RESUMO
Streptococcus agalactiae serotype distribution and its antibiotic susceptibility affect disease prevention strategies, but the serotype distribution varies among patient groups. The objectives of this study were to establish the group B Streptococcus (GBS) serotype distribution in patients from Egypt and to assess antibiotic sensitivity of invasive GBS isolates. A total of 490 patients participated in this multicenter study; 160 had urinary tract infection, 115 complained of diabetic foot ulcers, 125 men had genital tract infections, and 30 women females had genital tract infections. Others had bronchopneumonia, otitis media, synovitis, or meningitis. Serotyping of the isolated GBS was performed at the CDC in the United States. Antibiotic sensitivity patterns were determined using the disk diffusion method. In men, the most common serotypes were II, III, and V, whereas types Ia, II, III, and V were isolated from women. Macrolides (erythromycin) resistance occurred in 4.1% of the isolates; 10.2% were resistant to both clindamycin and inducible resistance of macrolides, lincomycin, and streptogramin; 17.3% were resistant to quinolones; and 95.9% were resistant to tetracyclines. GBS primarily infected the urinary tract, skin, soft tissue, and genital tract in both genders. Isolates were sensitive to beta-lactam drugs, vancomycin, and linezolid; 14.0% were resistant to macrolides with or without clindamycin. Only 6.0% of the strains were sensitive to tetracyclines. Although GBS causes invasive infections in Egyptian adults, it rarely causes neonatal meningitis or sepsis. Future studies should determine whether GBS isolates are transmitted sexually, by performing a follow-up study of the partner of the infected patient.
Assuntos
Diabetes Mellitus/epidemiologia , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/genética , Adulto , Antibacterianos/uso terapêutico , Pé Diabético/tratamento farmacológico , Pé Diabético/epidemiologia , Pé Diabético/microbiologia , Farmacorresistência Bacteriana , Egito/epidemiologia , Feminino , Humanos , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/epidemiologia , Meningites Bacterianas/microbiologia , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Epidemiologia Molecular , Otite Média/tratamento farmacológico , Otite Média/epidemiologia , Otite Média/microbiologia , Pneumonia Bacteriana/tratamento farmacológico , Pneumonia Bacteriana/epidemiologia , Pneumonia Bacteriana/microbiologia , Infecções do Sistema Genital/tratamento farmacológico , Infecções do Sistema Genital/epidemiologia , Infecções do Sistema Genital/microbiologia , Sorogrupo , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/fisiologia , Sinovite/tratamento farmacológico , Sinovite/epidemiologia , Sinovite/microbiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Adulto JovemRESUMO
BACKGROUND: Transient synovitis of the hip affects mostly preschool children, and its etiology is unknown. Kingella kingae has been identified recently as a common etiologic agent of osteoarticular infections (OAI) in young children and could potentially be associated to transient synovitis of the hip. The main objective of this study was to evaluate the association between transient synovitis of the hip and oropharyngeal carriage of K. kingae among preschool children. METHODS: This was a prospective case-control study conducted at a tertiary care pediatric emergency department. Cases were children between 6 and 71 months of ages with a diagnosis of transient synovitis of the hip. For each transient synovitis case, an age-matched control was recruited among children presenting for a trauma. A second control group included children with any OAI. The independent variable was the presence of oropharyngeal K. kingae identified by a specific polymerase chain reaction assay. The primary analysis was the association between oropharyngeal K. kingae carriage and final diagnosis. RESULTS: A total of 73 children were included in the study. Among them, 25 had a transient synovitis, 16 an OAI, and 22 controls. Baseline demographics were similar between the groups. There was no difference in oropharyngeal carriage of K. kingae for children with transient synovitis (5/25; 0.20) in comparison to controls (3/22; 0.14), while it was higher for children with OAI (10/16; 0.63). CONCLUSIONS: There is no association between oropharyngeal K. kingae and transient synovitis of the hip among preschool children.
