Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Acute venereal arthritis, a syndrome of fever and inflammatory arthritis following recent sexual intercourse, is a frequently misdiagnosed arthritic presentation. Nearly half of 39 patients admitted with a diagnosis of acute gonococcal arthritis were subsequently recognized as having acute Reiter syndrome. A retrospective study of both diseases revealed differentiating features that, when prospectively applied to 21 consecutive patients, permitted a correct and prompt bedside diagnosis. Acute Reiter syndrome could be differentiated by characteristic mucucutaneous lesions, arthritis/tenosynovitis confined to lower extremities, massive recurrent knee effusions, low back pain, conjunctivitis, and genitourinary inflammation. Gonococcal arthritis could be differentiated by migratory arthralgias, high fevers, arthritis/tenosynovitis initially confined to upper extremities, typical cutaneous lesions, and dramatic defervescence to penicillin therapy. Laboratory data provided support for each diagnosis.
 ...
PMID:Acute venereal arthritis. Comparative study of acute Reiter syndrome and acute gonococcal arthritis. 14 16

A 27 year old, HIV positive, homosexual man was admitted for evaluation and treatment of acute oligoarticular arthritis. Gonococcal arthritis was found in a single hip and a single sternoclavicular joint, which is an unusual distribution for this bacterial pathogen.
 ...
PMID:An unusual presentation of gonococcal arthritis in an HIV positive patient. 190 19

Gonococcal arthritis is a frequently occurring clinical entity that should be included routinely in a differential diagnosis of pedal joint pain. Unfortunately, the lack of specificity in the presentation makes gonococcal arthritis difficult to diagnose. Indices of suspicion should rise with any sexually active patient, particularly when septic arthritis is suspected without a detectable portal of entry. The authors emphasize again the importance of carefully choosing empiric antibiotic coverage for gonococcal arthritis. Three factors that should be considered are regional epidemiology, the anatomical site of the primary infection, and the possible coexistence of other infectious agents. Understanding the clinical staging of this condition will help to achieve a timely diagnosis and successful treatment.
 ...
PMID:Monarthric gonococcal arthritis involving the calcaneocuboid joint. 240 18

Gonococcal arthritis, a rare complication of gonorrhoea, more frequent in women, causes polyarthritis in 75% of cases or monoarthritis. An erythematous skin rash or acute pustular rash (40%), recent signs of genital infection (75% of cases in man, less than 50% in women) suggest the diagnosis. The gonococcal nature of the arthritis is confirmed by isolation of the germ in the joint fluid, the blood and the skin biopsies. In about half the cases, these bacteriological investigations are negative, but the diagnosis remains very probable if the germ is isolated from one or other of the primary foci of the infection: ureter, cervix, vagina, rectum and even pharynx. The rapidly favourable course under antibiotic treatment with penicillin or ampicillin confirms the diagnosis. The pathogenesis of arthritis is a direct toxic action of the gonococcus on the synovial membrane and the periarticular structures. The role of circulating immune complexes recently demonstrated in gonococcemia is probably not relevant.
 ...
PMID:[Gonococcal arthritis]. 722 40

Acute polyarthritis is an important cause of morbidity in many tropical countries. Classification has often been difficult, with the term tropical polyarthritis used for those in whom a diagnosis could not be made. The implication that this is a distinct entity is probably incorrect, with likely causes being septic arthritis or post-infective reactive arthritis. This study aimed to determine the types of arthritis found in 43 patients (30 men) presenting consecutively to the Goroka Base Hospital in the Eastern Highlands of Papua New Guinea. Gonococcal arthritis was diagnosed in eight patients (six men) on the basis of isolation of Neisseria gonorrhoeae from the joint aspirate. In all cases the N gonorrhoeae was identified by the closed culture system on chocolate agar, but not always by routine plating. There were no specific clinical features that identified patients with a gonococcal septic arthritis. The remaining 34 patients had an undifferentiated oligoarthritis. The pattern of arthritis in men and women was of a lower limb pauciarticular arthritis with a predilection for the knee and ankle joints. A total of 30% of male patients had a history of urethral discharge and 44% of all patients had preceding diarrhoea. Arthritis was the only feature in 59% of patients and in 32% there was an associated enthesitis. In this study most patients had an oligoarthritis consistent with a reactive arthritis or a septic arthritis due to N gonorrhoeae. Broth inoculation of synovial fluid was the best method to isolate N gonorrhoeae, with standard methods for gonococcal isolation failing in some patients. It is recommended that the term 'tropical polyarthritis' is no longer used as it does not refer to a specific entity but consists of several known arthritides.
 ...
PMID:Arthritis in the highlands of Papua New Guinea. 842 14

