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1.
Zhonghua Nei Ke Za Zhi ; 59(2): 134-139, 2020 Feb 01.
Artigo em Chinês | MEDLINE | ID: mdl-32074687

RESUMO

Objective: To investigate the clinical and imaging characteristics of infectious sacroiliitis. Methods: A total of 110 patients diagnosed with infectious sacroiliitis were retrospectively analyzed between 2008 and 2017.Clinical manifestations and therapeutic responses, laboratory tests such as HLA-B(27), erythrocyte sedimentation rate (ESR), C reactive protein (CRP), T cell spot test for tuberculosis infection(TB-SPOT), Brucella agglutination test ect., blood culture of pathogens, pathological findings as well as magnetic resonance imaging were all recorded and analyzed. Results: Among the 110 patients, the male to female ratio was 44 to 66 with an average age 15-58(29.4±10.8) years and the course of disease 0.3-60 (5.7±13.2) months. As to the pathogens, 71 cases were pyogenic, 24 cases with tuberculous sacroiliitis, and 15 cases were brucellosis infections. The majority of patients (97.3%) had unilateral sacroiliac joint involvement. Ten (9.1%) patients suffered infectious sacroiliac arthritis after delivery. Hip pain was the main clinical manifestation (83/110,75.5%) and fever as the second (77/110,70.0%). HLA-B(27) was positive in 11 patients (10.0%). Both ESR and CRP were elevated in the majority. There were 103 patients receiving sacroiliac joint puncture biopsy. Seven patients were diagnosed through blood culture or brucellosis agglutination test. Bone marrow edema and osteolytic lesions in magnetic resonance imaging (MRI) were more common in pyogenic or tuberculous sacroiliitis than in brucellosis infections. Conclusion: Infectious sacroiliitis should be differentiated from spondyloarthritis, which develops more in female patients, with short disease duration and fever, mostlynegative HLA-B(27). The majority patients present unilateral sacroiliitis. Active inflammatory lesions are usually beyond sacroiliac joints with osteolytic changes in MRI examinations.


Assuntos
Artrite Infecciosa/diagnóstico , Infecções Bacterianas/complicações , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/patologia , Sacroileíte/diagnóstico , Adolescente , Adulto , Artrite Infecciosa/microbiologia , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/microbiologia , Biópsia , Brucella , Brucelose , Criança , Pré-Escolar , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Articulação Sacroilíaca/microbiologia , Sacroileíte/microbiologia , Adulto Jovem
2.
Pediatr Clin North Am ; 67(1): 59-69, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31779837

RESUMO

Pediatric populations are prone to infections and most can be managed appropriately in a primary care setting. There are, however, some infectious processes that require intervention or management from an orthopedic surgeon. The most serious infectious processes in the pediatric population from an orthopedic standpoint are osteomyelitis and septic arthritis. Early recognition of these conditions and prompt referral of serious infections, as well as the ability to differentiate which infections should be referred for specialist evaluation is critical.


Assuntos
Artrite Infecciosa/microbiologia , Doenças Musculoesqueléticas/microbiologia , Osteomielite/microbiologia , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Criança , Humanos , Osteomielite/diagnóstico , Osteomielite/terapia
3.
BMC Musculoskelet Disord ; 20(1): 623, 2019 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-31878902