Assuntos
Portador Sadio , Articulação do Quadril/microbiologia , Kingella kingae , Infecções por Neisseriaceae/microbiologia , Orofaringe/microbiologia , Sinovite/microbiologia , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Articulação do Quadril/patologia , Humanos , MasculinoRESUMO
BACKGROUND: Cutibacterium are the most common cause of periprosthetic shoulder infections, as defined by ≥2 deep cultures. Established Cutibacterium periprosthetic infections cannot be resolved without prosthesis removal. However, the decision for implant removal must be made from an assessment of infection risk before the results of intraoperative cultures are finalized. We hypothesized that the risk for a Cutibacterium infection is associated with characteristics that are available at the time of revision arthroplasty. METHODS: In a retrospective review of 342 patients having prosthetic revisions between 2006 and 2018 for whom definitive deep culture results were available, we used univariate and multivariate analyses to compare the preoperative and intraoperative characteristics of 101 revisions with Cutibacterium periprosthetic infections to the characteristics of 241 concurrent revisions not meeting the definition of infection. RESULTS: Patients with definite Cutibacterium periprosthetic infections were younger (59 ± 10 vs. 64 ± 12, P < .001), were more likely to be male (91% vs. 44%, P < .001), were more likely to have had their index procedure performed for primary osteoarthritis (54% vs. 39%, P = .007), were more likely to be taking testosterone supplements (8% vs. 2%, P = .02), had lower American Society of Anesthesiologists scores (1.9 ± 0.7 vs. 2.3 ± 0.7, P < .001), and had lower body mass indices (29 ± 5 vs. 31 ± 7, P = .005). Patients with definite Cutibacterium periprosthetic infections also had significantly higher preoperative loads of Cutibacterium on their unprepared skin surface (1.7 ± 0.9 vs. 0.4 ± 0.8, P < .001) and were more likely to have the surgical finding of synovitis (41% vs. 16%, P < .001). CONCLUSIONS: The risk of definite Cutibacterium periprosthetic infections is associated with observations that can be made before or at the time of revision arthroplasty.
Assuntos
Artroplastia do Ombro/efeitos adversos , Infecções por Bactérias Gram-Positivas/cirurgia , Propionibacteriaceae/isolamento & purificação , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Androgênios/administração & dosagem , Feminino , Infecções por Bactérias Gram-Positivas/microbiologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/cirurgia , Reoperação , Estudos Retrospectivos , Fatores Sexuais , Pele/microbiologia , Sinovite/microbiologia , Sinovite/cirurgia , Testosterona/administração & dosagemRESUMO
PURPOSE: To analyze the utility of arthroscopic biopsies for detection of periprosthetic infection in painful shoulder arthroplasty without objective signs of infection. METHODS: A retrospective analysis of all patients who underwent a diagnostic arthroscopy for painful shoulder arthroplasty from June 2012 through July 2018 was performed. Patients with a subsequent revision shoulder arthroplasty after diagnostic arthroscopy were included. Arthroscopic tissue culture results were compared with the culture results of intraoperative tissue samples obtained at the time of open revision surgery. A minimum of 3 tissue samples from synovia and bone-prosthesis interface with signs of synovitis or abnormal appearance was routinely collected. Cases with 2 or more positive cultures for the same microorganism obtained at open revision surgery were considered as true presence of infection. The study protocol was reviewed and approved by the institutional ethics committee. RESULTS: Twenty-three cases in 22 patients were included in this study. Five of these 23 cases were classified as true infection based on the samples obtained during open revision surgery, and 16 cases had a positive culture in diagnostic arthroscopy. Cutibacterium acnes was isolated in each case. Classifying any microbiologic growth in the arthroscopic biopsies as positive resulted in a sensitivity and negative predictive value of 100%, specificity of 39%, and positive predictive value of 31.3% for the detection of a periprosthetic shoulder infection (PPSI). If at least 2 positive samples with the same microbiologic growth in the arthroscopic biopsies were considered as positive, sensitivity and negative predictive value dropped to 80% and 94.4%, respectively, but the specificity and positive predictive value increased to 94.4% and 80%, respectively. CONCLUSIONS: Diagnostic arthroscopy is a useful diagnostic tool in patients with suspicion but no clear evidence of PPSI. Arthroscopically obtained tissue biopsies for culture offer a high sensitivity and specificity in the diagnosis of PPSI if at least 2 cultures positive for the same microorganism are considered as infection. LEVEL OF EVIDENCE: Level III.
