Presentation
With variation present between disease presentations from case to case, it is possible that the spectrum of PAPA syndrome is wider than currently thought. [ncbi.nlm.nih.gov]
The incidence of anemia correlated with delayed presentation, a higher rate in patients that presented later than 6 days compared to the ones that presented earlier (64.5% vs. 15.4% P < 0.003) was observed. [nigerianjsurg.com]
[…] on Admission - Yes) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present on Admission - Yes) Total National Projected Hospitalizations - Annualized (Present on Admission - Not Y) Total Medicare Hospitalizations - Oct 2015 to Sep 2018 (Present [dexur.com]
Entire Body System
- Fever
[ 713.6 ] Staphylococcus 711.0 Streptococcus 711.0 syphilis (see also Syphilis) 094.0 [ 711.4 ] syringomyelia 336.0 [ 713.5 ] thalassemia (see also Thalassemia) 282.40 [ 713.2 ] tuberculosis (see also Tuberculosis, arthritis) 015.9 [ 711.4 ] typhoid fever [icd9data.com]
Such patients presenting with unexplained fever of more than 1 degrees C(1.8 degrees F) and acute symptoms of joint inflammation should have an arthrocentesis. [ncbi.nlm.nih.gov]
Fever of undetermined origin in patients with the acquired immunodeficiency syndrome in Brazil: report on 55 cases. [scielo.br]
It discusses pharyngitis, and cervical adenitis and the monogenic autoinflammatory diseases that cause recurrent fevers including familial Mediterranean fever, hyper-immunoglobulin (Ig) D and periodic fever syndrome, tumor necrosis factor receptor-associated [read.qxmd.com]
- Swelling
Calf swelling and tenderness with apparent antibiotic resistance in pyogenic arthritis of the knee are the major signs of the diagnosis. [ncbi.nlm.nih.gov]
Infectious Arthritis Also called: Septic arthritis Most kinds of arthritis cause pain and swelling in your joints. Joints are places where two bones meet, such as your elbow or knee. Infectious arthritis is an infection in the joint. [icdlist.com]
Although conventional radiographs are obtained as the initial study, they are relatively insensitive to the early findings of the disease except for soft tissue swelling and osteopenia. [learningradiology.com]
[…] route of infection is hemic to the synovial tissue, causing destruction of the articular cartilage; may become chronic, with sinus formation, osteomyelitis, deformity, and disability. bacterial arthritis An acute arthropathy characterised by painful swelling [medical-dictionary.thefreedictionary.com]
- Asymptomatic
[…] al. in South-Western Nigeria. [12] However, the percentage of septic arthritis of the shoulder in this study is similar to the finding by Akinyoola et al. and more than the percentage in Western children reported by Jackson and Nelson. [17] Trauma, asymptomatic [nigerianjsurg.com]
Concomitant mucosal infection of the urethra or cervix is often present but usually asymptomatic. Urethral and cervical cultures or a nucleic amplification test will frequently yield N. gonorrhoeae (19,32). [the-hospitalist.org]
Considering the population in question, a majority of elderly patients have pre-existing asymptomatic rotator cuff tears, which would aid in access to the joint and may benefit from gentle debridement. [clinicaladvisor.com]
The large majority of these patients have asymptomatic genital, anal, or pharyngeal gonococcal infections ( 122 ). [doi.org]
- Hodgkin Lymphoma
Ongoing or history of concomitant malignancies of lymphoid cells such as lymphocytic leukemia, non-Hodgkin's lymphoma, and immunodeficiency with thymoma. 4. [clinicaltrials.jp]
Gastrointestinal
- Overeating
Racial disparities still exist, with little improvement over time. [ncbi.nlm.nih.gov]
Staphylococcus aureus contributes over two-thirds of identified… CONTINUE READING [semanticscholar.org]
- Vomiting
Other symptoms may include fever, headache, sore throat, and vomiting. Treatment includes the use of intravenous antibiotics and drainage of the site, either by needle or through a surgical procedure. [kidshealth.org]
- Loss of Appetite
Along with joint inflammation and pain, many people experience fatigue, loss of appetite and a low- grade fever. It has everything to do with your joints - - the places where your bones connect - - such as your wrists, knees, hips, or fingers. [ajugovuted.ml]