RESUMO

BACKGROUND: Sonication is a valuable tool in the diagnosis of periprosthetic joint infections (PJI). However, conditions and definition criteria for PJI vary among studies. The aim of this study was to determine the diagnostic performance (i.e., specificity, sensitivity) of sonicate fluid culture (SFC) against periprosthetic tissue culture (PTC), when using European Bone and Joint Infection Society (EBJIS) criteria. METHODS: From March 2017 to April 2018, 257 implants were submitted for sonication. PJI was defined according to the EBJIS criteria as well as according to the International Consensus Meeting criteria of 2018 (ICM 2018). Only cases with at least one corresponding tissue sample were included. Samples were cultured using traditional microbiological plating techniques. Sensitivity and specificity were determined using two-by-two contingency tables. McNemar's test was used to compare proportions among paired samples. Subgroup analysis was performed dividing the cohort according to the site of PJI, previous antibiotic treatment, and time of manifestation. Prevalence of pathogens was determined for all patients as well as for specific subgroups. RESULTS: Among the 257 cases, 145 and 112 were defined as PJI and aseptic failure, respectively. When using the EBJIS criteria, the sensitivity of SFC and PTC was 69.0 and 62.8%, respectively (p = .04). Meanwhile, the specificity was 90.2 and 92.9%, respectively (p = .65). When adopting ICM 2018 criteria, the sensitivity of SFC and PTC was 87.5 and 84.4% (p = .63) respectively, while the specificity was 85.1 and 92.5% (p = .05), respectively. The most commonly identified pathogens were coagulase-negative staphylococci (26% overall), while 31% of PJI were culture-negative and 9% polymicrobial. CONCLUSIONS: SFC exhibited significantly greater sensitivity versus PTC when using the EBJIS criteria. Nevertheless, the diagnosis of PJI remains a difficult challenge and different diagnostic tools are necessary to optimize the outcome.


Assuntos
Artrite Infecciosa/diagnóstico , Técnicas de Cultura , Prótese Articular , Infecções Relacionadas à Prótese/diagnóstico , Sonicação , Idoso , Artrite Infecciosa/microbiologia , Feminino , Humanos , Masculino , Infecções Relacionadas à Prótese/microbiologia , Estudos Retrospectivos , Sensibilidade e Especificidade
4.
Pan Afr Med J ; 33: 237, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31692731

RESUMO

The wrist is a rare location of septic arthritis. It often involves patients with preexisting joint disease which symptoms could be confused with infection making the diagnosis more difficult and usually delayed. It is often responsible for residual functional impairment and for a high mortality rate among vulnerable patients. We report 6 cases of septic arthritis of the wrist in 3 males and 3 females. The mean age was 32 years in the male patients and 66 in the female patients. All the women were followed for rheumatoid arthritis. Biological results showed elevated rates of white blood cells and c-reactive protein in all the patients. Joint fluid analyses showed elevated white blood cell count. The treatment was medico-surgical consisting in synovectomy, joint debridement and immobilization of the wrist. At the average follow-up of 1 year and 4 months, 3 patients recovered a perfect mobility of the wrist without any limitation of the range of motion nor the strength. Three patients developed stiffness of the wrist.


Assuntos
Artrite Infecciosa/cirurgia , Desbridamento/métodos , Articulação do Punho/cirurgia , Adulto , Idoso , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/patologia , Artrite Reumatoide/complicações , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , Estudos Retrospectivos , Resultado do Tratamento , Articulação do Punho/patologia
5.
Pediatrics ; 144(6)2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31722963

RESUMO

OBJECTIVES: In this study, we aimed to contrast the bacteriologic epidemiology of osteoarticular infections (OAIs) between 2 patient groups in successive 10-year periods, before and after the extensive use of nucleic acid amplification assays in the diagnostic process. METHODS: Epidemiologic data and bacteriologic etiologies of all children presenting with OAIs on admission to our institution over 20 years (1997-2016) were assessed retrospectively. The population was divided into 2 cohorts, using the standardized use of polymerase chain reaction as the cutoff point (2007). The conventional cohort included children with OAIs mainly investigated by using classic cultures, whereas the molecular cohort referred to patients also investigated by using molecular assays. RESULTS: Kingella kingae was the most frequently isolated pathogen, responsible for 51% of OAIs, whereas other classic pathogens were responsible for 39.7% of cases in the molecular cohort. A statistically significant increase in the mean incidence of OAIs was observed, as was a decrease in the mean age at diagnosis after 2007. After 2007, the pathogen remained unidentified in 21.6% of OAIs in our pediatric population. CONCLUSIONS: Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between 6 and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriologic etiology of OAIs.