Assuntos
Artroplastia do Ombro/efeitos adversos , Artroscopia/métodos , Infecções Relacionadas à Prótese/diagnóstico , Prótese de Ombro/efeitos adversos , Adulto , Idoso , Biópsia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propionibacterium acnes/isolamento & purificação , Infecções Relacionadas à Prótese/etiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/patologia , Reoperação , Estudos Retrospectivos , Sensibilidade e Especificidade , Articulação do Ombro/microbiologia , Articulação do Ombro/patologia , Articulação do Ombro/cirurgia , Membrana Sinovial/microbiologia , Membrana Sinovial/patologia , Sinovite/microbiologiaRESUMO
OBJECTIVE: Osteoarthritis (OA) is a common cause of disability affecting millions of people of all ages worldwide. The pathogenesis involves an inflammatory component, but the cause of the inflammation remains incompletely understood. The intracellular bacteria Chlamydia trachomatis and C. pneumoniae have been demonstrated in patients with reactive arthritis. Both of these microorganisms can cause chronic and persistent infections, with C. trachomatis being the most common cause of reactive arthritis. This study was performed to investigate the presence of C. pneumoniae in a large number of patients with primary OA. METHODS: The study included 75 patients who underwent total knee arthroplasty. During surgery, a synovial biopsy was performed and synovial fluid drawn. Real-time polymerase chain reaction (PCR) of C. pneumoniae was run on all patients, and real-time PCR of bacterial 16S rDNA was conducted on 30 of the 75 patients to screen for the presence of other bacteria. RESULTS: Real-time PCR showed no evidence of the presence of C. pneumoniae in the patients' specimens, nor were other bacteria detected. CONCLUSIONS: Although an inflammatory component is part of the pathogenesis of OA, we found no evidence indicating that C. pneumoniae is a stimulator of that inflammation.
Assuntos
Infecções por Chlamydophila/complicações , Chlamydophila pneumoniae/isolamento & purificação , Osteoartrite/microbiologia , Líquido Sinovial/microbiologia , Membrana Sinovial/microbiologia , Sinovite/diagnóstico , Idoso , Artroplastia , Infecções por Chlamydophila/microbiologia , DNA Bacteriano/genética , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/genética , Osteoartrite/cirurgia , Reação em Cadeia da Polimerase , Prognóstico , RNA Ribossômico 16S/genética , Sinovite/genética , Sinovite/microbiologiaRESUMO
Bacterial colonization of synovial structures can cause infections that are difficult to treat. Systemic and local antimicrobials and repeated joint lavages are the mainstays of therapy. However, despite aggressive treatments, infection may persist, leading to significant tissue damage or death of the patient. In order to investigate the impact of bacterial culture and antimicrobial resistance on survival to discharge, we reviewed medical records of horses admitted to the University of Pennsylvania's large animal teaching hospital from 2010-2015. Two-hundred and six cases with a definitive diagnosis of septic synovitis and a synovial fluid sample submitted for microbiological culture were included in the study. Of these horses, 48% were culture negative and 52% were positive for any bacterial growth, of which 66% were gram-positive and 28% were gram-negative aerobic organisms with 4% anaerobic and 2% fungal organisms. Overall survival to discharge from hospital was 86%. Horses that had negative growth on culture were more likely to survive until discharge (p < 0.02). Multivariable analyses revealed that the likelihood of euthanasia was significantly associated with identification of coagulase positive Staphylococcus spp. (OR 7.66, 5.46-10.74, p < 0.0001), ß-hemolytic Streptococcus spp. (OR 5.18, 3.56-7.55, p < 0.0001), Enterococcus spp. (OR 18.38, 11.45-29.52, p = 0.002), Enterobacteriaceae (OR 31.37, 22.28-44.17, p < 0.0001), Pseudomonas aeruginosa (OR 9.31, 5.30-16.34, p = 0.0004) or other gram-negative species (OR 3.51, 2.07-5.94, p = 0.001). Multi-drug resistance and gram-negative bacteria species were associated with significantly decreased survival rates (OR 119.24, 70.57-201.46, p < 0.0001). In conclusion, prognosis for survival to discharge was poor for horses that were infected with gram-negative organisms, particularly those with MDR phenotypes.