[…] of appetite These symptoms can seem like other health conditions. [stlouischildrens.org]
Clumsiness is initially experienced, but without due care, this can progress to quadriplegia or even death.[32] Constitutional symptoms[edit] Constitutional symptoms including fatigue, low grade fever, malaise, morning stiffness, loss of appetite and [en.wikipedia.org]
- Nausea
Antibiotics carry a risk of side effects, including nausea, vomiting and diarrhea. Allergic reactions also can occur. Ask your doctor about what side effects to expect from your medication. [mayoclinic.org]
Children sometimes develop nausea and vomiting. Septic arthritis is considered a medical emergency because of the damage it causes to bone as well as cartilage, and its potential for creating septic shock, which is a potentially fatal condition. [encyclopedia.com]
Hemoptysis -- Chapter 91: Hypertensive Urgencies and Emergencies -- Chapter 92: Hyperthermia and Fever -- Chapter 93: Hypotension -- Chapter 94: Hypothermia -- Chapter 95: Hypoxia -- Chapter 96: Sleep Disturbance in the Hospitalized Patient -- Chapter 97: Nausea [worldcat.org]
[…] methotrexate, sulfasalazine and hydroxychloroquine may also effectively control disease activity.[92] Adverse effects should be monitored regularly with toxicity including gastrointestinal, hematologic, pulmonary, and hepatic.[90] Side effects such as nausea [en.wikipedia.org]
Liver, Gall & Pancreas
- Jaundice
Emergencies -- Chapter 153: Adrenal Insufficiency -- Chapter 154: Pituitary Disease -- Section 5: Gastroenterology -- Chapter 155: GERD and Esophagitis -- Chapter 156: Upper Gastrointestinal Bleeding -- Chapter 157: Acute Pancreatitis -- Chapter 158: Jaundice [worldcat.org]
Flucloxacillin jaundice. Lancet 339 : 679. ↵ Ferreras, M., F. Hoper, S. M. Dalla, D. A. Colin, G. Prevost, and G. Menestrina. 1998. [doi.org]
Flucloxacillin jaundice. Lancet 339 : 679. [ PubMed ] [ Google Scholar ] 46. Ferreras, M., F. Hoper, S. M. Dalla, D. A. Colin, G. Prevost, and G. Menestrina. 1998. [ncbi.nlm.nih.gov]
Musculoskeletal
- Arthritis
pyogenic) 711.0 Pyarthrosis (see also Arthritis, pyogenic) 711.0 tuberculous - see Tuberculosis, joint Pyemia, pyemic (purulent) (see also Septicemia) 038.9 arthritis (see also Arthritis, pyogenic) 711.0 joint (see also Arthritis, pyogenic) 711.0 Septic [icd9data.com]
PURPOSE: To assess magnetic resonance (MR) imaging features in differentiating tuberculous arthritis from pyogenic arthritis. [ncbi.nlm.nih.gov]
arthritis of elbow Infective arthritis of foot Infective arthritis of hip Infective arthritis of knee Infective arthritis of left ankle Infective arthritis of left elbow Infective arthritis of left foot Infective arthritis of left hand Infective arthritis [icd10data.com]
Infectious arthritis complicating rheumatoid arthritis and other chronic rheumatic disorders. Arthritis Rheum 1989; 32:496–502. 49. Gardner GC, Weisman MH. [journals.lww.com]
Acute suppurative arthritis in infancy and childhood. J Bone Joint Surg Br 1970;52:474-82. 15. Nade SM. Acute septic arthritis in infancy and childhood. J Bone Joint Surg Br 1983;65:234-41. 16. Goldenberg DL. Septic arthritis. [nigerianjsurg.com]
Skin
- Skin Lesion
This syndrome clinically manifests as early onset of recurrent episodes of acute aseptic inflammation of the joints, generally occurring in the first two decades of life, followed by manifestation of characteristic skin lesions in the third decade, after [ncbi.nlm.nih.gov]
There can be joint destruction from the arthritis, and scarring on the skin from the deep skin lesions. For more detailed information, please refer to this article that we used for reference: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3048314/ [autoinflammatory.org]
Management and treatment Arthritis and skin lesions have sometimes been reported to be responsive to glucocorticoids. However, two alternative therapeutics have been suggested so far. [orpha.net]
The patient had various histories of skin and joint disorders and experienced subarachnoid hemorrhage during pregnancy; however, her skin lesion was unaffected. [read.qxmd.com]
lesions; - unlike most forms of septic arthritis, GC does not necessarily require surgical washout, and and usually responds to IV antibiotics alone. - references: - Antibiotic concentrations in septic joint effusions. - Etiology and medical management [wheelessonline.com]
