxygen species and the magnitude of this production. Phagocytosis was measured by incubating phagocytes with opsonized E. coli and measuring the percentage of phagocytes containing E. coli and the number of bacteria per cell. Complete blood counts and serum C-reactive protein (CRP) concentrations were also determined. Serum CRP concentration was negatively and positively correlated with segmented and band neutrophil concentrations, respectively. Overall, no differences in phagocyte function were found between dogs with CPE and healthy control dogs. However, infected dogs with neutropenia or circulating band neutrophils had decreased PMA-stimulated oxidative burst activity compared to healthy controls. Additionally, CPE dogs with neutropenia or circulating band neutrophils had decreased PMA- and E. coli–stimulated oxidative burst activity and decreased phagocytosis of E. coli compared to CPE dogs without neutropenia or band neutrophils. We conclude that phagocytes have decreased oxidative burst and phagocytic activity in neutropenic CPE dogs and in CPE dogs with circulating band neutrophils.

Neonatal Toxic Shock Syndrome–Like Exanthematous Disease in North America

2019 ◽  
Author(s):  
Megan Culler Freeman ◽  
Stephanie Mitchell ◽  
John Ibrahim ◽  
John V Williams
Keyword(s):  
North America ◽  
Diagnostic Criteria ◽  
Skin Rash ◽  
Toxic Shock Syndrome ◽  
Disease Process ◽  
Toxic Shock ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
First Case

Abstract Neonatal toxic shock syndrome (TSS)-like exanthematous disease (NTED) is a syndrome first reported in Japan. Neonates develop systemic exanthema, thrombocytopenia, and fever usually during the first week of life. The disease is distinguished from frank TSS because affected infants are not severely ill and do not meet TSS criteria. Most infants are confirmed to be colonized with TSST-1 producing strains of S. aureus. Suggested diagnostic criteria for NTED include a skin rash with generalized macular erythema and one of the following symptoms: fever >38.0°C, thrombocytopenia <150 x103uL, or low positive C-reactive protein (1-5 mg/dL) in the absence of another known disease process. NTED is common in Japanese NICUs, but outside Japan, only one case has been reported in France. We describe the first case of NTED reported in North America.

scholarly journals Coronavirus disease (COVID-19) pandemic: an overview of systematic reviews

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Israel Júnior Borges do Nascimento ◽  
Dónal P. O’Mathúna ◽  
Thilo Caspar von Groote ◽  
Hebatullah Mohamed Abdulazeem ◽  
Ishanka Weerasekara ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Troponin I ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Severe Disease ◽  
Ground Glass Opacity ◽  
Cochrane Library ◽  
Reactive Protein ◽  
Overview Of Systematic Reviews ◽  
The Impact

Abstract Background Navigating the rapidly growing body of scientific literature on the SARS-CoV-2 pandemic is challenging, and ongoing critical appraisal of this output is essential. We aimed to summarize and critically appraise systematic reviews of coronavirus disease (COVID-19) in humans that were available at the beginning of the pandemic. Methods Nine databases (Medline, EMBASE, Cochrane Library, CINAHL, Web of Sciences, PDQ-Evidence, WHO’s Global Research, LILACS, and Epistemonikos) were searched from December 1, 2019, to March 24, 2020. Systematic reviews analyzing primary studies of COVID-19 were included. Two authors independently undertook screening, selection, extraction (data on clinical symptoms, prevalence, pharmacological and non-pharmacological interventions, diagnostic test assessment, laboratory, and radiological findings), and quality assessment (AMSTAR 2). A meta-analysis was performed of the prevalence of clinical outcomes. Results Eighteen systematic reviews were included; one was empty (did not identify any relevant study). Using AMSTAR 2, confidence in the results of all 18 reviews was rated as “critically low”. Identified symptoms of COVID-19 were (range values of point estimates): fever (82–95%), cough with or without sputum (58–72%), dyspnea (26–59%), myalgia or muscle fatigue (29–51%), sore throat (10–13%), headache (8–12%) and gastrointestinal complaints (5–9%). Severe symptoms were more common in men. Elevated C-reactive protein and lactate dehydrogenase, and slightly elevated aspartate and alanine aminotransferase, were commonly described. Thrombocytopenia and elevated levels of procalcitonin and cardiac troponin I were associated with severe disease. A frequent finding on chest imaging was uni- or bilateral multilobar ground-glass opacity. A single review investigated the impact of medication (chloroquine) but found no verifiable clinical data. All-cause mortality ranged from 0.3 to 13.9%. Conclusions In this overview of systematic reviews, we analyzed evidence from the first 18 systematic reviews that were published after the emergence of COVID-19. However, confidence in the results of all reviews was “critically low”. Thus, systematic reviews that were published early on in the pandemic were of questionable usefulness. Even during public health emergencies, studies and systematic reviews should adhere to established methodological standards.

Grading scale of radiographic findings in the public bone and symphysis in athletes

2003 ◽  
Vol 44 (1) ◽  
pp. 79-83
Author(s):  
J. Besjakov ◽  
C. von Scheele ◽  
O. Ekberg ◽  
C. F. Gentz ◽  
N. E. Westlin
Keyword(s):  
Groin Pain ◽  
Pelvic Ring ◽  
Age Groups ◽  
Pubic Bone ◽  
Control Group ◽  
Male Athletes ◽  
Radiographic Findings ◽  
Bone Changes ◽  
Grading Scale ◽  
Group 2

Purpose: Radiographic abnormalities in the pubic bone and symphysis are often seen in athletes with groin pain. The aim was to create a grading scale of such radiologic changes. Material and Methods: Plain radiography of the pelvic ring including the pubic bone and the symphysis was performed in 20 male athletes, age 19–35, with long-standing uni- or bilateral groin pain. We used two control groups: Control group 1: 20 healthy age-matched men who had undergone radiologic examination of the pelvis due to trauma. Control group 2: 120 adults (66 men and 54 women) in 9 age groups between 15 and 90 years of age. These examinations were also evaluated for interobserver variance. Results and Conclusion: The grading scale was based on the type and the amount of the different changes, which were classified as follows: No bone changes (grade 0), slight bone changes (grade 1), intermediate changes (grade 2), and advanced changes (grade 3). The grading scale is easy to interpret and an otherwise troublesome communication between the radiologist and the physician was avoided. There was a high interobserver agreement with a high kappa value (0.8707). Male athletes with long-standing groin pain had abnormal bone changes in the symphysis significantly more frequently and more severely ( p>0.001) than their age-matched references. In asymptomatic individuals such abnormalities increased in frequency with age both in men and women.

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