We prospectively studied the demographics, the clinical and diagnostic features, the HIV-1 serostatus and the therapeutic response for all new patients with septic arthritis (SA) admitted to the Department of Internal Medicine of the Centre Hospitalier de Kigali, Rwanda, over a 19 month period. SA was diagnosed in 24 patients (10 male, 14 female), of whom 19 (79%) were HIV-1 seropositive (HIVpos). Gonococcal arthritis was found in four patients, all HIVpos. Non-gonococcal bacterial arthritis was established in 16 patients, of whom 13 were HIVpos. Causative organisms involved in this group and the corresponding HIV-1 serostatus of the patients were: Staphylococcus aureus: 4; 2 HIVpos. 2 HIVneg: Streptococcus pneumoniae: 4; 4 HIVpos; Salmonella group B: 2; 2 HIVpos; Streptococcus group D: 1; 1 HIVpos; Klebsiella pneumoniae: 1; 1 HIVpos; undetermined: 4; 3 HIVpos; 1 HIVneg. Tuberculous arthritis was presumed in four patients, of whom two were HIVpos. HIV-1-associated SA had a classical acute presentation and an overall good prognosis Compared to a control group consisting of hospitalized patients with malaria as the sole diagnosis, patients with SA were more likely to be infected with HIV-1 (P = 0.005, or 6.3; 95% CI 1.7 22.2). Prevalence rate estimates of SA among HIVpos and HIVneg patients were 0.5 and 0.25%, respectively (P = 0.38). We conclude that HIV-1 infection appears as a risk factor for SA among patients hospitalized at the Centre Hospitalier de Kigali, but that SA cannot be used as a predictor for HIV-1 infection for hospitalized patients. SA occurs infrequently and may present at any stage of HIV-1 infection.
 ...
PMID:HIV infection as a risk factor for septic arthritis. 913 65

The current review describes the microbiology, diagnosis and management of septic arthritis and osteomyelitis due to anaerobic bacteria in children. Staphylococcus aureus, Haemophilus influenzae type-b, and Group A streptococcus, Streptococcus pneumoniae, Kingela kingae, Neisseria meningiditis and Salmonella spp are the predominant aerobic bacteria that cause arthritis in children. Gonococcal arthritis can occur in sexually active adolescents. The predominant aerobes causing osteomyelitis in children are S. aureus, H. influenzae type-b, Gram-negative enteric bacteria, beta-hemolytic streptococci, S. pneumoniae, K. kingae, Bartonella henselae and Borrelia burgdorferi. Anaerobes have rarely been reported as a cause of these infections in children. The main anaerobes in arthritis include anaerobic Gram negative bacilli including Bacteroides fragilis group, Fusobacterium spp., Clostridium spp. and Peptostreptococcus spp. Most of the cases of anaerobic arthritis, in contrast to anaerobic osteomyelitis, involved a single isolate. Most of the cases of anaerobic arthritis are secondary to hematogenous spread. Many patients with osteomyelitis due to anaerobic bacteria have evidence of anaerobic infection elsewhere in the body, which is the source of the organisms involved in osteomyelitis. Treatment of arthritis and osteomyelitis involving anaerobic bacteria includes symptomatic therapy, immobilization in some cases, adequate drainage of purulent material and antibiotic therapy effective to these organisms.
 ...
PMID:Joint and bone infections due to anaerobic bacteria in children. 1239 47

