ABSTRACT
Septic arthritis of the knee developed in a 21-month-old child. The causative organism, isolated from two separate arthrocenteses, was identified as Capnocytophaga ochracea morphologically and by biochemical reactions. Previous human infections (bacteremias) have occurred in granulocytopenic hosts with concomitant oral pathology including periodontitis and gingivitis. No abnormalities of oral hygiene were present in this patient, and granulocyte numbers were normal or elevated. Eradication of the infection was accomplished with 8 weeks of antibiotic therapy combined with surgical drainage. Septic arthritis expands the spectrum of infections reported to be caused by Capnocytophaga spp.
Subject(s)
Arthritis, Infectious/microbiology , Bacterial Infections/microbiology , Capnocytophaga/isolation & purification , Cytophagaceae/isolation & purification , Knee/microbiology , Female , Humans , InfantABSTRACT
The ability of quantitative sacro-iliac scintigraphy (QSS) to detect sacro-iliac joint (SIJ) disease was compared to that of standard radiographs in a prospective study of 26 patients with low back pain suggestive of spondylitis. Of 52 SIJs studied, QSS was abnormal in 21 (40%) and radiographs positive in 23 (44%) (p = 0.47). QSS was abnormal in only 11 of the 23 (48%) radiographically abnormal SIJs. Conversely, 29 radiographically equivocal or negative SIJs yielded positive scintigraphs in ten (34%). Although QSS in general is no more sensitive than standard radiographs, it may allow detection of radiographically inapparent sacro-iliitis in carefully selected patients.
Subject(s)
Sacroiliac Joint/diagnostic imaging , Spondylitis, Ankylosing/diagnostic imaging , Adult , Aged , Female , Humans , Male , Middle Aged , Prospective Studies , Radiography , Radionuclide ImagingABSTRACT
A young woman with hepatitis B surface antigen negative chronic active hepatitis and hypergammaglobulinemia was treated successfully with oral pulse steroid therapy consisting of prednisone, 90 mg/day, given in repeated 3--5-day courses at 3--4-wk intervals. This approach, which is hypothetically founded on the ability of steroids to cause prolonged inhibition of immunoglobulin G synthesis and proposed mechanisms of hepatocellular damage in chronic active hepatitis, permitted complete clinical, chemical, and histologic remission without morbidity. Oral pulse prednisone therapy deserves further study as a possible adjunct or alternative to existing methods of managing hepatitis B surface antigen negative chronic active hepatitis associated with hypergammaglobulinemia.