Assuntos
Artrite Infecciosa/diagnóstico , Kingella kingae/isolamento & purificação , Infecções por Neisseriaceae/diagnóstico , Osteoartrite/diagnóstico , Osteomielite/diagnóstico , Adolescente , Artrite Infecciosa/genética , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Kingella kingae/genética , Masculino , Infecções por Neisseriaceae/genética , Osteoartrite/genética , Osteomielite/genética , Reação em Cadeia da Polimerase em Tempo Real/métodos , Estudos Retrospectivos
6.
J Radiol Case Rep ; 13(1): 17-23, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31565164

RESUMO

We present the clinical, imaging, and laboratory findings of a 41-year-old male with culture proven Sporothrix schenckii osteoarticular infection of the right knee. Fungal arthropathies are a rare and indolent form of septic arthritis, which often leads to a delayed diagnosis. Early diagnosis and treatment of fungal arthropathies is critical to preventing permanent functional disability.


Assuntos
Artrite Infecciosa/diagnóstico , Artrite Infecciosa/microbiologia , Diagnóstico Tardio , Sporothrix/isolamento & purificação , Esporotricose/diagnóstico , Adulto , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/microbiologia , Imagem por Ressonância Magnética , Masculino
7.
In Vivo ; 33(5): 1625-1633, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31471415

RESUMO

BACKGROUND/AIM: Prosthetic joint infections (PJI) are difficult to diagnose and treat. For a correct diagnosis, an array of information has to be processed and weighted. Successful treatment depends on the diagnosis, timing, and surgical strategy paired with treatment of the infectious agent. The complexity and interdisciplinarity needed cause difficulties concerning decision-making, the communication between disciplines, and the execution of a treatment strategy. The aim of this study was to develop a software platform to enhance the collection of information for the diagnosis of PJI, the interdisciplinary decision-making process, the communication between team members, and continuous evaluation of treatment. PATIENTS AND METHODS: In regular planning sessions with an information technology (IT) specialist, a concept for an IT solution was chosen and the tool was designed in an interdisciplinary approach. RESULTS: The tool has been used as a trial version since June 2017. It consists of 14 user interfaces with 431 items. A total of 117 patients with 118 infections have been entered and the strategy decided upon and communicated using 298 infection board documents outlining the treatment. The tool is now being used to organize the infections board agenda, schedule patient case discussions, document the relevant data and treatment plan, as well as communicate with the other teams involved in the treatment. CONCLUSION: Using the developed tool enables the infections team to work collaboratively and under division of labor on each case, rendering the work flow more efficient for each team member.


Assuntos
Assistência ao Convalescente , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Informática Médica/métodos , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/terapia , Interpretação Estatística de Dados , Sistemas de Gerenciamento de Base de Dados , Gerenciamento Clínico , Gestão da Informação em Saúde/métodos , Humanos , Masculino
8.
BMC Musculoskelet Disord ; 20(1): 392, 2019 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-31470834

RESUMO

BACKGROUND: Chronic recurrent multifocal osteomyelitis (CRMO) is a rare idiopathic autoinflammatory bone disease that mostly affects children and adolescents. It is a diagnosis of exclusions since no clinical signs and symptoms are pathognomonic. Radiological tests are often essential, but bone biopsy may be needed in unclear cases. CASE PRESENTATION: A 9-year-old Caucasian girl with a history of bone pain. The data from the history and results of laboratory tests suggested osteomyelitis, but no adequate response to the treatment was observed. A number of imaging tests did not confirm the diagnosis, therefore a bone biopsy was necessary. CONCLUSIONS: Differential diagnosis of CRMO is challenging and it is based on exclusions. Since it might be misdiagnosed or mistreated, bone biopsy should be considered in patients reporting bone pain who are unresponsive to treatment.


Assuntos
Dor Musculoesquelética/etiologia , Osteomielite/diagnóstico , Doenças Raras/diagnóstico , Artrite Infecciosa/diagnóstico , Biópsia , Medula Óssea/diagnóstico por imagem , Medula Óssea/patologia , Neoplasias Ósseas/diagnóstico , Criança , Diagnóstico Diferencial , Feminino , Humanos , Imagem por Ressonância Magnética , Osteomielite/complicações , Osteomielite/patologia , Cintilografia , Doenças Raras/complicações , Doenças Raras/patologia , Tíbia/diagnóstico por imagem , Tíbia/patologia , Tomografia Computadorizada por Raios X
10.
Knee ; 26(5): 1152-1158, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31427242

