scholarly journals Ewingella Americana: An Emerging True Pathogen

2012 ◽  
Vol 2012 ◽  
pp. 1-2 ◽  
Author(s):  
Syed Hassan ◽  
Syed Amer ◽  
Chetan Mittal ◽  
Rishi Sharma
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Shoulder Joint ◽  
Intravenous Drug ◽  
Drug Abuser ◽  
Immunocompromised Patients ◽  
Causative Pathogen ◽  
Intravenous Drug Abuser ◽  
Fluid Analysis ◽  
Ewingella Americana

Infections caused byEwingella americanahave been rarely reported in the literature. Most of the cases that have been reported were among the immunocompromised patients. We report a case ofE. americanacausing osteomyelitis and septic arthritis of the shoulder joint in a previous intravenous drug abuser. The causative pathogen was identified by synovial fluid analysis and culture.

scholarly journals Coexistent Pseudogout andMycobacterium avium-intracellulareSeptic Arthritis in a Patient with HIV and ESRD

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Wais Afzal ◽  
Omer M. Wali ◽  
Kelly L. Cervellione ◽  
Bhupinder B. Singh ◽  
Farshad Bagheri
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Mycobacterium Avium ◽  
Immunosuppressive Drugs ◽  
Calcium Pyrophosphate ◽  
Initial Assessment ◽  
Calcium Pyrophosphate Dihydrate ◽  
Immunocompromised Patients ◽  
Fluid Analysis ◽  
Mycobacterium Avium Intracellulare

Pseudogout is a crystal-induced arthropathy characterized by the deposition of calcium pyrophosphate dihydrate (CPPD) crystals in synovial fluid, menisci, or articular cartilage. Although not very common, this entity can be seen in patients with chronic kidney disease (CKD). Septic arthritis due toMycobacterium avium-intracellulare(MAI) is a rare entity that can affect immunocompromised patients such as those with acquired immunodeficiency syndrome (AIDS) or those who are on immunosuppressive drugs. Here, we describe a 51-year-old female who presented with fever, right knee pain, swelling, warmth, and decreased range of motion for several days. The initial assessment was consistent with pseudogout, with negative bacterial and fungal cultures. However, due to high white blood cell (WBC) count in the synovial fluid analysis, she was empirically started on intravenous (IV) vancomycin and piperacillin-tazobactam and discharged on IV vancomycin and cefepime, while acid-fast bacilli (AFB) culture was still in process. Seventeen days later, AFB culture grewMycobacterium avium-intracellulare(MAI), and she was readmitted for relevant management. This case illustrates that septic arthritis due to MAI should be considered in the differential diagnosis of septic arthritis in immunocompromised patients.

Tuberculous Chancre in the Partner of an Intravenous Drug Abuser

Dermatology ◽  
1994 ◽  
Vol 188 (3) ◽  
pp. 236-238
Author(s):  
C. Garciandía ◽  
J.S. Conejo-Mir ◽  
M. Casals ◽  
G. Tomas ◽  
T. Rodriguez-Cañas
Keyword(s):  
Intravenous Drug ◽  
Drug Abuser ◽  
Intravenous Drug Abuser

Stomatococcus mucilaginosus Endocarditis in an Intravenous Drug Abuser

1987 ◽  
Vol 155 (5) ◽  
pp. 1080-1082 ◽  
Author(s):  
D. A. Relman ◽  
K. Ruoff ◽  
M. J. Ferraro
Keyword(s):  
Intravenous Drug ◽  
Drug Abuser ◽  
Intravenous Drug Abuser

scholarly journals MP031: Synovial fluid analysis in the diagnosis of septic arthritis: comparing local data to the literature

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S76-S77
Author(s):  
E. Logan ◽  
J. Fedwick
Keyword(s):  
Synovial Fluid ◽  
Septic Arthritis ◽  
Emergency Departments ◽  
Positive Culture ◽  
Diagnostic Algorithm ◽  
Clinical Findings ◽  
Gram Stain ◽  
Local Data ◽  
Fluid Analysis ◽  
Synovial Fluid Analysis

