Treatment of Nongonococcal Bacterial Septic Arthritis

1981 ◽  
Vol 15 (7-8) ◽  
pp. 531-535 ◽  
Author(s):  
Gilles L. Fraser
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Joint Space ◽  
Volume Of Distribution ◽  
Joint Fluid ◽  
Epidemiologic Factors ◽  
Clinically Normal ◽  
Cell Counts ◽  
White Blood Cell Counts ◽  
Primary Focus

Septic arthritis carries significant morbidity and mortality, necessitating prompt, appropriate therapy with joint fluid aspiration, intravenous antibiotics, and, occasionally, surgical intervention. The initial choice of antimicrobial agent is guided by the results of synovial fluid gram stain, by identification of the pathogenesis of the primary focus, or by epidemiologic factors. Adequacy of therapy is assessed by serial synovial fluid white blood cell counts and by determining antimicrobial concentrations in the joint space. The goal of treatment is a clinically normal and sterile joint. Factors that may affect antimicrobial joint penetration include the degree of joint tissue inflammation, the degree of drug protein binding, and the chemical characteristics of the drug. Perhaps most important in determining the extent of joint penetration are factors that may affect serum antibiotic concentrations, for example, dose, route of administration, volume of distribution, and rate of elimination.

Absolute and relative cell counts for synovial fluid from clinically normal shoulder and stifle joints in cats

2004 ◽  
Vol 225 (12) ◽  
pp. 1866 ◽  
Author(s):  
Philip D. Pacchiana ◽  
Robert S. Gilley ◽  
Larry J. Wallace ◽  
David W. Hayden ◽  
Daniel A. Feeney ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Clinically Normal ◽  
Cell Counts

scholarly journals Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990–2018

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
John J Ross ◽  
Kevin L Ard ◽  
Narath Carlile
Keyword(s):  
Staphylococcus Aureus ◽  
Drug Use ◽  
Synovial Fluid ◽  
Septic Arthritis ◽  
Injection Drug Use ◽  
Injection Drug ◽  
Facet Joints ◽  
Cell Counts ◽  
Culture Positive ◽  
Fluid Cell

Abstract Background The clinical spectrum of septic arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint septic arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990–2008 and 2009–2018, the proportion of septic arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P < .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA septic arthritis included injection drug use (P < .001), bacteremia (P < .001), health care exposure (P < .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P < .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of <50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for septic arthritis in our patient population. Septic arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of <50 000 cells/mm3 are common in culture-positive septic arthritis.

scholarly journals Effects of Joint Lavage with Dimethylsulfoxide on LPS-Induced Synovitis in Horses—Clinical and Laboratorial Aspects

2020 ◽  
Vol 7 (2) ◽  
pp. 57
Author(s):  
Eric Danilo Pauls Sotelo ◽  
Cynthia Prado Vendruscolo ◽  
Joice Fülber ◽  
Sarah Raphaela Torquato Seidel ◽  
Fernando Mosquera Jaramillo ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Cartilage Degradation ◽  
Cell Counts ◽  
Tnf Α ◽  
Equine Medicine ◽  
Lactated Ringer's Solution ◽  
White Blood Cell Counts ◽  
Factor Α ◽  
Joint Lavage

Several studies in human and equine medicine have produced controversial results regarding the role of dimethylsulfoxide (DMSO) as a therapeutic agent. This study aimed to evaluate the effect of joint lavage with different DMSO concentrations on biomarkers of synovial fluid inflammation and cartilage degradation in joints with lipopolysaccharide (LPS)-induced synovitis. Twenty-six tibiotarsal joints of 13 horses were randomly distributed into four groups (lactated Ringer’s solution; 5% DMSO in lactated Ringer’s; 10% DMSO in lactated Ringer’s; and sham). All animals were evaluated for the presence of lameness, and synovial fluid analyses were performed at 0 h, 1 h, 8 h, 24 h, and 48 h (T0, T1, T8, T24, and T48, respectively). The white blood cell counts (WBC), total protein (TP), urea, prostaglandin E2 (PGE2), interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor-α (TNF-α), hyaluronic acid (HA), and chondroitin sulfate (CS) concentrations were measured. The WBC counts and PGE2, IL-1β, IL-6, and TP concentrations increased in all groups at T8 compared to baseline values (p < 0.05). At T48, only the 5% DMSO and 10% DMSO groups showed a significant decrease in WBC counts (p < 0.05). Furthermore, the 10% DMSO group had lower concentrations of PGE2 and IL-1β at T48 than at T8 (p < 0.05) and presented lower IL-6 levels than the5% DMSO and lactated Ringer’s groups at T24. All groups showed an increase in CS concentration after LPS-induced synovitis. Joint lavage with 10% DMSO in lactated Ringer’s has anti-inflammatory but not chondroprotective effects.