RESUMO

Tuberculosis (TB) affecting a prosthetic knee is an unusual and diagnostically challenging presentation of this disease. This study reported a case of an 80-year-old man with a left total knee arthroplasty (TKA) performed eight years before his presentation. He presented with left knee swelling and pain for one month. Knee X-rays showed a normal joint space with no loosening of his prosthesis. His chest X-ray showed miliary disease, and microbiological studies of his sputum and synovial fluid aspirate grew Mycobacteria tuberculosis complex. He was successfully medically treated with anti-tuberculous therapy alone for one year. His knee hardware was retained, and he did not require debridement, resection, or revision. It is believed that this is the first reported case of miliary TB with delayed-onset TKA prosthetic joint infection (PJI) in which the prosthesis was successfully retained. Thirty-eight published TB TKA PJI cases in medical literature were also reviewed.


Assuntos
Antituberculosos/uso terapêutico , Artrite Infecciosa/transmissão , Artroplastia do Joelho/efeitos adversos , Articulação do Joelho/diagnóstico por imagem , Prótese do Joelho/efeitos adversos , Infecções Relacionadas à Prótese/terapia , Tuberculose Miliar/terapia , Idoso de 80 Anos ou mais , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/microbiologia , Humanos , Articulação do Joelho/microbiologia , Articulação do Joelho/cirurgia , Prótese do Joelho/microbiologia , Masculino , Mycobacterium tuberculosis/isolamento & purificação , Infecções Relacionadas à Prótese/diagnóstico , Infecções Relacionadas à Prótese/microbiologia , Radiografia , Tuberculose Miliar/diagnóstico , Tuberculose Miliar/microbiologia
11.
Indian J Tuberc ; 66(3): 422-426, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31439192

RESUMO

A 34 year-old lady was referred for rheumatology review by the orthopaedic team for further investigation of chronic left sternoclavicular joint pain. No preceding event such as trauma, injury or infection had occurred. A rheumatology workup turned out to be negative for an inflammatory arthropathy. After extensive investigations including blood tests, an MRI scan, a CT scan, and a bone scan, and in consultation with the orthopaedic team, the affected joint was biopsied and tested for mycobacterium avium-intracellulare infection. The results came back as positive and the patient was started on anti-mycobacterial treatment. We report the diagnosis, management and 3-year follow-up of this unique case. This highlights an uncommon and often misdiagnosed cause of septic arthritis caused by mycobacterium avium-intracellulare infection. To our knowledge this is the first confirmed sternoclavicular mycobacterium avium-intracellulare infection in an immunocompetent host reported in the literature.


Assuntos
Artrite Infecciosa/diagnóstico , Complexo Mycobacterium avium/isolamento & purificação , Infecção por Mycobacterium avium-intracellulare/diagnóstico , Articulação Esternoclavicular , Adulto , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/tratamento farmacológico , Artrite Infecciosa/microbiologia , Diagnóstico Diferencial , Feminino , Humanos , Imunocompetência , Imagem por Ressonância Magnética , Infecção por Mycobacterium avium-intracellulare/diagnóstico por imagem , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Infecção por Mycobacterium avium-intracellulare/microbiologia
12.
Orthop Clin North Am ; 50(4): 461-470, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31466662

RESUMO

Septic arthritis in children is a surgical emergency, and prompt diagnosis and treatment are mandatory. If diagnosed quickly and treated correctly, the outcomes can be good. With delay in diagnosis and without proper treatment, outcomes often are quite devastating, with growth disturbance and joint destruction.


Assuntos
Artrite Infecciosa/diagnóstico , Artrite Infecciosa/terapia , Terapia Combinada/métodos , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Desbridamento , Diagnóstico Precoce , Humanos , Prognóstico , Resultado do Tratamento
13.
Ital J Pediatr ; 45(1): 111, 2019 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-31443670