Assuntos
Artrite Infecciosa/veterinária , Farmacorresistência Bacteriana Múltipla , Infecções por Enterobacteriaceae/veterinária , Bactérias Gram-Negativas/efeitos dos fármacos , Infecções por Bactérias Gram-Negativas/veterinária , Sinovite/microbiologia , Sinovite/veterinária , Animais , Antibacterianos/farmacologia , Artrite Infecciosa/microbiologia , Enterobacteriaceae/efeitos dos fármacos , Infecções por Enterobacteriaceae/mortalidade , Infecções por Bactérias Gram-Negativas/mortalidade , Doenças dos Cavalos/microbiologia , Doenças dos Cavalos/mortalidade , Cavalos , Hospitais Veterinários , Testes de Sensibilidade Microbiana , Alta do Paciente/estatística & dados numéricos , Pseudomonas aeruginosa/efeitos dos fármacos , Staphylococcus/efeitos dos fármacos , Líquido Sinovial/citologia , Líquido Sinovial/microbiologiaRESUMO
RATIONALE: Primary tuberculous infection in hand and wrist is a rare disease. Few articles reported on hand primary tuberculous synovitis. PATIENT CONCERNS: A 68-year-old Chinese male, without history of tuberculosis (TB), had complained of pain and swelling in right palm and little finger for 3 months. Patient came to our hospital on 9th Oct 2016. X-ray just showed soft tissue swelling in little finger. Magnetic resonance imaging (MRI) showed synovitis around flexor tendon of little finger, volar palm, and carpal tunnel. Notably, it also implied nodular images in little finger sizing 5âmmâ×â11âmm. Laboratory tests revealed C-reactive protein (CRP): 22âmg/L, erythrocyte sedimentation rate (ESR): 49âmm/h, and white blood cells (WBC): 11.8â×â10/L. DIAGNOSES: He was diagnosed with primary hand tuberculous synovitis. INTERVENTIONS: The patient received aspiration biopsy in right palm guided by ultrasound on 13rd Oct and pathological examination indicated Mycobacterium tuberculosis (MTB) infection. We performed radical synovetomy and collected abnormal tissue for pathological examination on 18th Oct. Finally, result showed MTB infection, which was the same with the result of first pathological examination. Then, this patient received antituberculous treatment. OUTCOMES: One year after operation, pain and swelling relieve and no recurrence of the clinical symptoms happened. LESSONS: Primary tuberculous synovitis of hand and wrist is rare, MTB infection should be considered as an infectious agent, especially in developing countries. Radical synovectomy and antituberculous treatment regain a satisfactory outcome.
