Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone-patellar-tendon-bone allograft.
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PMID:Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft. 1768 31

Septic arthritis (SA) is a clinical emergency with considerable morbidity and mortality that can lead to rapid joint destruction and irreversible loss of function. The reported incidence varies from 2-5 cases per 100.000 individuals per year in the general populations to 70 cases per 100.000 individuals annually among patients with rheumatoid arthritis (RA). Predisposing factors are immunosuppressive and corticosteroids therapy and RA "itself". The expected decrease in incidence of SA was not seen over the last 20 years period but we can, on the contrary, expect an increase in the frequency of its appearance because of the population ageing, the increasingly prosthetic joint replacement, the ability of the bacteria to evade clearance by the host immune response and the rapidly growing number of patients with RA, ankylosing spondylitis and psoriatic arthritis treated with tumour necrosis factor alpha (TNF alpha) antagonists. Up to now there have been conflicting reports regarding joint infections in patients under anti-TNF therapy but according to data from Deutsch as well as the British register there might be an increase in the incidence of joint infections in anti-TNF treated patients. Microscopic analysis and culture of synovial fluid are fundamental diagnostic tools in the evaluation of possible joint sepsis. Sonographic guidance of arthrocentesis led to successful aspiration of difficult-to-access joints as shoulder and hip. There is controversy over which mode of drainage of septic synovial fluid should be employed but needle aspiration appear to be preferable to surgical treatment as an initial mode of treatment of SA. Rheumatologists should have a central role in the diagnosis and management of SA.
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PMID:[Septic arthritis: what is the role for the rheumatologist?]. 1843 19

We have earlier shown that clumping factor A (ClfA), a fibrinogen binding surface protein of Staphylococcus aureus, is an important virulence factor in septic arthritis. When two amino acids in the ClfA molecule, P(336) and Y(338), were changed to serine and alanine, respectively, the fibrinogen binding property was lost. ClfAP(336)Y(338) mutants have been constructed in two virulent S. aureus strains Newman and LS-1. The aim of this study was to analyze if these two amino acids which are vital for the fibrinogen binding of ClfA are of importance for the ability of S. aureus to generate disease. Septic arthritis or sepsis were induced in mice by intravenous inoculation of bacteria. The clfAP(336)Y(338) mutant induced significantly less arthritis than the wild type strain, both with respect to severity and frequency. The mutant infected mice developed also a much milder systemic inflammation, measured as lower mortality, weight loss, bacterial growth in kidneys and lower IL-6 levels. The data were verified with a second mutant where clfAP(336) and Y(338) were changed to alanine and serine respectively. When sepsis was induced by a larger bacterial inoculum, the clfAP(336)Y(338) mutants induced significantly less septic death. Importantly, immunization with the recombinant A domain of ClfAP(336)SY(338)A mutant but not with recombinant ClfA, protected against septic death. Our data strongly suggest that the fibrinogen binding activity of ClfA is crucial for the ability of S. aureus to provoke disease manifestations, and that the vaccine potential of recombinant ClfA is improved by removing its ability to bind fibrinogen.
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PMID:Fibrinogen binding sites P336 and Y338 of clumping factor A are crucial for Staphylococcus aureus virulence. 1849 18

Melioidosis is an infection caused by Burkholderia pseudomallei. It is an important human pathogen in the tropical area. The clinical manifestations are protean with multisystem involvement. Septic arthritis and prostatic abscess are rare but well-recognized forms of the disease. Herein we report a case of melioidosis presenting with a rare combination of septic arthritis, prostatic abscess, and septicemia.
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PMID:Melioidosis--an unusual cause of septic arthritis. 1850 68

Septic arthritis and sepsis are common and feared complications of staphylococcal infections, and the increasing antibiotic resistance among staphylococci urge the extended research for virulence factors involved in these diseases. Staphylcoccus aureus produces a number of virulence factors controlled by several global regulatory genes including agr and sarA. MgrA is a recently identified global regulator, belonging to the SarA subfamily, which upregulates expression of several virulence factors including capsule and sortase. In addition, MgrA has been shown to regulate antibiotic resistance and decrease bacterial autolysis. In this study we have assessed the role of mgrA gene expression on induction and progression of septic arthritis and sepsis. Mice inoculated with the mgrA mutant displayed significantly less severe arthritis and showed a significantly better weight development, than wild-type inoculated mice. Importantly, all 10 mice inoculated with the mgrA mutant survived as compared to 70% mortality in the wild-type inoculated mice (p=0.003). In addition, the mgrA mutant showed significantly less bacterial persistence in kidneys as compared to the wild-type strain. We conclude that mgrA regulates virulence factors important for establishment and progression of septic arthritis and sepsis.
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PMID:mgrA regulates staphylococcal virulence important for induction and progression of septic arthritis and sepsis. 1869 91