RESUMO

BACKGROUND: Familial Mediterranean Fever is a monogenic autoinflammatory disease, typically characterized by recurrent attacks of fever, serositis, aphthous of oral mucosa, erythema. "Pyogenic arthritis, pyoderma gangrenosum and acne syndrome" is a rare autoinflammatory disease with variable expression and typically involving joints and skin. Both the diseases are linked by the overproduction of IL-1. CASE PRESENTATION: We report on the case of two siblings affected by recurrent attacks of fever, oral aphthous stomatitis, abdominal pain, arthritis, undefined dermatitis at the hands, associated with increased AST, ALT, C-reactive protein, erythrocyte sedimentation rate, serum amyloid A, leucocytosis with neutrophilia. Infectious diseases were excluded. The genetic study for Familial Mediterranean Fever, tumor necrosis factor receptor-associated periodic syndrome, Mevalonate kinase deficiency, showed the homozygous mutation p.M680I of exon 10 in MEFV. Their parents were heterozygous for the same mutation p.M680I, however, the mother showed severe symptoms of FMF (recurrent attacks of fever, arthralgia and arthritis, abdominal pain, thoracic pain), the father showed recurrent pustulosis prevalent on the hands and limbs, with arthralgia and abdominal pain. Both the patients started colchicine, with an improvement in clinical manifestations and a reduction of serum amyloid A. For the atypical dermatologic signs present in the two siblings and in the father, the study of other autoinflammatory syndromes was performed with next generation sequencing and showed the heterozygous rare missense mutation of unknown significance: p.(Val408Ile) of PSTPIP1 gene in the two siblings and in the mother, the father was negative. Canakinumab treatment was started in the younger patient, with the resolution of the clinical symptoms and the normalization of serum amyloid A. CONCLUSIONS: Further studies are needed to better describe the correlation between genotype and phenotype in patients with PAPA syndrome and with PAPA syndrome associated with FMF, considering that the presence of mutations in both genes may amplify clinical presentation and evolution of both diseases.


Assuntos
Acne Vulgar/complicações , Acne Vulgar/diagnóstico , Artrite Infecciosa/complicações , Artrite Infecciosa/diagnóstico , Febre Familiar do Mediterrâneo/complicações , Febre Familiar do Mediterrâneo/diagnóstico , Pioderma Gangrenoso/complicações , Pioderma Gangrenoso/diagnóstico , Adolescente , Criança , Humanos , Masculino
14.
Bone Joint J ; 101-B(7_Supple_C): 91-97, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31256641

RESUMO

AIMS: There is little information regarding the risk of a patient developing prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) when the patient has previously experienced PJI of a TKA or total hip arthroplasty (THA) in another joint. The goal of this study was to compare the risk of PJI of primary TKA in this patient population against matched controls. PATIENTS AND METHODS: We retrospectively reviewed 95 patients (102 primary TKAs) treated between 2000 and 2014 with a history of PJI in another TKA or THA. A total of 50 patients (53%) were female. Mean age was 69 years (45 to 88) with a mean body mass index (BMI) of 36 kg/m2 (22 to 59). In total, 27% of patients were on chronic antibiotic suppression. Mean follow-up was six years (2 to 16). We 1:3 matched these (for age, sex, BMI, and surgical year) to 306 primary TKAs performed in 306 patients with a THA or TKA of another joint without a subsequent PJI. Competing risk with death was used for statistical analysis. Multivariate analysis was followed to evaluate risk factors for PJI in the study cohort. RESULTS: The cumulative incidence of PJI in the study cohort (6.1%) was significantly higher than the matched cohort (2.6%) at ten years (hazard ratio (HR) 3.3; 95% confidence interval 1.18 to 8.97; p = 0.02). Host grade in the study group was not a significant risk factor for PJI. Patients on chronic suppression had a higher rate of PJI (HR 15; p = 0.002), with six of the seven patients developing PJI in the study group being on chronic suppression. The new infecting microorganism was the same as the previous in only two of seven patients. CONCLUSION: In this matched cohort study, patients undergoing a clean primary TKA with a history of TKA or THA PJI in another joint had a three-fold higher risk of PJI compared with matched controls with ten-year cumulative incidence of 6.1%. The risk of PJI was 15-fold higher in patients on chronic antibiotic suppression; further investigation into reasons for this and mitigation strategies are recommended. Cite this article: Bone Joint J 2019;101-B(7 Supple C):91-97.