Assuntos
Antituberculosos/uso terapêutico , Articulação da Mão , Mycobacterium tuberculosis , Sinovectomia/métodos , Sinovite/terapia , Tuberculose Osteoarticular/terapia , Punho , Idoso , Terapia Combinada , Humanos , Masculino , Sinovite/microbiologia , Resultado do TratamentoRESUMO
Rhodococcus equi is one of the most important causes of disease in foals. Infection is typically characterized by pyogranulomatous pneumonia although extrapulmonary infections occur occasionally. Uveitis and polysynovitis have been reported in foals naturally infected with R. equi and are thought to be the result of an immune-mediated process. However, the pathogenesis of these conditions is poorly understood. The objectives of this study were to document the occurrence of uveitis and polysynovitis after experimental infection with R. equi and to determine if these disorders are the direct result of infection at these sites. Foals between 3 and 4 weeks of age were infected intratracheally with virulent R. equi using inocula of 1×108 CFU (high inoculum; n = 16) or 1×107 CFU (low inoculum; n = 12). Foals were monitored twice daily and necropsy was performed 14 days post-infection. Aqueous humor and synovial fluid were collected aseptically and the percentage of affected lung was calculated. The mean (± SD) percentage of affected lung was significantly higher with the high inoculum (31.8 ± 14.6%) than with the low inoculum (14.4 ± 11.4%). Fourteen of 25 foals developed uveitis and 20 of 28 foals developed polysynovitis. R. equi was cultured from the aqueous humor of 11 foals and from the synovial fluid of 14 foals. The risk of development of polysynovitis and protein concentration in the aqueous humor were significantly higher in foals that received the high inoculum. These results indicate that polysynovitis and uveitis are septic complications associated with the severity of lung disease.
Assuntos
Infecções por Actinomycetales/veterinária , Doenças dos Cavalos/microbiologia , Rhodococcus equi/patogenicidade , Sepse/veterinária , Sinovite/veterinária , Uveíte/veterinária , Infecções por Actinomycetales/microbiologia , Animais , Cavalos , Pneumonia Bacteriana/microbiologia , Pneumonia Bacteriana/veterinária , Sepse/microbiologia , Sinovite/microbiologia , Uveíte/microbiologia , VirulênciaRESUMO
Mycoplasma bovis (M. bovis) is an important bacterium, causing severe respiratory infection, and arthritis in dairy animals worldwide. This study is based on 50 suckling calves among which 15 showed respiratory distress, lameness and swollen joints and died later. M. bovis was isolated and identified from all dead (n = 15) and live (17.14%; 06 out of 35) calves on the basis of bacteriological examination. In morbid calves, the carpus and stifle joints were severely affected, while necropsy revealed multiple well-circumscribed calcified abscesses and caseous exudates in cranio-ventral and diaphragmatic lobes of lungs. Suppurative polyarthritis, fibrino-suppurative, teno-synovitis and otitis media were the common and striking lesion observed at postmortem examination. Histopathological examination revealed broncho-interstitial pneumonia and necrotic fibrino-purulent broncho-pneumonia in lungs. Similarly, synovial membranes and joints revealed presence of multiple foci of liquefactive necrosis surrounded by lymphocytes, plasma cells, macrophages and peripheral fibroplasia. In the bacteriological investigations, the characteristic fried egg colonies of M. bovis further confirmed this infection in all suspected cases. In conclusion, the current clinico-histo-pathological features are the depictive picture, and is the first report of M. bovis infection in calves in Pakistan.
Assuntos
Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/patologia , Surtos de Doenças/veterinária , Infecções por Mycoplasma/epidemiologia , Infecções por Mycoplasma/microbiologia , Infecções por Mycoplasma/patologia , Mycoplasma bovis/patogenicidade , Abscesso/patologia , Animais , Artrite/microbiologia , Artrite/patologia , Artrite Infecciosa , Autopsia , Bovinos , Doenças dos Bovinos/mortalidade , Coxeadura Animal , Pulmão/microbiologia , Pulmão/patologia , Masculino , Mortalidade , Infecções por Mycoplasma/mortalidade , Mycoplasma bovis/isolamento & purificação , Otite Média Supurativa/microbiologia , Otite Média Supurativa/patologia , Pneumonia Bacteriana , Pneumonia por Mycoplasma/microbiologia , Pneumonia por Mycoplasma/patologia , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/microbiologia , Infecções Respiratórias/patologia , Sinovite/microbiologia , Sinovite/patologiaRESUMO