Introduction: A hot, painful, swollen joint is a common presentation to the emergency department. Of the potential etiologies, septic arthritis (SA) is the most devastating. Prompt diagnosis and treatment are essential to improve outcomes. Both culture proven and clinically suspected SA are thought to have the same prognosis, with similar morbidity and mortality estimates. No clinical exam or serum lab finding has the sensitivity or specificity to diagnose or exclude SA. Instead, diagnosis relies mainly on joint aspiration and synovial fluid analysis. A synovial white blood cell count (sWBC) greater than 50,000 cells/microliter is suggestive of SA and organisms seen on gram stain or growing in culture effectively makes the diagnosis. However, culture and gram stain are positive in only 67% and 50% of cases respectively. The objective of this study was to analyze the accuracy of synovial fluid analysis in our local practice environment. Methods: All those encounters with diagnoses related to SA at four adult emergency departments in Calgary between 2013-2014 were reviewed. Hospital records were analyzed for synovial analysis, antibiotic usage and surgical procedures. Results: Of 286 encounters, 87 were determined to satisfy the definition for SA in that culture was positive, gram stain was positive or clinical findings lead to treatment with antibiotics and/or surgical intervention. Gram stain was positive in 22% of cases with cultures positive in 51% of patients. sWBC were less than 50000 in 55% of cases and less than 25000 in 24% of cases. Of 88 gram stains performed, 28% were negative but had positive culture. All positive gram stains were associated with positive cultures. Conclusion: Culture, gram stain and sWBC of patients diagnosed with SA in Calgary show differences compared with the published literature. In Calgary, the majority of SA diagnoses were made clinically. The sWBC is central to making the diagnosis. Interestingly, 55% of patients diagnosed with SA had a count less than 50,000. It remains unclear what features of history, physical exam, imaging and lab analysis lead to the diagnosis of SA in these cases. Future studies will focus on these outliers to see if a more appropriate diagnostic algorithm would be useful in Calgary. Collaboration between infectious disease specialists, orthopedics, and emergency departments guided by local data is needed to ensure accurate and timely diagnosis.

scholarly journals Severe respiratory illness in an intravenous drug abuser

Breathe ◽  
2006 ◽  
Vol 3 (2) ◽  
pp. 207-211
Author(s):  
A. Elsheikh ◽  
H. Barker ◽  
D. Mukherjee ◽  
B. Yung
Keyword(s):  
Respiratory Illness ◽  
Intravenous Drug ◽  
Drug Abuser ◽  
Intravenous Drug Abuser ◽  
Severe Respiratory Illness

scholarly journals A case ofCandida lambicafungemia misidentified asCandida kruseiin an intravenous drug abuser

2008 ◽  
Vol 46 (8) ◽  
pp. 853-856 ◽  
Author(s):  
Steven Vervaeke ◽  
Kathy Vandamme ◽  
Elke Boone ◽  
Emmanuel De Laere ◽  
Danielle Swinne ◽  
...  
Keyword(s):  
Intravenous Drug ◽  
Drug Abuser ◽  
Intravenous Drug Abuser

scholarly journals Isolated Pulmonary Valve Endocarditis Complicated With Septic Emboli to the Lung Causing Pneumothorax, Pneumonia, and Sepsis in an Intravenous Drug Abuser

2013 ◽  
Vol 1 (4) ◽  
pp. 232470961351456 ◽  
Author(s):  
Deephak Swaminath ◽  
Yasir Yaqub ◽  
Roshni Narayanan ◽  
Ralph F. Paone ◽  
Kenneth Nugent ◽  
...  
Keyword(s):  
Pulmonary Valve ◽  
Intravenous Drug ◽  
Drug Abuser ◽  
Intravenous Drug Abuser ◽  
Septic Emboli
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