Assuntos
Artrite Infecciosa/complicações , Artroplastia de Quadril/efeitos adversos , Artroplastia do Joelho/efeitos adversos , Previsões , Infecções Relacionadas à Prótese/etiologia , Idoso , Idoso de 80 Anos ou mais , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/cirurgia , Feminino , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infecções Relacionadas à Prótese/epidemiologia , Reoperação , Estudos Retrospectivos , Fatores de Risco , Estados Unidos/epidemiologia
16.
Pediatr Emerg Care ; 35(7): 509-513, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31261255

RESUMO

Septic arthritis is an emergent condition caused by bacterial infection of a joint space. The most common etiology is hematogenous spread from bacteremia, but it can also occur from direct inoculation from bites, injection injuries, cellulitis, abscesses, or local trauma. Septic arthritis occurs most frequently in the lower extremities, with the hips and knees serving as the most common locations. The most sensitive findings include pain with motion of the joint, limited range of motion, tenderness of the joint, new joint swelling, and new effusion. Laboratory testing and imaging can support the diagnosis, but the criterion standard is diagnostic arthrocentesis. Treatment involves intravenous antibiotics and joint decompression.


Assuntos
Antibacterianos/uso terapêutico , Artrite Infecciosa , Descompressão Cirúrgica , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/etiologia , Artrite Infecciosa/microbiologia , Artrite Infecciosa/terapia , Bacteriemia/complicações , Mordeduras e Picadas/complicações , Criança , Terapia Combinada , Humanos , Lactente , Infusões Intravenosas , Líquido Sinovial/imunologia
18.
Folia Med Cracov ; 59(1): 5-14, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31180072

RESUMO

Lyme disease is an emerging problem in Poland. Analysis has been undertaken of the medical documentation of 86 patients hospitalized in the Infectious Diseases Department, University Hospital in Cracow in 2013-2016, suspected of Lyme arthritis. It has especially considered medical history including potential exposure to the infection, detailed characteristics of the symptoms, diagnostic challenges and results of the treatment. Only some patients had a history of erythema migrans and not all of them recalled tick-bite. The majority of the patients had affected large joints, especially knee joints, and polyarthritis was rarely observed. Symptoms were resolved completely or partially after antibiotic treatment in most patients. The diagnosis of Lyme arthritis in areas endemic for Lyme disease is still a diagnostic challenge in patients with other rheumatic diseases, including osteoarthritis.


Assuntos
Artrite Infecciosa/tratamento farmacológico , Eritema Migrans Crônico/tratamento farmacológico , Doença de Lyme/tratamento farmacológico , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico , Artrite Infecciosa/fisiopatologia , Ceftriaxona/uso terapêutico , Diagnóstico Diferencial , Doxiciclina/uso terapêutico , Eritema Migrans Crônico/diagnóstico , Eritema Migrans Crônico/etiologia , Feminino , Articulações do Pé , Articulação da Mão , Articulação do Quadril , Hospitalização , Hospitais Universitários , Humanos , Articulação do Joelho , Doença de Lyme/complicações , Doença de Lyme/diagnóstico , Doença de Lyme/fisiopatologia , Masculino , Pessoa de Meia-Idade , Osteoartrite/diagnóstico , Polônia , Articulação do Ombro , Picadas de Carrapatos , Resultado do Tratamento
20.
Georgian Med News ; (288): 26-32, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31101770

RESUMO

Based on the results of hematological, biochemical, immunological, clinical microscopic and bacteriological studies, the article assessed the condition of patients with bacterial arthritis of the knee joints and periprosthetic infection of the hip joints and developed an algorithm for their clinical and laboratory examination. The algorithm clinical-laboratory examination of patients based on the most informative laboratory markers for bacterial arthritis of the knee: number of stab neutrophils, erythrocyte sedimentation rate, glycoproteins, haptoglobin (the exponents of the inflammatory process), chondroitinsulfates (markers destruction of cartilage and bone of the affected joints) circulating immune complexes (an indicator of the reactivity of the immune system to the toxic-infectious inflammatory process), cytosis, neutrophils and synoviocytes (markers of articular punctate and the nature of the inflammatory process).


Assuntos
Artrite Infecciosa , Articulação do Joelho , Artrite Infecciosa/diagnóstico , Biomarcadores , Sedimentação Sanguínea , Articulação do Quadril/microbiologia , Prótese de Quadril , Humanos , Articulação do Joelho/microbiologia , Prótese do Joelho
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