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Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The spectrum of severe Haemophilus influenzae type b disease exclusive of meningitis includes: epiglottitis, pneumonia, arthritis, septicemia, cellulitis and pericarditis. The results of a 7 year-epidemiologic study (Jan 1980 to Dec 1986) performed in 2 French departments are reported. Sixty-nine cases were detected, representing a yearly rate of 9/100,000 children aged 0 to 4 years. The real incidence is probably higher and was estimated as 11/100,000. In all of France, it corresponds to 382 annual cases and, more specifically to 60 to 70 annual cases of epiglottitis. No deaths were recorded and only 2 cases with minor sequelae were documented in this series. These results, as compared with those of previous studies, show that the incidence is lower than that in other countries, especially with regard to epiglottitis which is more frequent in North America and in Scandinavian countries.
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PMID:[Epidemiology of Haemophilus influenzae type b infections (excluding meningitis) in 2 French departments]. 278 12

Clinical manifestations and epidemiological characteristics of Lyme disease in Hailin county, Heilongjiang Province, China have been reported. The clinical picture of erythema chronicum migrans (ECM) is variable. ECM in the form of annular erythematous patch is uncommon. It is an extensive and indurated lesion. In some instances, a vesicle or necrosis appears in the center of the lesion. Secondary erythema may present in some patients. The neurologic abnormalities consist of meningitis, facial palsy, and polyneuritis. Cardiac abnormalities are rare. In addition, there were cases with lymphadenosis benigna cutis (LABC), which had heretofore only been reported in Europe. The attack rate of ECM is 8.4%. There was a significant sex difference, and most cases occurred in May and June. All patients had a history of tick bite. The prevalence rates of neurologic abnormalities and arthritis were 4.6% and 6.6%, respectively. Three strains of spirochete that are closely related to Borrelia burgdorferi were isolated from Ixodes persulcatus ticks and facial palsy patients. From the above results it is concluded that a focus of Lyme disease exists in this region.
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PMID:Clinical manifestations and epidemiological characteristics of Lyme disease in Hailin county, Heilongjiang Province, China. 319 Jan 1

There are many obvious similarities between Lyme disease and syphilis. The major ones are their spirochetal etiology, the ability of the spirochetes to stay alive in human tissue for years, occurrence of clinical manifestations in stages, early disease in the skin and later disease in the brain, and susceptibility to antibiotic treatment. Thus, one can assume that many of the same lessons learned from the centuries of experience with syphilis will apply to Lyme disease. One of these lessons that should be constantly borne in mind is that spirochetal disease of the brain can mimic many other neurological diseases. Thus, the "effective clinician" must take special care to consider Lyme disease primarily because of the excellent response to antibiotics early in its course in relationship to some of the diseases it mimics. Lyme meningitis, occurring in the "second stage" of the disease, usually is fairly easily recognized because it occurs in the summer or early fall, often is associated with ECM or a recent history of it, and has a characteristic clinical picture of lymphocytic meningoradiculoneuritis. Many patients with Lyme meningitis or ECM have very mild symptoms, and it is likely that a large percentage of patients go undiagnosed and untreated. The frequency of progression of these patients to third-stage disease is unknown but may be quite high. This can be inferred from a similar situation in the other major late manifestation of Lyme disease: Lyme arthritis. A large number of patients present with joint involvement as their only manifestation of Lyme disease. Similarly, patients may present with symptoms of third-stage Lyme disease affecting the CNS, but they may not be recognized because of the lack of earlier stages usually associated with the disease. Thus, serology has become a very important tool for identifying patients exposed to B. burgdorferi. At the present time, serologic tests are the key to diagnosis of Lyme disease in its later stages, since, as in neurosyphilis, cultures and tests for antigen have not proven useful. Lyme arthritis and acrodermatitis atrophicans (ACA) both are associated with quite high antibody titers to the organism, while the test is understandably unreliable for identification of patients with ECM. Antibody titers in Lyme meningoradiculoneuritis are generally positive but often are not as high as those in ACA or arthritis. The antibody response in serum in CNS Lyme disease seems to be related to the presence of other manifestations; patients who have had both arthritis and CNS disease have quite high titers, while those with only CNS disease sometimes do not.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Borrelia burgdorferi in the nervous system: the new "great imitator". 319 Jan 4

Haemophilus influenzae type b has rarely been implicated as a pathogen of osteomyelitis in infants and children. Sixteen cases of Haemophilus osteomyelitis were identified in a 28-year review, representing 4.4% of all cases during that period. In the 1 to 24 months age group, H. influenzae type b caused 13.3% of all cases of osteomyelitis. The mean age was 15 months (range, 12 days to 34 months). All cases had fever, 75% had a history of a preceding respiratory tract infection, 75% had localized swelling, 69% had decreased range of motion of the affected or adjacent joint, 38% had local erythema and 13% had localized tenderness. The lower extremities were involved more often than the upper limbs. Concurrent adjacent suppurative arthritis was present in 75% and meningitis in 19% of patients. Clinical resolution was satisfactory in all but two of our patients, and both were associated with suppurative arthritis and inadequate surgical drainage.
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PMID:Haemophilus influenzae type b osteomyelitis in infants and children. 325 3