- Skin Ulcer
[…] integrity Psoriasis Eczema Skin ulcers Trauma Surgery – arthroscopy Procedure related – intra-articular steroids, Synvisc-One Chronic disease Diabetes mellitus Chronic renal/ hepatic disease Alcohol abuse Immunosuppression Intravenous drug use Bacteremia [arupconsult.com]
AIM: We investigated a 33-year-old man with a long-standing history of ulcerative colitis, severe acne and recurrent skin ulcerations, and a 3-year history of a recalcitrant pustular rash... [read.qxmd.com]
Concomitant or pre-existing skin involvement (eschars and/or leg ulcers) was found in 16 (14.7 %) patients. [bmcinfectdis.biomedcentral.com]
Rheumatoid vasculitis can thus commonly present with skin ulceration and vasculitic nerve infarction known as mononeuritis multiplex.[22] Other, rather rare, skin associated symptoms include pyoderma gangrenosum, Sweet's syndrome, drug reactions, erythema [en.wikipedia.org]
- Flushing
Critical Care Setting -- Chapter 140: Mechanical Ventilation -- Chapter 141: Sepsis and Shock -- Chapter 142: Acute Respiratory Distress Syndrome -- Chapter 143: Prevention in the Intensive Care Unit Setting -- Section 3: Dermatology -- Chapter 144: Flushing [worldcat.org]
Neurologic
- Confusion
Multivariate analysis suggests that important predictors of death are: confusion at presentation, age ⩾65 years, multiple joint sepsis or involvement of the elbow joint, and of morbidity are: age ⩾ 65 years, diabetes mellitus, open surgical drainage, [doi.org]
You have a fever and are confused. Seek care immediately if: You are urinating little or not at all. You have severe abdominal pain. You have sudden, severe joint pain. Contact your healthcare provider if: Your symptoms return. [drugs.com]
We also confirmed that older age, diabetes mellitus, bacteraemia, chronic renal failure, inflammation [ 29 ] and confusion [ 6 ] on admission are risk factors associated with death directly attributable to AS. [bmcinfectdis.biomedcentral.com]
Children Septic arthritis is easily missed in children, as localising signs may be absent, and may be confused with more common conditions - eg, transient synovitis and trauma. [patient.info]
Radiographic diagnosis results in diagnosis of a fracture within a joint, which is not to be confused with osteoarthritis which is a degenerative pathology affecting a high incidence of distal phalangeal joints of female patients. [en.wikipedia.org]
Workup
+ - Effusion Effusion Joint Aspiration IV Antibiotics Admit Ortho* OR Admit Pediatrics Equivocal Septic Arthritis Afebrile Decreased Range of Motion Limp Labs, X-rays + - + - US Ortho Consult Consider Aspiration Consider admit Pediatrics for further workup [chop.edu]
Magnetic resonance imaging (MRI) has no role in the initial workup. The use of this expensive and time-consuming modality should be reserved for situations in which simpler measures, such as joint aspiration, fail to provide a diagnosis. [emedicine.com]
Diagnostic Workup Diagnostic workup begins with a high index of suspicion, and should include standard and advanced imaging techniques, laboratory studies, and diagnostic aspirations. [clinicaladvisor.com]
Biopsy
- Granulomatous Arthritis
The patient's history and clinical course often provide clues to distinguish between gonococcal, nongonococcal, and granulomatous arthritis. [doi.org]
Treatment
PURPOSE: To discuss the indications and therapeutic outcomes of synovectomy, debridement, and continuous irrigation for the treatment of pyogenic arthritis caused by intra-articular injection used in the treatment of osteoarthritis of the knee. [ncbi.nlm.nih.gov]
To discuss the indications and therapeutic outcomes of synovectomy, debridement, and continuous irrigation for the treatment of pyogenic arthritis caused by intra-articular injection used in the treatment of osteoarthritis of the knee. Methods. [journals.sagepub.com]
Prognosis
Patients with a positive culture from the hip or shoulder who had been pretreated with antibiotics had the worst prognosis. [ncbi.nlm.nih.gov]
Physicians should be aware that a delayed diagnosis results in a worse prognosis. [synapse.koreamed.org]
With adequate management the prognosis of suppurative sacroiliitis in pediatric patients is excellent, despite persistent abnormal radiographic findings in most patients. Received November 1, 1979. Accepted December 21, 1979. [pediatrics.aappublications.org]