Bacterial culture and antimicrobial susceptibility testing of septic synovial samples allows instigation of targeted antimicrobial therapy; however, bacterial culture takes more than 24 h and has low sensitivity. This study aimed to identify the most frequently cultured bacteria and their antimicrobial susceptibility profile from septic synovial samples in our referral equine hospital, to allow recommendations regarding appropriate initial antimicrobial therapy prior to culture results. Hospital records for all horses with synovial sepsis and a synovial sample submitted to the microbiology laboratory between 2004 and 2013 were retrieved (n= 379 samples). One horse had positive cultures from more than one synovial structure, and two horses had positive cultures obtained from repeat samples. Overall, 114 bacterial isolates were obtained. Gram-positive bacteria were isolated in 75% of cases, of which 22% were haemolytic Staphylococcus spp., and 52% were Staphylococcus aureus including two multidrug-resistant isolates. Gram-negative bacteria were isolated from 25% of cases. Anaerobic Clostridium spp. was isolated in 3% of cases. Of the first line antimicrobials, oxytetracycline and doxycycline were effective against 70-100% of the Gram-positive bacteria and 20-100% of the Gram-negative organisms, whilst trimethoprim-sulphamethoxazole and gentamicin efficacy ranged between 50% and 88% for both Gram-positive and Gram-negative bacteria. Of the equine protected antimicrobials, ceftiofur was effective against 70-90% of all bacterial isolates whilst 80% of isolates were susceptible to enrofloxacin. These results indicate that tetracyclines, trimethoprim-sulphamethoxazole or gentamicin may be suitable first-line antimicrobials for treatment of synovial sepsis cases while awaiting laboratory results, findings which support current recommendations for antimicrobial stewardship in equine medicine.
Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Farmacorresistência Bacteriana , Doenças dos Cavalos/epidemiologia , Sepse/veterinária , Sinovite/veterinária , Animais , Estudos Transversais , Inglaterra/epidemiologia , Feminino , Doenças dos Cavalos/microbiologia , Cavalos , Masculino , Testes de Sensibilidade Microbiana/veterinária , Prevalência , Sepse/epidemiologia , Sepse/microbiologia , Membrana Sinovial/microbiologia , Sinovite/epidemiologia , Sinovite/microbiologiaAssuntos
Infecções por Burkholderia/diagnóstico , Infecções por Burkholderia/microbiologia , Burkholderia , Sinovite/diagnóstico , Sinovite/microbiologia , Adulto , Artroplastia do Joelho/efeitos adversos , Artroscopia , Biomarcadores , Biópsia , Burkholderia/classificação , Burkholderia/genética , Burkholderia/isolamento & purificação , Humanos , Masculino , RNA Ribossômico 16S/genética , Análise de Sequência de DNAAssuntos
Anticorpos Anticitoplasma de Neutrófilos , Vasculite por IgA/diagnóstico , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Vasculite Leucocitoclástica Cutânea/diagnóstico , Deficiência de alfa 1-Antitripsina/diagnóstico , Acidentes por Quedas , Evolução Fatal , Humanos , Masculino , Pessoa de Meia-Idade , Pseudomonas aeruginosa , Sinovite/microbiologia , Vasculite Leucocitoclástica Cutânea/patologiaRESUMO
Mycobacterium kansasii is a nontuberculous mycobacterium that primarily causes pulmonary disease in AIDS patients, however it has also been known, rarely, to result in skeletal infection. When skeletal infection occurs, the time from onset of symptoms to diagnosis is up to 5 years in previously reported cases. We describe a 48-year-old woman with HIV/AIDS who presented with chronic, isolated left knee pain and swelling of over two decades which had recently worsened. Radiographs and magnetic resonance imaging demonstrated marked subarticular erosions, synovial thickening, and bone marrow edema, which had progressed compared with prior imaging done seven years earlier. Synovial biopsy grew Mycobacterium kansasii. Following the presentation of our case, clinical and imaging findings, including the differential diagnosis, of monoarticular arthritis caused by Mycobacterium kansasii are reviewed and discussed.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Mycobacterium kansasii/isolamento & purificação , Sinovite/microbiologia , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Quimioterapia Combinada , Feminino , Humanos , Infecções por Mycobacterium não Tuberculosas/tratamento farmacológico , Sinovite/diagnóstico , Sinovite/tratamento farmacológicoAssuntos
