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

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.

2021 ◽  
Vol 10 (4) ◽  
pp. 758
Author(s):  
Jason W. Lee ◽  
Tobi Somerville ◽  
Stephen B. Kaye ◽  
Vito Romano

Bacterial keratitis is a devastating condition that can rapidly progress to serious complications if not treated promptly. Certain causative microorganisms such as Staphylococcus aureus and Pseudomonas aeruginosa are notorious for their resistance to antibiotics. Resistant bacterial keratitis results in poorer outcomes such as scarring and the need for surgical intervention. Thorough understanding of the causative pathogen and its virulence factors is vital for the discovery of novel treatments to avoid further antibiotic resistance. While much has been previously reported on P. aeruginosa, S. aureus has been less extensively studied. This review aims to give a brief overview of S. aureus epidemiology, pathophysiology and clinical characteristics as well as summarise the current evidence for potential novel therapies.


2020 ◽  
Vol 7 (10) ◽  
Author(s):  
Justin J Kim ◽  
Alison Lydecker ◽  
Rohini Davé ◽  
Jacqueline T Bork ◽  
Mary-Claire Roghmann

Abstract We identified deep diabetic foot infections by culture and conducted a case–control study examining the risk factors for moderate to severe methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) diabetic foot infections. Our MRSA prevalence was lower than literature values; PsA was higher. Gangrene may be predictive of Pseudomonas infection.


2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S202-S202
Author(s):  
Valerie Gobao ◽  
Mostafa Alfishawy ◽  
Neel Shah ◽  
Karin Byers ◽  
Mohamed Yassin ◽  
...  

Abstract Background Staphylococcus aureus is a common organism in native septic arthritis. It is traditionally believed to be self-limited with rapid and aggressive debridement and appropriate antibiotic selection. The incidence of S. aureus septic arthritis is increasing, and further characterization is needed to improve diagnosis and treatment. For patients presenting with native S. aureus septic arthritis, we evaluated the reliability of methicillin-resistant S. aureus (MRSA) screening as a predictor to rule out MRSA septic arthritis, the risk factors associated with this disease, and the treatment and surgical outcomes. Methods A retrospective case–control study of patients diagnosed with septic arthritis in the UPMC health system (Pittsburgh, PA) between 2012 and 2016 was completed. The primary outcomes of interest were surgical intervention and the need to alter antibiotic treatment. Patient demographics, characteristics, and outcomes were recorded. Results A total of 215 cases of septic arthritis were identified, and 64% (n = 138) had S. aureus cultured. In this set, 36% (50/138) of these patients were identified with MRSA. Of the patients diagnosed with MRSA septic arthritis, 50% screened prior to admission had a positive result (8/16) and 48% screened during admission had a positive result (14/29). Compared with septic arthritis with other organisms, risk factors associated with S. aureus included history of intravenous drug use (OR: 4.3, CI: 1.7 to 10.8, P = 0.002) and being immunocompetent (OR: 0.3, CI: 0.1 to 0.6, P = 0.002). These infections were associated with concurrent infections of the spine (OR: 5.7, CI: 2.1 to 15.1, P = 0.0005). As compared with other organisms, there was a high probability of switching antibiotics during treatment (OR: 3.7, CI: 1.1 to 13.0, P = 0.04) and relapse of infection (OR: 4.2, CI: 1.2 to 14.6, P = 0.02). Conclusion S. aureus septic arthritis is associated with intravenous drug use, and not with immunosuppression. A negative MRSA screen does not rule out this organism. Concurrent spine infections are common. There is a high likelihood of infection relapse and that antibiotics will need to be altered during treatment. With the opioid epidemic, the incidence is likely to increase further. More work is needed to improve diagnosis and overcome treatment challenges. Disclosures All authors: No reported disclosures.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S738-S739
Author(s):  
Maya Bell ◽  
Courtney Veltri ◽  
Evelina Kolychev ◽  
Leila S Hojat

