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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A fatally ending index case of septic osteoarthritis that was diagnosed retrospectively initiated this report. This patient had severe, asymmetrically distributed metaphyseal growth disturbances at many long bones. In order to determine the features of early radiologic diagnosis we report the findings of 7 further patients with neonatal septic osteoarthritis with clinical and radiological follow-up. The most important observation for early radiologic diagnosis of osteoarthritis is the displacement of fat layers along the metaphysis. Other findings of the soft tissues have the same diagnostic value as bone destruction and subperiosteal new bone formation found one to three weeks later on roentgenfilms. Detecting early signs of osteoarthritis helps in localizing the focus for bacteriologic diagnosis, which is said to be more successful than blood cultures. Diagnosing a joint empyema initiates surgical intervention for pressure relief in order to avoid necrosis of the epiphysis as seen in the femoral head in septic arthritis of the hip joint. Early diagnosis and treatment prior to destruction of the growing cartilage is necessary to avoid growth disturbances and length discrepancies of long bones. In cases of sepsis a so called "babygram" and a repeat examination 10 to 14 days later is mandatory.
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PMID:[Osteoarthritis in the neonate. Radiologic diagnosis and follow-up observations (author's transl)]. 15 14

The authors have studied the results of attempts to restore joint movement in stiff knees after septic non-union of fractures of the femoral shaft or after septic arthritis of the knee by arthrolysis and quadriceps release. Fifteen procedures were done on fourteen patients with severe limitation of movements. The results were gratifying; eight very good and four good. No case was made worse. The technique is described in detail and operative and post-operative complications described. A long-term follow-up study showed that the results tended to improve after several years. The prognosis can be based on the degree of flexion obtained during operation, though free flexion should be distinguished from forced flexion. It is concluded that the procedures used are worthwhile in spite of previous sepsis.
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PMID:[Surgical treatment of stiff knee following femoral sepsis and septic arthritis of the knee (author's transl)]. 15 46

Sixty-nine cases of Osteomyelitis, and 27 of septic arthritis have been presented. 69/96 (71%) were children below 12. The sites frequently involved were tibia, femur and humerus. Septic arthritis commonly involved the knee. The commonest organism was Penicillin - resistant Staphylococcus aureus. Though we sought but failed to establish that overt clinical malnutrition was aetiologically important, since 54% were well-fed children, the virulence of the sepsis in which an entire bone shaft may die is disturbing but unexplained. Whereas arthrotomy plus antibiotics gave uniformly good results for septic arthritis, in osteomyelitis, no single treatment regime was outstanding. We would recommend the tetracyclines, (eg. "Reverin"), in addition to appropriate surgery, as a routine.
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PMID:A clinical study of Osteomyelitis and septic arthritis. 26 74

In the first 4 years (1974 to 1978) of operation of the Children's Hospital of Eastern Ontario, in Ottawa, 50 children were treated for septic arthritis. The neonatal group (birth to 6 months) of three patients had the most severe involvement and the worst prognosis. The early childhood group (6 months to 4 years) of 15 patients was characterized by sepsis due to Hemophilus influenzae. The 32 older children (4 to 16 years), more susceptible to staphylococcal infections, commonly presented with atypical and unusual symptoms. The erythrocyte sedimentation rate was the most reliable laboratory investigation. Positive joint cultures were obtained in 66% of patients. Arthrotomy with drainage was the most reliable form of treatment, particularly in cases of hip joint sepsis. Six patients have substantial residual joint damage with some degree of permanent disability. Early diagnosis of the condition and rapid removal of pus are mandatory for the survival of the joint.
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PMID:Septic arthritis in childhood. 31 36

During a nine-year period (1968--76) 75 patients were admitted to Coventry Hospitals becaues of pyogenic arthritis. Of these patients, 22 suffered from pre-existing rheumatoid disease, and in these the foot was the most common site of primary infection. Adequate and energetic management of foot problems and associated skin sepsis in patients suffering from rheumatoid disease appears to offer the best opportunity of reducing the incidence of superimposed pyogenic arthritis.
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PMID:Pyogenic arthritis and rheumatoid disease: the importance of the infected foot. 36 18