Epifise Deslocada/patologia , Lesões do Quadril/diagnóstico , Lesões do Quadril/tratamento farmacológico , Doença de Legg-Calve-Perthes/patologia , Sinovite/diagnóstico , Sinovite/tratamento farmacológico , Ataxia/etiologia , Criança , Pré-Escolar , Diagnóstico Precoce , Epifise Deslocada/complicações , Epifise Deslocada/diagnóstico , Epifise Deslocada/terapia , Feminino , Lesões do Quadril/complicações , Lesões do Quadril/microbiologia , Humanos , Doença de Legg-Calve-Perthes/complicações , Doença de Legg-Calve-Perthes/diagnóstico , Doença de Legg-Calve-Perthes/terapia , Masculino , Sinovite/complicações , Sinovite/microbiologia , Resultado do TratamentoRESUMO
OBJECTIVE: The objective of this study was to investigate the role of periodontal pathogens in RA in remission. METHODS: Twenty-one patients with active RA and 70 patients in clinical remission, including 48 patients with synovitis [US power Doppler (USPD)(+) group] and 22 patients without synovitis [USPD(-) group] were clinically assessed by US. CRP, ESR, haemoglobin, MMP-3, RF and ACPA were measured. Antibody titres against four types of periodontal pathogen [Aggregatibacter actinomycetemcomitans, Eikenella corrodens (Ec), Porphyromonas gingivalis and Prevotella intermedia (Pi)] were analysed using ELISA. RESULTS: Musculoskeletal US examination showed that 68.6% of patients with RA in clinical remission exhibited synovitis. CRP, ESR, haemoglobin, MMP-3 and RF levels in both the USPD(+) and USPD(-) groups were clearly lower compared with the RA group in non-remission. The IgG serum antibody titre against Ec in the non-remission RA(+) group was significantly greater than that in the USPD(+) group, and the IgG antibody titre against Pi in the non-remission RA and USPD(+) groups was greater than in the USPD(-) group. CONCLUSION: More than half of RA patients in remission showed persistent synovitis. This synovitis may be associated with periodontal disease-causing Pi. Thus, treating periodontal disease should also be considered in order to achieve more profound remission of RA.
Assuntos
Artrite Reumatoide/microbiologia , Periodontite Crônica/microbiologia , Sinovite/microbiologia , Idoso , Anticorpos Antibacterianos/sangue , Antirreumáticos/uso terapêutico , Artrite Reumatoide/diagnóstico por imagem , Artrite Reumatoide/tratamento farmacológico , Infecções por Bacteroidaceae/microbiologia , Biomarcadores/sangue , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Prevotella intermedia/imunologia , Prevotella intermedia/isolamento & purificação , Indução de Remissão , Estudos Retrospectivos , Sinovite/diagnóstico por imagem , UltrassonografiaRESUMO
Lyme borreliosis (LB) is a multi-systemic tick-borne disease affecting both humans and animals, including horses, and is caused by a group of interrelated spirochetes classified within the Borrelia burgdorferi sensu lato (s.l.) complex. Despite the high reported seroprevalence in the European equine population for B. burgdorferi s.l., to-date no documented clinical cases have been described. A 6-year-old Paint gelding was referred with a history of three weeks of fever, intermittent lameness and digital flexor tendon sheath effusion of the right hind limb. Based on a strict diagnostic protocol, which included serological tests for infectious diseases and molecular investigations, a final diagnosis was made of polysynovitis due to B. burgdorferi s.l. infection. An unreported aspect observed in this case was the absence of the pathogen DNA in two of the affected joints. To the authors' knowledge, the case described represents the first documented clinical case of equine LB in Italy. Moreover, the absence of pathogen DNA in two of the affected joints observed in this case revealed a possible similarity with the same condition described in humans, where an immunomediated pathogenesis for arthropathy due to B. burgdorferi s.l. infection is suspected. Since humans and horses share the same habitat, this report supports the role of the horse as potential sentinel for human biological risk.