Abstract Background The 2019 American Thoracic Society and Infectious Diseases Society of America Community-Acquired Pneumonia (CAP) guidelines concluded that the major risk factors for methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa (PsA) include prior isolation of these organisms and previous hospitalization with IV antibiotic use within 90 days. However, the guidelines recognized that results may vary by region and recommended local validation of risk factors. The primary objective of this study was to determine which potential risk factors are associated with MRSA and Pseudomonas aeruginosa in CAP in our institution. This study also evaluated appropriateness of antibiotics used for empiric CAP therapy. Methods This was a single-center, retrospective cohort study performed in an urban academic medical center in Cleveland, OH. Adults hospitalized for CAP who had a respiratory culture performed between January 2016 and September 2020 were included. Patients were randomized in a 1:1:1 ratio into MRSA, PsA, and non-resistant CAP (NR-CAP) groups. Patients with bacterial co-infections or resistant pathogens other than MRSA or PsA were excluded. Results The study included 111 patients with 37 patients in each group. The median age was 61 years (IQR 52-70), and 58.6% of patients were male. There were no independent risk factors for MRSA (Table 1). Independent risk factors for PsA included prior isolation and enteral feeding (Table 2). MRSA risk factors as defined by the 2019 CAP guidelines were found in 48.6% of patients with MRSA CAP (Figure 1). Guideline-defined PsA risk factors were found in 56.8% of patients with PsA CAP (Figure 2). In NR-CAP, 62.2% received empiric MRSA coverage while only 27% had a guideline-defined risk factor; PsA coverage was administered in 78.4% of NR-CAP patients, but risk factors were found in only 24.3% of this cohort. MRSA and P. aeruginosa Risk Factor Analyses Empiric MRSA and P. aeruginosa Coverage and Guideline-Defined Risk Factors Conclusion Our findings were consistent with the risk factors identified in the 2019 CAP guidelines, but additional risk factors may be present in our patient population. Empiric coverage for MRSA and PsA was disproportionately high relative to the rate of recovery. This study encourages local validation of risk factors; however, further analyses are needed to determine the impact on empiric therapy. Disclosures All Authors: No reported disclosures


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
F. Jasmijn Smits ◽  
Herman Frima ◽  
Christoph Schaeffeler ◽  
Christoph Sommer

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.


2021 ◽  
Vol 23 (1) ◽  
pp. 123-130
Author(s):  
H.I. Atta ◽  
F.F. Umar

Otitis media is an inflammatory disease of the mucosal lining of the middle ear. It occurs more frequently in children due to the shorter and more horizontal eustachian tube in their ears. The focus of this study is determining the prevalence of otitis media in children aged 6 months – 10 years attending a primary health care facility in Samaru, Zaria, Nigeria. Fifty swabs from ear discharge and imparted wax were obtained from the study subjects regardless of whether they were presenting with symptoms of otitis media or not. Information on certain symptoms, as well as demographic and risk factors was obtained through the use of questionnaires. A prevalence of 54% of otitis media was obtained in this study. The following bacterial species were isolated: Pseudomonas aeruginosa (25.7%), Escherichia coli (25.7%), Klebsiella pneumoniae (14.3%), Staphylococcus aureus (14.3%), Proteus mirabilis (8.6%), Coagulase negative Staphylococci (8.6%) and Proteus vulgaris (3.7%). The infection was observed to be higher in children in the age range, six months to two years. Risk factors such as the use of cotton buds in cleaning the ear, posture of the child during breast-feeding and not being exclusively breast-fed were shown to be very prominent among the children studied. Antibiotic susceptibility tests revealed that among the Gram negative bacteria isolated, Pseudomonas aeruginosa and Klebsiella pneumoniae were resistant to more than two antibiotics. Coagulase negative Staphylococcus was resistant to all the antibiotics except Ceftriaxone, Streptomycin and Cefuroxime. On the other hand, Staphylococcus aureus was susceptible to all the antibiotics tested with the exception of Cefuroxime, Ceftriaxone and Ampiclox. Therefore, it is recommended that antibiotic susceptibility testing be conducted before treatment of otitis media in children. The importance of exclusive breast-feeding and good personal hygiene should be emphasized to nursing mothers. Key words: Otitis media, Children, Bacteria, Antibiotics, Zaria


Author(s):  
Valerie C Gobao ◽  
Mostafa Alfishawy ◽  
Clair Smith ◽  
Karin E Byers ◽  
Mohamed Yassin ◽  
...  

Abstract Background Staphylococcus aureus is the most common cause of native septic arthritis. Few studies have characterized this disease during the U.S. opioid epidemic. The role of MRSA nasal screening in this disease has not been elucidated. We sought to identify risk factors and outcomes for S. aureus native septic arthritis and to evaluate MRSA screening in this disease. Methods A retrospective cohort study of native septic arthritis patients (2012-2016) was performed. Demographics, risk factors, and outcomes were compared between Staphylococcus aureus and other native septic arthritis infections. Sensitivity, specificity, and predictive values of MRSA screening were assessed. Results 215 cases of native septic arthritis were included. S. aureus was cultured in 64% (138/215). MRSA was cultured in 23% (50/215). S. aureus was associated with injection drug use (OR: 4.33, CI: 1.74 to 10.81, p=0.002) and switching antibiotics (OR: 3.92, CI: 1.01 to 21.38, p=0.032). For every ten-year increase in age, odds of S. aureus decreased (OR: 0.72, CI: 0.60 to 0.87, p=0.001). For one unit increases in CCMI, odds of S. aureus decreased (OR: 0.82 CI: 0.73 to 0.91, p=0.0004). MRSA screening during admission demonstrated sensitivity of 0.59, specificity of 0.96, positive predictive value of 0.85, and negative predictive value of 0.84 for MRSA native septic arthritis. Conclusions The opioid epidemic may be contributing to a demographic shift in native septic arthritis to younger, healthier individuals. S. aureus native septic arthritis has unique risks, including injection drug use. MRSA screening may be useful to rule in MRSA native septic arthritis.


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