scholarly journals Protein Electrophoresis and Haptoglobin Values for Captive Bongo (Tragelaphus eurycerus)

2021 ◽  
Vol 8 ◽  
Author(s):  
Susan L. Bartlett ◽  
Nadine Lamberski ◽  
Kristopher L. Arheart ◽  
Carolyn Cray
Keyword(s):  
Acute Phase Proteins ◽  
Protein Electrophoresis ◽  
Normal Female ◽  
Serum Samples ◽  
Clinically Normal ◽  
Cell Counts ◽  
White Blood Cell Counts ◽  
Normal Males ◽  
A Minor ◽  
G Ratio

Serum samples collected from 37 clinically normal bongo (Tragelaphus eurycerus) and 13 abnormal bongo were tested using assays for acute-phase proteins (APPs) and by protein electrophoresis. Abnormal bongo samples (n = 27) had significantly higher levels of fibrinogen (FIB) (p &lt; 0.001) and trending but not significantly increased haptoglobin (HP) (p = 0.07) vs. samples from normal bongo (n = 37). There were no significant differences in values for total white blood cell counts or for any of the fractions determined by protein electrophoresis. Clinically normal female bongo (n = 19) had significantly lower levels of FIB than normal males (n = 18) (p = 0.014), and this observation was also made with samples from the clinically abnormal group (p = 0.004). Many weak to moderate significant correlations were observed with increasing age, including increased globulins, FIB, and HP and decreased albumin-to-globulin (A/G) ratio and albumin. In clinical cases reviewed in this study, mild HP changes categorized this reactant as a minor APP, which contrasts with the major APP classification of HP in the related species of the cow. The preliminary data indicate that the quantitation of these APPs may offer value in assessing inflammation in this species, but additional studies are needed.

Diagnostic value of synovial fluid adenosine deaminase level in tuberculous arthritis

2021 ◽  
pp. 1-8
Author(s):  
Kyung Mok Sohn
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Adenosine Deaminase ◽  
Body Fluid ◽  
Bacterial Culture ◽  
Diagnostic Value ◽  
Joint Fluid ◽  
Tuberculous Arthritis ◽  
Infectious Origin

Although body fluid adenosine deaminase (ADA) level is useful for diagnosing tuberculosis but little is known about joint fluid ADA level in tuberculous (TB) arthritis. This study aimed to evaluate the diagnostic value of synovial fluid ADA (SF-ADA) in TB arthritis. Of 43 patients enrolled, nine had confirmed TB arthritis. Fourteen had non-TB septic arthritis, and 20 patients had non-infectious etiologies. The SF-ADA levels were significantly elevated in patients with TB arthritis compared to those with non-infectious origin (P <0.05). All SF-ADA levels were ?76 U/L in TB arthritis and ? 60 U/L in non-infectious synovial fluid. The ADA was not different between TB arthritis and non-TB septic arthritis (P = 0.87). The possibility of identifying synovial fluid with an ADA under 60-76 U/L of tuberculous etiology may be very low. In addition, an SF-ADA ?76 U/L with negative ordinary bacterial culture results is highly suspicious for TB arthritis. Continuous...

Aseptic Lymphocytic-Dominated Vasculitis-Associated Lesions Scores Do Not Correlate With Metal Ion Levels or Unreadable Synovial Fluid White Blood Cell Counts

2017 ◽  
Vol 32 (4) ◽  
pp. 1340-1343 ◽  
Author(s):  
Darren R. Plummer ◽  
Paul H. Yi ◽  
Joshua J. Jacobs ◽  
Robert M. Urban ◽  
Mario M. Moric ◽  
...  
Keyword(s):  
Synovial Fluid ◽  
Blood Cell ◽  
White Blood Cell ◽  
Metal Ion ◽  
Cell Counts ◽  
Blood Cell Counts ◽  
Associated Lesions ◽  
White Blood Cell Counts
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