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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Over a period of four years, seven of 110 maintenance hemodialysis patients developed olecranon bursitis. In all patients it appeared in the arm on which AV access was constructed but one patient also had bilateral bursitis. None of the patients gave a history of trauma or gout. Despite similar clinical presentation, culture of bursal aspirate demonstrated septic bursitis in two patients. (One diabetic, the other on steroids). Sustained pressure on the olecranon bursa during maintenance hemodialysis and/or milk trauma in the anticoagulated state may be responsible for the lesion. Infection can occur in susceptible individuals despite no visible skin infection. Local steroid instillation and patient education to avoid putting pressure on bursa during dialysis was effective therapy in the aseptic group. Multiple aspirations and antibiotics were necessary in the septic group.
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PMID:Septic and aseptic olecranon bursitis in patients on maintenance hemodialysis. 734 43

The 1992 literature on septic arthritis reiterated the factors that portend a poor outcome in septic arthritis. However, we still know very little about how to improve the outcome for such patients. Infections of the musculoskeletal system may be more common among patients with HIV than the reported cases indicate. Bacterial endocarditis is frequently associated with musculoskeletal complaints. Low back pain may be a presenting manifestation. Acute gout and septic arthritis can cause peripheral arthritis in some patients with bacterial endocarditis. Septic arthritis can present unusual manifestations and can occur as a complication of arthroscopic surgery; the risk factors for its development after arthroscopy have been identified. Arthroscopy as a therapeutic procedure to drain an infected joint is discussed.
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PMID:Bacterial arthritis. 835 41

During a 6-month period in 1994-1995, 0.7% of patient visits (51 visits of 47 patients) at the emergency unit of the Department of Medicine, Helsinki University Central Hospital, were due to joint symptoms. Infection seemed to play an important role as the etiologic factor for the joint complaints. Acute joint exacerbation in pre-existing arthritis was the reason for 11.7%, and suspected Baker's cyst for 3.9% of the visits. Confirmed (12.8%) or suspected reactive arthritis (10.6%), septic arthritis/spondylitis (6.4%), arthritis with inflammatory bowel disease (6.4%), and gout (14.9%) were the most common final diagnoses for the patients. In a quarter of the patients, the etiology for joint symptoms could not be confirmed. In conclusion, joint symptoms very seldom lead to visits to an emergency unit. In such cases, infection seems to be an important contributing factor. Patients with chronic rheumatic diseases only occasionally have to seek help at an emergency unit.
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PMID:Arthritis patient as an emergency case at a university hospital. 905 99

Infection and noninfection inflammatory diseases commonly affect the foot and ankle; they have a significant impact on the cost of medical care and are a major source of referral for MR imaging evaluation. Recognition of the MR imaging appearance of the various manifestations of these disorders is important so that prompt and appropriate medical or surgical management can be instituted. This article emphasizes MR imaging of the most important diseases in this category, diabetic foot infection and the rheumatoid foot, but will also discuss manifestations in the foot and ankle of various other inflammatory diseases, such as gout and seronegative spondyloarthropathies.
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PMID:MR imaging of inflammatory conditions of the ankle and foot. 1169 30

Due to its function, anatomy, and exposition to multiple pathogens, the hand is highly susceptible to infection. Most of these infections are post-traumatic. Isolates of pathogens from infected hands contain mainly Staphylococcus aureus and ss-haemolytic group A streptococci. But differential diagnosis also includes pyoderma gangrenosum, tumors of the hand, rheumatoid arthritis, and articular gout, as they may mimic hand infections. Infections of the hand can lead to massive tissue damage that needs to be reconstructed. The selection of methods depends on the localization and size of defects and includes primary closure, split- and full-thickness skin grafts, and more complex operations such as local, regional, and distant flaps.
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PMID:[Surgical therapy for hand infections Part 2]. 1598 53

A 41-year-old man underwent skeletal scintigraphy due to chronic pain in the left foot and polyarthralgia. He was taking medication for gout and had previously had sarcoidosis, for which he had received corticosteroids and other therapy that was discontinued 4 years ago. Scintigraphy revealed a mass in the shaft of the left humerus that, according to biopsy, was an asymptomatic osteomyelitis caused by Mycobacterium avium. The shaft of the left humerus is an uncommon site for tuberculous osteomyelitis. A viable fistula remained after the biopsy that persisted despite pharmacologic treatment with ethambutol, rifabutin and clarithromycin. Four months later, sequestrectomy was performed with insertion of gentamicin-impregnated beads, which resulted in rapid resolution. The foot pain resolved spontaneously. The incidence of bone tuberculosis has increased over the last 2 decades. The most commonly affected sites are the spine and large joints. Infection with M. avium is sometimes involved. Because of the increasing incidence it is important to include mycobacterial infections in the differential diagnosis of focal bone lesions, especially when standard cultures are initially negative.
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PMID:[Atypical tuberculous osteomyelitis of the humeral shaft caused by Mycobacterium avium]. 1737