Routine use of the Isolator 1.5 Microbial Tube lysis direct plating blood culture system at our institution since November, 1983, provided a unique opportunity to study bacteremia in children from a quantitative perspective. In a 3-year period, 90 episodes of Haemophilus influenzae bacteremia occurred in immunocompetent outpatients; 83 of these met the criteria for study. Patients with high grade bacteremia (greater than 100 colony-forming units/ml) were more likely to have meningitis than those with low grade bacteremia (less than or equal to 100 colony-forming units/ml); conversely low grade bacteremia patients were more likely to have cellulitis or arthritis. Of 38 meningitis patients those with high grade bacteremia (n = 25) had a significantly shorter duration of illness before presentation than those with low grade bacteremia (median, 1 vs. 3 days; P less than or equal to 0.006). In addition high grade bacteremia patients had significantly lower white blood cell counts (median, 11.4 vs. 17.3 X 10(3)/mm3; P less than or equal to 0.007) and absolute neutrophil counts (5.5 vs. 11.1 X 10(3)/mm3; P less than or equal to 0.01). Only 1 of 8 meningitis patients who were pretreated with appropriate antibiotics had high colony counts compared to 7 of 8 matched controls (P = 0.04).
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PMID:Correlates of high grade and low grade Haemophilus influenzae bacteremia. 327 94

Erythema migrans or Lyme borreliosis may be classified according to 3 stages. Erythema migrans is the typical initial lesion of the disease, often associated with general symptoms. Carditis, meningitis, musculoskeletal symptoms including arthralgia may develop in stage 2; arthritis (arthralgia), acrodermatitis chronica atrophicans (ACA), and encephalomyelitis may occur in stage 3. Borrelial lymphocytoma may be seen either in the early phase of the disease or along with the ACA. However, there is no definite therapeutical concept, so far. We recommend tetracyclines during the first stage, and high doses of penicillin G during stages 2 and 3 as well as for pregnant women.
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PMID:[Clinical aspects of erythema migrans (Lyme) borreliosis]. 329 40

The clinical manifestations of patients with group A beta-hemolytic streptococcal (GAS) bacteremia presenting to an urban children's hospital were reviewed. Group A beta-hemolytic streptococci were isolated from blood cultures from 17 children over a three-year period. Systemic illnesses that may have predisposed these children to GAS bacteremia were identified in seven patients: preceding varicella infection (four patients) or malignant neoplasm/immunosuppressive therapy (three patients). Possible sources of GAS included compromised integument (seven patients), the oropharynx (six patients), or the lower respiratory tract (two patients). The clinical manifestations of GAS sepsis included the following: fever (15 patients); arthritis or arthralgias (four patients); cellulitis (three patients); maculopapular eruption (one patient); petechial or pustular exanthems (three patients); osteomyelitis (two patients); cervical adenitis (one patient); empyema (one patient); and meningitis with multiple brain abscesses (one patient). Two patients died of apparent overwhelming GAS sepsis while at home. Group A beta-hemolytic streptococcal bacteremia can present with a wide range of clinical manifestations and cause mild to fulminant disease in children.
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PMID:Group A beta-hemolytic streptococci as a cause of bacteremia in children. 329 24

Twenty cases of Group A beta-hemolytic streptococcal bacteremia in children diagnosed between 1980 and 1987 are reported. Most cases occurred during the winter. The skin and soft tissues were the most common sources of the Group A beta-hemolytic streptococcal bacteremia. Three patients died. Two separate groups of children were observed: (1) a group of 12 young, well-nourished, previously healthy infants, who did not generally develop focal complications and had a favorable course; (2) a group of 8 older children suffering from malnutrition and underlying diseases, such as psychomotor retardation, infected hemangiomata, hemophilia and acute hepatitis B who commonly had focal infections such as pneumonia, meningitis or arthritis/osteomyelitis and had a worse prognosis. M protein-typable strains traditionally related to Group A beta-hemolytic Streptococcus virulence were an inconstant finding in this series.
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PMID:Group A beta-hemolytic streptococcal bacteremia in children. 332 Sep 30

Broth cultures of cerebrospinal and joint fluids are important components in the culture detection of meningitis and septic arthritis. The authors examined 121 strains of bacteria isolated from clinical specimens representing 13 species or groups that cause meningitis and arthritis for growth in supplemented Thioglycolate broth (THIO), Supplemented Peptone Broth (SPB), and minced beef heart (MBH) media each alone or with added IsoVitaleX. Both SPB and MBH with IsoVitaleX performed better as broth culture media than the media without IsoVitaleX or THIO with or without IsoVitaleX.
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PMID:Evaluation of broth media for routine culture of cerebrospinal and joint fluid specimens. 335 72

Streptococcus suis is a zoonotic pathogen which causes meningitis, arthritis and septicaemia in pigs, and rarely meningitis or septicaemia in humans. This organism has recently been isolated from pigs in New Zealand, where it appears to be widely distributed in pig herds. This case is the first report of human infection in New Zealand.
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PMID:Streptococcus suis bacteraemia. 345 49


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