scholarly journals Acute Streptococcus mitis Sacroiliitis in a Teenager with Unclear Source of Bacteremia: A Case Report and Literature Review

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Fatma Al-Farsi ◽  
Ibrahim Al-Busaidi ◽  
Khalfan Al-Zeedi
Keyword(s):  
Septic Arthritis ◽  
Bacterial Endocarditis ◽  
Hematogenous Spread ◽  
Streptococcus Mitis ◽  
Rare Form ◽  
Osteoarticular Infections ◽  
Prosthetic Joint ◽  
Septic Sacroiliitis ◽  
Spread Of Infection ◽  
Viridans Group Streptococci

Septic arthritis is an orthopedic emergency that is commonly caused by Staphylococcus aureus. Old age, diabetes mellitus, rheumatoid arthritis, prosthetic joint, and recent surgery are the main predisposing risk factors. Most cases of septic arthritis are caused by hematogenous spread of infection. Infectious sacroiliitis is a rare form of septic arthritis which is often clinically challenging to diagnose due its various and nonspecific presentations. Streptococcus mitis belongs to viridans group streptococci (VGS) bacteria, which is a component of body flora that is commonly involved in bacterial endocarditis. VGS in general and S. mitis specifically is an uncommon cause of osteoarticular infections. Here, we report a case of spontaneous Streptococcus mitis bacteremia complicated by septic sacroiliitis in a healthy teenager in the absence of infective endocarditis or a clear source of bacteremia.

scholarly journals Septic polyarthritis presentation of three cases

2020 ◽  
pp. 32-35
Author(s):  
Nadia Riscanevo ◽  
Elisa Novatti ◽  
Janet Flores ◽  
Diego Baenas ◽  
Francisco Caeiro ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
High Mortality ◽  
Structural Damage ◽  
Clinical Suspicion ◽  
Medical Emergency ◽  
Hematogenous Spread ◽  
Spread Of Infection ◽  
Joint Lavage ◽  
Septic Polyarthritis

Polyarticular septic arthritis is defined as the infection of two or more joints, almost always of bacterial etiology and hematogenous spread. It is considered a medical emergency, which should be recognized early, avoiding the spread of infection, associated with high mortality and the risk of joint structural damage. We present three cases of polyarticular septic arthritis, highlighting the importance of clinical suspicion and early synovial fluid study for diagnosis and treatment with antimicrobials, joint evacuation and joint lavage.

scholarly journals Long-Term Use of Tedizolid in Osteoarticular Infections: Benefits among Oxazolidinone Drugs

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 53
Author(s):  
Eva Benavent ◽  
Laura Morata ◽  
Francesc Escrihuela-Vidal ◽  
Esteban Alberto Reynaga ◽  
Laura Soldevila ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Joint Infection ◽  
Diabetic Foot Infections ◽  
Osteoarticular Infections ◽  
Prosthetic Joint ◽  
Implant Retention ◽  
Lower Drug ◽  
Drug Drug Interaction ◽  
Staphylococcus Spp

Background: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. Methods: Multicentric retrospective study (January 2017–March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. Results: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15–44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. Conclusions: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.

scholarly journals Pediatric Septic Arthritis of the Knee Due to a Multi-Sensitive Streptococcus pyogenes Strain Responsive to Clindamycin—A Case Report

Children ◽  
2021 ◽  
Vol 8 (3) ◽  
pp. 189
Author(s):  
Giada Maria Di Pietro ◽  
Irene Maria Borzani ◽  
Sebastiano Aleo ◽  
Samantha Bosis ◽  
Paola Marchisio ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Streptococcus Pyogenes ◽  
Antibiotic Sensitivity ◽  
Antimicrobial Treatment ◽  
Antibiotic Regimen ◽  
Hematogenous Spread ◽  
Clinical Resistance ◽  
Antibiotic Sensitivity Test ◽  
Clinical Conditions