We describe a 66-year-old woman hospitalized with fever, fatigue and hepatopathy. In her medical history arterial hypertension (treated with propranolol and lisinopril), diabetes mellitus type 2 (no treatment before admission) and a gout arthropathy were noted wherefore a therapy with allopurinol 300 mg per day has been started 4 months before. Liver biopsy revealed fibrin-ring granulomas, compatible with allopurinol-induced hepatitis. Because of persistence of high fever after stopping allopurinol, steroids (1 mg/kg) were started. Under this treatment, she developed pancytopenia and fever. The bone marrow aspiration revealed Leishmania infantum. A second liver biopsy showed amastigotes and a disappearance of the granulomas. The history revealed a travel to Malta 2 years earlier. Despite adequate treatment with liposomal amphotericin B the patient deteriorated and finally died in septic shock.
Infection 2008 Aug
PMID:Hepatitis with fibrin-ring granulomas. 1792

Varanid lizards have been maintained in zoological parks for more than a century, yet few studies to date have attempted to pinpoint significant health issues affecting their management or areas of captive husbandry that are in need of improvement. In an effort to identify and better understand some of the husbandry-related challenges and health issues specifically affecting varanids in zoos, this study examined mortality in 16 species maintained at the Bronx Zoo between 1968 and 2009. Out of 108 records reviewed, complete necropsy reports were available for 85 individuals. Infection-related processes including bacterial (15.3%), protozoal (12.9%), nematode (9.4%), and fungal (3.5%) infections accounted for the greatest number of deaths (47.1%). Noninfectious diseases including female reproductive disorders (7.1%), neoplasia (7.1%), gout (10.8%), and hemipenal prolapse (1.3%) accounted for 29.4% of deaths. Multiple disease agents were responsible for 5.9% of deaths, and a cause for death could not be determined for 17.7% of individuals. Reproductive complications accounted for 11.5% of female deaths, but were identified in 23.1% of females. Although not necessarily the cause for death, gout was present in 18.8% of individuals. Differences in mortality between species, genders, and origin (captive-bred vs. wild-caught) were also evaluated. The results of this study corroborate earlier findings that identify bacterial infections, neoplasia, female reproductive disorders, gout, and endoparasitism as major sources of mortality in captive varanids. In light of these results, we discuss potential etiologies and offer recommendations for improving captive management practices in zoos.
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PMID:A retrospective study of mortality in varanid lizards (Reptilia: Squamata: Varanidae) at the Bronx Zoo: implications for husbandry and reproductive management in zoos. 2299 89

Renal infection with flagellated protozoa was retrospectively evaluated in 29 reptiles, including 12 turtles, 7 tortoises, and 6 chameleons; overall, 20 species of reptiles were represented. Most cases presented with nonspecific clinical signs or a combination of several concurrent diseases. Nineteen of 29 reptiles had tubulointerstitial nephritis associated with flagellates, and this lesion was considered contributory to death in 15 cases, although concurrent diseases were frequent. Infection was invasive into the renal interstitium in three reptiles due to tubular rupture and in one chameleon also spread to adjacent tissues, coelomic cavity, and blood vessels due to renal rupture. Cytologic or ultrastructural evaluation of trophozoites in two cases was consistent with diplomonad flagellates. Renal disease was often complicated with soft-tissue mineralization and/or gout. Gastrointestinal and cloacal infection with flagellates and inflammation were frequent in reptiles in which the digestive tract was available for histopathologic examination, and this supports the possibility of infections ascending the urinary tract from the cloaca. Renal disease associated with flagellate protozoa is rare in vertebrates but appears to be relevant in reptiles, particularly chelonians and chameleons.
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PMID:Renal flagellate infections in reptiles: 29 cases. 2471 68

Objective The aim of this study was to investigate the clinical characteristics of infectious ulceration over tophi in patients with gout. Methods Participants were recruited from the First Affiliated Hospital of Wenzhou Medical University. The clinical characteristics of the patients and wound characteristics were recorded. Results Of the 38 enrolled patients, 18 were found to have infectious ulceration over tophi. Staphylococcus aureus was the most common pathogen and was identified in nine patients. Patients with infection were significantly older (69.6 vs. 60.1 years) and had a worse quality of life than those without infection. Patients with infection also had a significantly longer ulcer duration (125.6 vs. 54.2 days), larger ulcer size (2.47 vs. 1.99 cm2), a higher rate of tissue necrosis in the ulcer bed (55.6% vs. 20.0%), a lower rate of callus at the edge (27.8% vs. 70.0%), and a higher moisture level than did patients without infection. Additionally, patients with infection had significantly delayed wound healing (35.3 vs. 20.3 days) compared with patients without infection. Conclusions Older patients with a long ulcer duration and larger ulcer size are more susceptible to infection. Infection can lower patients' quality of life and delay wound healing.
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PMID:Clinical characteristics of infectious ulceration over tophi in patients with gout. 2958 74


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