In a 20-day-old female infant, bacteremia, osteomyelitis, and pyogenic arthritis developed due to infection with group B streptococcus, type Ic. She had an unusual clinical presentation with overwhelming sepsis and acute congestive heart failure.
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PMID:Group B streptococcal sepsis with osteomyelitis and arthritis. Its occurrence with acute heart failure. 38 36

In a prematurely born infant of a diabetic mother a purulent arthritis with osteomyelitis of the elbow occurred 18 days after an enterobacter aerogenes-septicemia was proved. Enterobacter (aerobacter) aerogenes is a nosocomial gramnegative germ, that is more and more regarded responsible for infection of the newborn in intensive care units. In accordance with the literature recording a high rate functional loss after septic arthritis also our patient suffered from a mobility deficiency in his right elbow a year after the onset of the disease.
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PMID:[Septic arthritis and osteomyelitis as a complication of neonatal intensive care (author's transl)]. 53 Jul 34

Forty-two patients were treated with intravenous cefoxitin, a new cephamycin antibiotic. These patients had postoperative abdominal sepsis (26), intrathoracic infections (6), urinary tract infections (5), gram-negative bacterial meningitis (2), septic arthritis (1), epidural abscess (1) and isolated septicemia (1). The antibacterial spectrum of cefoxitin was found to be one which included all gram-positive organisms except enterococci, most gram-negative organisms except Pseudomonas aeruginosa, and almost all of the important anaerobic organisms. The only five treatment failures included one patient with empyema and one with septic arthritis, both caused by Serratia marcescens, initially only moderately susceptible to cefoxitin, which subsequently developed increased resistance, two patients with contaminated intravenous catheters, and one patient with epidural abscess and cerebritis, who was treated late in the course. There was one serious clinical superinfection with P. aeruginosa. The drug levels noted in the pus and joint fluid were half to two-thirds of the simultaneous serum level. In inflamed meninges, up to 30% of the serum level was noted in the cerebrospinal fluid, and as the process resolved, 10 to 15% was noted. Toxicity of cefoxitin was mild and constituted skin rash in three patients (7%) and phlebitis in eight (19%).
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PMID:Use of cefoxitin, new cephalosporin-like antibiotic, in the treatment of aerobic and anaerobic infections. 74 74

Neonatal septic arthritis of the knee was encountered in nine infants during a two-year period, representing an incidence of 16.5 per 1,000 admissions to a neonatal intensive care unit. The etiologic agents included Staphylococcus aureus (3), Klebsiella (1), Streptococcus, group B (2), and Candida albicans (3). Two infants with systemic fungal infection died. Arthritis was the presenting feature of neonatal septicemia in three of six infants with bacterial infection and was accompanied by osteomyelitis in two. In eight of the infants, the same organism was cultured from the skin of the umbilicus as was cultured from the joint. Umbilical catheters had been placed in all of these infants. Full recovery of joint function has been noted in the seven surviving infants.
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PMID:Neonatal septic arthritis. 94 94

We report a case of Yersinia enterocolitica septicemia with septic arthritis. Gentamicin administration controlled the septicemia but failed to eradicate the organisms in the joint, in spite of a synovial fluid level four times its minimal inhibitory concentration after four days of therapy. Development of azotemia necessitated change of antibiotic therapy to chloramphenicol, which eradicated the infection. While Y enterocolitica infection in the United States is uncommon, it must be added to the list of organisms causing suppurative arthritis and septicemia in susceptible hosts. Septic arthritis must be distinguished from the much more common reactive theumatic polyarthritis associated with Y enterocolimica infection, for which antibiotic therapy is neither needed nor helpful.
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PMID:Yersinia enterocolitica septicemia with septic arthritis. 98 93


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