Septic arthritis is an inflammatory process usually generated by a bacterial infection. The knee is one of the most frequently involved joints. The etiology varies depending on age, and hematogenous spread remains the primary cause in children. Herein, we report a case of a previously healthy three-year-old female who was referred to our institution for acute swelling of her right knee. After a clinical and radiological diagnosis of septic arthritis, an empirical treatment with a combination of cefotaxime and clindamycin was initiated. The isolation of a multi-sensitive Streptococcus pyogenes strain from the joint’s effusion prompted the discontinuation of clindamycin and the usage of cefotaxime alone. One week later, an ultrasound was executed due to worsening in the patient’s clinical conditions, and an organized corpuscular intra-articular effusion with diffuse synovial thickening was revealed. Cefotaxime was therefore replaced with clindamycin, which improved the symptoms. Despite the antibiotic sensitivity test having revealed a microorganism with sensitivity to both cephalosporin and clindamycin, clinical resistance to cefotaxime was encountered and a shift in the antimicrobial treatment was necessary to ensure a full recovery. This case study confirms that an antibiotic regimen based solely on a susceptibility test may be ineffective for such cases.

scholarly journals 329. Performance of Next Generation Sequencing in Isolating a Pathogen in Pediatric Osteoarticular Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S236-S237
Author(s):  
Nanda Ramchandar ◽  
Jessica Burns ◽  
Andrew Pennock ◽  
Christopher R Cannavino ◽  
Lauge Farnaes
Keyword(s):  
Next Generation Sequencing ◽  
Septic Arthritis ◽  
Standard Care ◽  
Pediatric Population ◽  
Single Site ◽  
Acute Osteomyelitis ◽  
Next Generation ◽  
Pathogenic Organism ◽  
Osteoarticular Infections ◽  
Generation Sequencing

Abstract Background Osteoarticular infections are often encountered in the pediatric population. Therapy is guided by isolation of a putative organism, however, operative cultures are often negative. Next generation sequencing (NGS) allows for more sensitive sampling of body compartments generally considered sterile. We sought to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Methods This was a single-site study to evaluate the utility of NGS in comparison to culture in detecting a pathogenic organism in acute osteomyelitis and septic arthritis in children. Eligible patients were all patients with osteomyelitis or septic arthritis admitted to Rady Children’s Hospital from July 2019 through July 2020. We excluded any patients with bone or joint surgery within 30 days prior to admission. Operative samples were chosen at the surgeon’s discretion (joint aspirate, synovium, or bone) based on operative findings. We compared NGS testing to standard care culture from the same site. Results We enrolled 41 subjects. NGS of the operative samples identified a pathogen in 26 (63.4%) patients versus 18 (43.9%) by culture. Operative culture missed the diagnosis in 10 cases, though PCR identified the organism in 6 of those cases (5 were cases in which Kingella kingae was identified). In 4 subjects, NGS identified a putative organism where standard care testing (either PCR or culture) was negative. NGS was falsely positive in 1 subject and falsely negative for one other subject. Sensitivity was 96.3% (CI 95%, 81.0–99.9%) and Specificity was 92.9% (CI 95%, 66.1–99.8) for NGS versus 64.3% (CI 95%, 44.1–81.4) and 84.6% (CI 95%, 54.6–99.9%) for culture respectively. Conclusion In this single site prospective study of pediatric osteoarticular infections, we demonstrate improved sensitivity and specificity of NGS testing when compared to standard culture. Disclosures All Authors: No reported disclosures

scholarly journals Bone and Joint Infections among Hematopoietic Stem Cell Transplant Recipients

2019 ◽  
Vol 4 (5) ◽  
pp. 209-215
Author(s):  
Cybele Lara Abad ◽  
Vania Phuoc ◽  
Prashant Kapoor ◽  
Pritish K. Tosh ◽  
Irene G. Sia ◽  
...  
Keyword(s):  
Stem Cell ◽  
Septic Arthritis ◽  
Hematopoietic Stem Cell ◽  
Joint Infection ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Joint Infections ◽  
Bone And Joint Infections ◽  
Prosthetic Joint ◽  
Increased Risk