Assuntos
Grupo Borrelia Burgdorferi/isolamento & purificação , Doenças dos Cavalos/diagnóstico , Doença de Lyme/veterinária , Sinovite/veterinária , Animais , DNA Bacteriano/análise , Ensaio de Imunoadsorção Enzimática/veterinária , Evolução Fatal , Doenças dos Cavalos/microbiologia , Cavalos , Itália , Doença de Lyme/diagnóstico , Doença de Lyme/microbiologia , Masculino , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Sinovite/diagnóstico , Sinovite/microbiologiaRESUMO
BACKGROUND: Recent studies have identified Propionibacterium acnes as the causal organism in an increasing number of postoperative shoulder infections. Most reports have found a high rate of P acnes infection after open surgery, particularly shoulder arthroplasty. However, there are limited data regarding P acnes infections after shoulder arthroscopy. MATERIALS AND METHODS: We prospectively collected data on all shoulder arthroscopies performed by the senior author from January 1, 2009, until April 1, 2013. Cultures were taken in all revision shoulder arthroscopy cases performed for pain, stiffness, or weakness. In addition, 2 cultures were taken from each of a cohort of 32 primary shoulder arthroscopy cases without concern for infection to determine the false-positive rate. RESULTS: A total of 1,591 shoulder arthroscopies were performed during this period, 68 (4.3%) of which were revision procedures performed for pain, stiffness, or weakness. A total of 20 revision arthroscopies (29.4%) had positive culture findings, and 16 (23.5%) were positive for P acnes. In the control group, 1 patient (3.2%) had P acnes growth. CONCLUSIONS: The rate of P acnes infection in patients undergoing revision shoulder arthroscopy is higher than previously published and should be considered in cases characterized by refractory postoperative pain and stiffness.
Assuntos
Artroscopia , Infecções por Bactérias Gram-Positivas/epidemiologia , Dor Pós-Operatória/microbiologia , Propionibacterium acnes , Articulação do Ombro , Sinovite/microbiologia , Adulto , Idoso , Artroplastia/efeitos adversos , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/terapia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória/patologia , Dor Pós-Operatória/cirurgia , Reoperação , Sinovite/patologia , Sinovite/cirurgiaRESUMO
OBJECTIVE: In the present study various tissues of pigs were investigated for the presence of histopathologic lesions after an experimental infection with Haemophilus (H.) parasuis serovar 5. MATERIAL AND METHODS: Conventional pigs (n = 36) were divided into a control group B (n = 9) and a challenge group A (n = 27), which was infected intratracheally. Pigs that did not die prior to study termination were euthanized on day 14 post inoculation. Postmortem samples of the lung, heart, liver, kidney, spleen, left tarsal joint capsule and brain were collected. RESULTS: All but one pig with detectable histopathologic lesions (n = 11) showed typical macroscopic changes. Histopathologic examination of all tissue samples identified pyelitis (n = 10), synovitis (n = 7) and meningitis (n = 7) and all those animals were euthanized prior to study termination. No histopathologic lesions were found in pigs of the control group. The correlations between pyelitis and meningitis, pyelitis and synovitis and synovitis and meningitis were significant (p < 0.001). No significant correlation could be observed between the histopathologic and the clinical examination of the joints. The investigation of samples from the joints by PCR was not significantly correlated with the observed synovitis. The clinical observation of neurologic signs was significantly correlated with meningitis (p = 0.03). A significant correlation (p < 0.001) could be detected between meningitis and the detection of H. parasuis by PCR in brain samples. CONCLUSIONS: H. parasuis constantly causes clinical signs and pathologic lesions as soon as it infects the brain while it can infect the joints without causing histopathologic lesions. Pigs with histopathologic lesions do not always show typical clinical signs. Only few studies described the finding of kidney lesions in pigs with Glässer's disease and this is the first study to describe a pyelitis in pigs experimentally infected with H. parasuis. The observed pyelitis mainly occurred in acute cases.