Recent reports using a staging system based on arthroscopic findings have proven that the prognosis worsens as the stage advances [ 10, 11 ]. [doi.org]
Etiology
Despite obtaining specimens from multiple sites for culture and using antigen detection tests only 64% of patients had an etiologic agent determined. [ncbi.nlm.nih.gov]
Joint aspiration under biplane fluoroscopic control and culture of the aspirated material is indicated in establishing the specific etiologic agent which is Staphylococcus aureus in most cases. [pediatrics.aappublications.org]
Etiology The gene responsible for the syndrome, the proline-serine-threonine phosphatase interacting protein 1 ( PSTPIP1 ) gene (previously known as the CD2 binding protein 1 ( CD2BP1 ) gene), was cloned in 2002. [orpha.net]
Epidemiology
OBJECTIVE: To study the epidemiological characteristics and predictors of treatment outcomes for Thai patients hospitalized with PA. MATERIALS AND METHODS: The nationwide hospital database from the 2010 fiscal year was analyzed. [ncbi.nlm.nih.gov]
Patient Population: Prevalence and Epidemiology Knee // Shoulder & Elbow // Hip // Spine // Foot & Ankle // Hand & Wrist Fragility Fractures: Diagnosis and Treatment Shoulder & Elbow The Characteristics of Surgeons Performing Total Shoulder Arthroplasty [mdedge.com]
Objective To study the epidemiological characteristics and predictors of treatment outcomes for Thai patients hospitalized with PA. Materials and methods The nationwide hospital database from the 2010 fiscal year was analyzed. [onlinelibrary.wiley.com]
Summary Epidemiology To date, only 34 patients with PAPA syndrome have been reported worldwide, from five families (two in the USA, one in Italy, one in the Netherlands, and one in New Zealand). [orpha.net]
Gímenez, None. « Back to 2013 ACR/ARHP Annual Meeting ACR Meeting Abstracts - https://acrabstracts.org/abstract/pyogenic-arthritis-clinical-and-epidemiological-features-of-101-cases-at-a-university-hospital/ [acrabstracts.org]
Pathophysiology
However, the pathophysiological function of PSTPIP1 remains to be elucidated. We have generated mouse strains that either are PSTPIP1 deficient or ectopically express mutant PSTPIP1. [ncbi.nlm.nih.gov]
The pathophysiology of septic arthritis – or how the disease occurs – is when organisms such as viruses, bacteria, or fungi enter the joint space directly (as in the case of an injury or injection that breaks the skin) or through the bloodstream from [joybauer.com]
Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms. Medicine. 1983;62:395. PubMed CrossRef Google Scholar 14. Herndon WA, Knauer S, Sullivan JA, et al. [link.springer.com]
The purpose of this article is to provide an overview of the pathophysiology, diagnosis, treatment and long-term follow-up of septic arthritis in children. Figure 1. [racgp.org.au]
Surgery related Simultaneous bilateral arthroplasty Operative time >2.5 hours Allogenic blood transfusion Postoperative complications Delayed wound healing Atrial fibrillation Myocardial infarction Urinary tract infection (UTI) Prolonged hospital stay Pathophysiology [arupconsult.com]
Prevention
Preventive measures directed to patients with prosthetic joints or osteosynthetic material, and a known haematogenous source would have prevented at most 8% of all cases. bacterial arthritis prosthetic joint infection epidemiology prevention Statistics [doi.org]
Postoperative physiotherapy and mobilisation of the joint is necessary, while splinting prevents contractures. Early treatment may prevent severe complications such as dislocation, acvascular necrosis and late osteoarthritis. [www0.sun.ac.za]
Ice may also help prevent tissue damage. Use a cold compress, or put crushed ice in a bag. Cover it with a towel and apply it to your joint for 15 to 20 minutes every hour, or as directed. Exercise as directed. [drugs.com]
While there are no official guidelines on nutrition for septic arthritis, a nutrient-rich diet that can help prevent or fight infection may be beneficial. [joybauer.com]
Outpatient settings policy options for improving infection prevention. Atlanta, GA: US Department of Health and Human Services, CDC; 2015. [imic.or.jp]