Abstract. Background: Hematopoietic stem cell transplantation (HSCT) recipients are at increased risk for infection. This study describes bone and joint infections (BJI) among HSCT recipients.Methods: We reviewed 5861 patients who underwent HSCT at Mayo Clinic, Rochester, MN from January 1, 2005 through January 1, 2015 for study inclusion. BJI was defined as native septic arthritis, prosthetic joint infection, osteomyelitis, and orthopedic implant infection. All adults with BJI after HSCT were included in the analysis.Results: Of 5861 patients, 33 (0.6%) developed BJI. Native joint septic arthritis was the most common BJI occurring in 15/33 (45.4%) patients. Patients were predominantly male (24/33, 72.7%), with median age of 58 (range 20-72) years. BJI was diagnosed a median of 39 (range 1-114) months after allogeneic (14/33, 42.4%) or autologous (19/33, 57.6%) HSCT. Organisms were recovered via tissue (24/27, 88.9%), synovial fluid (13/17, 76.5%), and/or blood cultures (16/25, 64%). Most underwent surgical debridement (23/33, 69.7%). Patients were followed a median of 78.3 months (range 74-119). Therapy was unsuccessful in 4/33 (12.1%), with death related to the underlying BJI in two (50%). Failure occurred a median of 3.4 (0.1-48.5) months from diagnosis. At last follow up, 7/33 (21.2%) patients were alive. Median overall survival was 13 months (0.07-70.6).Conclusion: BJI among HSCT recipients is infrequent. The most common infection is native joint septic arthritis. Pathogens appear similar to patients without HSCT. Treatment involving surgical-medical modalities is successful, with most patients surviving >1 year after BJI.

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 A case of prosthetic joint septic arthritis caused by Gordonia jacobaea

2021 ◽  
Author(s):  
Jennifer Guiraud ◽  
Maëlig Lescure ◽  
Deborah Faganello ◽  
Cécile Bébéar ◽  
Sabine Pereyre ◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Prosthetic Joint

ACUTE INFECTIOUS SINUSITIS IN CYANOTIC CONGENITAL HEART DISEASE

PEDIATRICS ◽  
1973 ◽  
Vol 52 (5) ◽  
pp. 692-696
Author(s):  
Amnon Rosenthal ◽  
Kenneth E. Fellows
Keyword(s):  
Congenital Heart Disease ◽  
Heart Disease ◽  
Brain Abscess ◽  
Paranasal Sinuses ◽  
Congenital Heart ◽  
Bacterial Endocarditis ◽  
Cyanotic Congenital Heart Disease ◽  
Hematogenous Spread ◽  
Subacute Bacterial Endocarditis

The prevalance and sequelae of infectious sinusitis in a hospitalized group of children with and without congenital heart disease (CHD) were studied. Sinusitis was more common (1% versus 0.3%) in the CHD group and occurred predominantly (90%) in the cyanotic patients. It was associated with subacute bacterial endocarditis in 20% (5 of 20) and brain abscess in 15% (3 of 20) of the CHD cases. It is postulated that proliferation and distension of the venous channels and marrow spaces in patients with cyanotic CHD enhances the hematogenous spread of bacteria from the paranasal sinuses.

scholarly journals Kingella kingae Osteoarticular Infections Approached through the Prism of the Pediatric Orthopedist

2021 ◽  
Vol 10 (1) ◽  
pp. 25
Author(s):  
Giacomo DeMarco ◽  
Moez Chargui ◽  
Benoit Coulin ◽  
Benoit Borner ◽  
Christina Steiger ◽  
...  
Keyword(s):  
Inflammatory Response ◽  
Septic Arthritis ◽  
Surgical Procedures ◽  
Clinical Presentation ◽  
Tendon Sheath ◽  
Skeletal System ◽  
Kingella Kingae ◽  
Osteoarticular Infections ◽  
Acute Hematogenous Osteomyelitis ◽  
Mild Clinical Presentation

Nowadays, Kingella kingae (K. kingae) is considered as the main bacterial cause of osteoarticular infections (OAI) in children aged less than 48 months. Next to classical acute hematogenous osteomyelitis and septic arthritis, invasive K. kingae infections can also give rise to atypical osteoarticular infections, such as cellulitis, pyomyositis, bursitis, or tendon sheath infections. Clinically, K. kingae OAI are usually characterized by a mild clinical presentation and by a modest biologic inflammatory response to infection. Most of the time, children with skeletal system infections due to K. kingae would not require invasive surgical procedures, except maybe for excluding pyogenic germs’ implication. In addition, K. kingae’s OAI respond well even to short antibiotics treatments, and, therefore, the management of these infections requires only short hospitalization, and most of the patients can then be treated safely as outpatients.

scholarly journals BACTERIAL (SEPTIC) ARTHRITIS AND PROSTHETIC JOINT INFECTION

2017 ◽  
Vol 55 (2) ◽  
pp. 192-200 ◽  
Author(s):  
B. S. Belov ◽  
S. A. Makarov ◽  
E. I. Byalik
Keyword(s):  
Septic Arthritis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint
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