Septic arthritis is a fearful condition because of its mortality and the potentially late sequels on immature skeleton including limb shortening, osteomyelitis, destruction of joint surface, severe limitation of motion, and dislocation.This study was performed to reveal the final outcome of our patients and find out the possible risk factors of poor result. The case records of 243 children who were admitted with the diagnosis of septic arthritis in Imam Khomeini and Bu Ali Sina Hospitals, Mazandaran Province, were studied between 1996 and 2005. The diagnosis was based on clinical and ultrasound findings in all patients and positive smear in 67% of them. Among these patients, we had access to 162 cases who had definitely septic arthritis and went through surgical interventions because of the involvement of the hip joint or uncertain response to medical treatments. As four out of six poor outcome cases were related to hip sepsis, hip was the main site of involvement and complications.Six cases of severe complications out of 162 showed the favorite result due to early diagnosis and intervention and highlighted the grave prognostic factors which were delayed diagnosis, infantile age and hip sepsis.
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PMID:Surgical intervention for treatment of septic arthritis in infancy and childhood; a retrospective study. 1956 60

IL-4 is an anti-inflammatory cytokine that inhibits the onset and severity in different experimental arthritis models. Group B streptococci (GBS) have been recognized as an ever-growing cause of serious invasive infections in nonpregnant adults. Septic arthritis is a clinical manifestation of GBS infection. To investigate the role of IL-4 in experimental GBS infection, IL-4 deficient or competent mice were inoculated with 1 x 10(7) GBS/mouse. Mortality, appearance of arthritis, GBS growth in the organs, and local and systemic cytokine and chemokine production were examined. IL-4-/- mice showed lower mortality rates but increased severity of arthritis and exhibited a lower microbial load in blood, kidneys, and joints than wt mice. Increased local levels of IL-1 beta, IL-6, TNF-alpha, MIP-1alpha, and MIP-2 accompanied the more severe arthritis in IL-4-/- mice. Our results suggest a detrimental role of IL-4 in GBS sepsis, whereas it plays a beneficial effect on GBS-induced arthritis.
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PMID:IL-4 deficiency decreases mortality but increases severity of arthritis in experimental group B Streptococcus infection. 1960 56

Septic arthritis secondary to Fusobacterium necrophorum is rare and may be related to Lemierre syndrome which classically presents as pharyngitis in young adults, followed by a septicemic illness characterized by internal jugular vein thrombosis and metastatic infection. However, there were only 5 case reports of isolated septic arthritis caused by F. necrophorum in previous literature. The authors reviewed the literature and report a 24-year-old woman who delayed presentation to the emergency department and was eventually diagnosed with isolated septic arthritis of the hip caused by F. necrophorum. Her condition was complicated by severe sepsis and treated with aggressive resuscitation, vasopressor, antibiotics and an open arthrotomy with repeated drainage. Eventually, her hip bone was destroyed and she required a joint replacement.
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PMID:Isolated septic arthritis of the hip secondary to Fusobacterium necrophorum. 2214 31

Infection after intra-articular steroid injection of the hip is rare, occurring in <1 of 15,000 cases. Septic arthritis following intra-articular injection is even rarer. This is the only documented case of systemic septicemia following intra-articular injection.The patient received an intra-articular steroid injection to the left hip under fluoroscopic guidance, which resulted in reduced pain and increased mobility. Two weeks after the injection, the patient noticed sharp pain in the left hip and groin and malaise. Over a 48-hour period, he became progressively ill and was hospitalized for severe groin and thigh pain, inability to extend his hip, and diaphoresis. He underwent aspiration of the hip, which revealed Gram-positive cocci in clusters.At admission, the patient underwent incision and drainage of the left hip with removal of approximately 25 cc of fluid. The patient was started on intravenous vancomycin, then converted to nafcillin as the cultures and sensitivities revealed methicillin-sensitive Staphylococcus aureus. After 6 days of intravenous methicillin, the blood cultures were negative, and the patient was discharged. The patient's laboratory findings were normal, and cultures for aerobic anaerobic bacteria were negative. The patient underwent hip resurfacing and aggressive rehabilitation and was able to return to work. Thirty months after hip resurfacing, the patient had no evidence of infection, walked without a limp, had normal laboratory findings, and was pain free.
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PMID:Methicillin-sensitive Staphylococcus aureus infection after steroid hip injection. 2222 23

Septic arthritis due to endocarditis is a rare and life-threatening disease. Endocarditis occurs with an incidence of 30 patients per 1 million citizens/year. Staphylococcus aureus is one of the most common causative pathogens. Methicillin-resistant Staphylococcus aureus (MRSA) can lead to a severe outcome with a high mortality rate, and embolic complications of the kidney, brain, and spleen are seen in one third of all cases. The diagnosis and treatment of endocarditis is a challenge for all health care providers. We report about a patient who was admitted to our hospital with generalized sepsis of unknown origin.
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PMID:[Septic arthritis as an initial manifestation of a bacterial endocarditis]. 2266 38


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