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Query: UMLS:C0026764 (multiple myeloma)
 36,148 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a case of septic arthritis caused by the fastidious gram-negative rod Campylobacter fetus. We suggest that the organism may be part of the endogenous flora and that the clinical infections tend to occur in compromised hosts. Our patient is the first to be described with multiple myeloma and C. fetus septic arthritis. The documented cases of culture-proven C. fetus septic arthritis reported to date have occurred in three men and one woman, all in the seventh and eighth decades of life, with a mono-articular large joint distribution. The septic arthritis always occurred in previously injured joints and curiously enough need not be associated with a toxic-appearing patient. C. fetus infections are also associated with the signs and symptoms of clinical thrombophlebitis. We stress caution in establishing this diagnosis of phlebitis on clinical evaluation only and urge differentiation of true deep vein thrombophlebitis from pseudothrombophlebitis or dissected popliteal synovial cyst. This latter diagnosis may be made non-invasively by ultrasound techniques.
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PMID:Campylobacter fetus septic arthritis: report of a case. 49 68

The authors confirm the great rarity of joint complications in patients with Kahler's disease. Among the records of 1953 cases the following complications were the only one found: 2 cases of proved articular amylosis, 2 cases of probable articular amylosis, 3 cases of possible articular amylosis, 20 cases of arthropathy that were impossible to classify, 27 cases of compression of the median nerve in the carpan canal, 6 cases of gouty arthritis, and 3 cases of septic arthritis. The data on symptoms obtained in the course of this enquiry are in conformity with the data in the literature. Articular amylosis often takes on the appearance of a polyarthritic syndrome of progressive installation and extension, involving in particular the hands and the wrists, but sometimes involving in a symmetrical bilateral manner the elbows, the shoulders, and the knees. The affected joints are swollen, stiff, and painful. Local signs of inflammation are, however, often absent. The deformations characteristic of rheumatoid arthritis do not develop. The joints do not show radiological signs for most of the time. In addition, it is not possible to detect the rheumatoid factor in the serum. The arthropathies can also assume an oligo-articular topography. Articular discharges are very frequent: they are usually of a mechanical nature. Whatever the clinical appearance, an exact diagnosis can be established only by means of anatomo-pathological examination of the synovial membrane or of certain para-articular amyloid nodules. Myelomas complicated by amyloid articular deposits are often light chain, with only little increase in the erythrocyte sedimentation rate, discrete hyperproteinaemia, moderate medullary plasmocytosis, and rare or limited radiological lesions. The carpal canal syndrome is either isolated or included within the framework of a polyarthropathy. Compression of the median nerve is due to amyloid infiltration into the synovial sheath of the tendons of the finger flexors, proof of which is not always easy. Gout is rare despite the frequency of hyperuricacidaemia caused by renal insufficiency. Septic arthritis is often caused by renal insufficiency. Septic arthritis is often caused by pneumococci to which those with a myeloma appear particularly suceptible.
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PMID:[Articular complications of Kahler's disease. Results of a survey of 1953 cases of plasmocytic myelomas]. 112 74

In this paper we report a 47 year old woman with septic arthritis due to Streptococcus pneumoniae. No known predisposing factor was found. After an extensive workup a multiple myeloma was discovered. In our case septic arthritis was the first manifestation of multiple myeloma.
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PMID:Pneumococcal septic arthritis as the first manifestation of multiple myeloma. 145

Although most patients with multiple myeloma are predisposed to pneumococcal infections, such infections usually involve the respiratory tract or the meninges. Pneumococcal arthritis is rare in the general population and is unexpectedly even rarer in patients with myeloma. We believe this to be the first case of pneumococcal septic arthritis of the knee in a patient with myeloma.
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PMID:Pneumococcal septic arthritis of the knee in a patient with multiple myeloma. 207 33

A 64-year-old white man presented with Neisseria meningitidis primary septic arthritis. Further evaluation revealed multiple myeloma. Increased susceptibility to infection occurs early in multiple myeloma; thus, a rare cause of primary septic arthritis, such as N. meningitidis, warrants a full evaluation for immunocompromise.
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PMID:Multiple myeloma presenting with primary meningococcal arthritis. 311 Dec 56