Gonococcal arthritis results from blood dissemination of Neisseria gonorrhoeae from primary sexually acquired mucosal infection. The disease has become rare in Western countries since the introduction of effective control programmes, but it still needs to be recognized promptly to avoid systemic, potentially life-threatening involvement, destructive changes associated with chronic arthritis and spread of the infection. Sexually active women are predominantly affected. Clinical features include polyarthralgia, sometimes migratory, tenosynovitis, arthritis, constitutional symptoms and skin lesions, which are mild and easily unnoticed. True arthritis occurs in less than 50% of cases. Primary mucosal infection may be asymptomatic.N. gonorrhoeae is a fragile micro-organism which is difficult to culture. Sampling of blood, synovial fluid, skin lesion, genito-urinary tract, pharynx and rectum must be performed before starting antibiotics. Samples should be plated immediately on fresh, pre-warmed appropriate media and sent quickly to the laboratory. Culture of N. gonorrhoeae is of tremendous importance not only for definite diagnosis but also for determination of drug susceptibility. When culture is negative, rapid response to antimicrobial treatment will allow a probable diagnosis. Penicillin resistance has developed worldwide in recent years, and penicillin is no longer the initially recommended antibiotic for gonococcal arthritis. Patients should be started on a third-generation cephalosporin and later switched to ampicillin or penicillin only when sensitivity to these antimicrobials has been demonstrated. Oral therapy substitutes the intravenous or intramuscular route after signs and symptoms have improved, in order to complete 7 days of antimicrobial therapy. Effusions should be aspirated until disappearance. Purulent effusions are rare but may require longer antibiotic treatment. The patient's sexual partner must be examined and treated. Patients should be tested and eventually treated for Chlamydia, syphilis and HIV, and educated about the sexual mode of transmission and means of preventing sexually transmitted diseases.
 ...
PMID:Gonococcal arthritis. 1278 21

This is a report of a 47-year-old man presenting to the Emergency Department complaining of bilateral shoulder pain after developing pain in the right shoulder about 1(1/2)-2 weeks prior after heavy lifting while at work. Clinical suspicion of Gonococcal arthritis was confirmed on the basis of laboratory studies. Although Gonococcal arthritis is occasionally associated with uniarticular arthritis, this patient presented with bilateral joint involvement.
 ...
PMID:Shoulder pain: a presentation of bilateral gonococcal arthritis of the shoulders. 1797 73

Gonococcal arthritis is typically acute and appears within 3 weeks after initial infection. Chronic gonococcal arthritis is now exceptionally rare, since the advent of the antibiotic era. Numerous host factors are involved in gonococcal dissemination, such as complement deficiency, HIV and gonococcus strain characteristics. Gonococcal arthritis shares the same risk factors. In this instance, our patient was a 16-year-old girl suffering from persistent polyarthralgia with joint swelling presenting with brief flare-ups for a period of 1 year. She disclosed a single episode of unprotected sexual intercourse 1 year ago, i.e. just before developing her first rheumatological symptoms. Therefore, we performed a joint aspiration (arthrocentesis), and synovial fluid was inoculated directly into aerobic and anaerobic blood culture bottles, which tested positive for Neisseria gonorrhoeae within 24 h. Clinical presentation was consistent with previous reports of chronic gonococcal arthritis. Further investigation revealed a C5 complement deficiency, which might explain the chronic Neisseria process. A favourable outcome was reached after a ten-day course of IV ceftriaxone, with no apparent sequelae found during follow-up 6 weeks later. This case demonstrates an unusual gonococcal arthritis with brief flare-ups for the course of a year, followed by a subacute form. N. meningitidis infections, similar to N. gonorrhoeae, are typically acute and may sometimes be involved in chronic processes. However, this characteristic appears to be rare in the case of N. gonorrhoeae. Risk factors for this chronic process will be discussed with a review of the literature.
 ...
PMID:Chronic gonococcal arthritis with C5 deficiency presenting with brief flare-ups: case study and literature review. 2477 71


1 2 Next >>