The clinical and diagnostic features of 29 adult patients with H. influenzae septic arthritis are reviewed. Twelve men and 17 women ranging in age from 22 to 82 years developed the infection. H. influenzae septic arthritis is an acute, febrile disease with a mean duration of symptoms before diagnosis of 4 days. Fifteen patients had monoarticular arthritis, 6 with an infected knee. Polyarticular involvement, with a range of 2 to 9 joints, was diagnosed in 14 patients. Nineteen patients had concurrent extraarticular sites of infection, including meningitis, pneumonia, pharyngitis, sinusitis, conjunctivitis, and cellulitis. Twenty-two of 29 patients had predisposing factors for infection, including ethanolism, trauma, rheumatoid arthritis, systemic lupus erythematosus, diabetes mellitus, splenectomy, multiple myeloma, lymphoma, gout, and acquired common variable hypogammaglobulinemia. Characteristic synovial fluid findings included purulent, greenish fluid, elevated WBC count, and gram-negative pleomorphic microorganisms. Treatment for these patients included antibiotic therapy, most often ampicillin and chloramphenicol, and joint drainage by repeated arthrocentesis or arthrotomy. A favorable outcome was reported in 25 of 29 patients. Hemophilus influenzae septic arthritis should be suspected in adults who are immunocompromised and have a concurrent extraarticular source of infection.
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PMID:Hemophilus influenzae septic arthritis in adults. A report of four cases and a review of the literature. 348 37

We have developed an enzyme-linked monoclonal antibody inhibition assay to detect bacterial antigens in cerebrospinal fluid. The monoclonal antibody used in this immunodiagnostic test was produced by continuous cultures of hybrid myeloma cell lines. Using this assay, type III GBS antigen was detected in CSF specimens from 11 culture-proven cases of GBS meningitis and in the knee aspirate from an infant with GBS septic arthritis. Five spinal fluid specimens from meningitis due to other bacterial pathogens and ten other control samples were negative. The ELMIA detected streptococcal antigen at a concentration of 10 ng/ml, and is more sensitive and specific than currently used immunodiagnostic tests.
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PMID:Use of monoclonal antibodies in an enzyme-linked inhibition assay for rapid detection of streptococcal antigen. 699 40

This article reports a case of pyogenic arthritis with Hemophilus influenzae in a previously healthy woman. This infection was the initial manifestation of an underlying serious systemic illness, multiple myeloma. Certain laboratory parameters as well as the causative organism suggested the underlying disease. Although infections are common in patients with known multiple myeloma, certain infections can provide a hint to concomitant serious systemic diseases and thus facilitate their early diagnosis.
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PMID:Multiple myeloma presenting with Hemophilus influenzae septic arthritis: case report and review of the literature. 837 Dec 86

We describe an apparently healthy woman who presented with monoarthritis of the right knee and a history of respiratory infection. The synovial fluid cultures grew beta lactamase-negative H. influenzae. Chest roentgenogram showed patchy densities throughout the right lung. Investigations for a predisposing factor for this H. influenzae infection revealed underlying multiple myeloma. As H. influenzae pyoarthrosis is extremely rare in adults, we suggest that an underlying systemic cause be sought in all such patients.
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PMID:Hemophilus influenzae septic arthritis and pneumonia in an adult as the first presentation of multiple myeloma. 897 30

The erythrocyte sedimentation rate (ESR) is a time-honored blood test, which assesses the degree of erythrocyte aggregation by acute phase proteins such as fibrinogen and immunoglobulins. Various intrinsic factors may influence the ESR, among them polycytemia, microcytosis or fibrinogen consumption lead to a decreased ESR, while anemia, macrocytosis or hypoalbuminemia lead to an increased ESR. The ESR still is a very valid test for the diagnosis of certain chronic diseases (polymyalgia, rheumatoid arthritis, multiple myeloma, septic arthritis and ostemyelitis) and the follow-up of certain chronic diseases (polymyalgia rheumatica, systemic lupus erythematodes, chronic infections, prostatic cancer, and Hodgkin's disease). In acute disease states and their monitoring C-reactive protein and eventually procalcitonin are the tests of choice. The ESR should not be used for screening and check-up examinations in asymptomatic patients.
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PMID:[Erythrocyte sedimentation rate--more than an old fashion?]. 1645 Jul 41


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