Septic arthritis of the pubic symphysis: a case report.

Septic arthritis of the pubic symphysis, so called osteomyelitis pubis is the infection which involves pubic symphysis and its joint. It is a rare condition, representing less than one percent of all cases of osteomyelitis. It affects most frequently young athletes and women undergoing gynecologic or urologic surgery. It presents itself with fever and pubic pain which irradiates to the genitals and increases when hip is mobilized, and this fact produces gait claudication. Diagnosis is based on clinic supported by microbiologic culture results, image methods, and proteins augment during acute phase. The etiologic agents most commonly found are Staphylococcus aureus, followed by gram-negative bacilli, and polymicrobial infection in recent pelvis surgery. The antibiotic treatment is adjusted depending on the microbiological diagnosis, adding NSAIDs, and bed rest. We report a 16 year-old male presenting with pubic pain and fever. Magnetic resonance imagery showed arthritis of the pubic symphysis. The patient was treated with antibiotics with a good clinical response.

Gonococcal polyarthritis with sternoclavicular joint involvement in pregnant woman: a case report.

Pregnancy is one of conditions that increase the risk of gonococcal arthritis which result from blood dissemination of neisseria gonorrhoeae. A 20-year-old africain female patient (in the second trimester of pregnancy), was admitted to hospital because of fever, asymmetric joint swollen affecting the hands, wrists, left ankle, and right sternoclavicular joint. Laboratory findings (erythrocyte sedimentation rate was 117 mm in first hour, The serum C-reactive protein level was 152 mg/L) the gram stain of genital sample was positif of neisseria gonorrhoeae and trichomonas vaginalis. With antibiotics, outcome of pregnancy was timely and uneventful. Patients should be educated about the mode of transmission of gonorrhea. Sexual partners should also be treated to prevent dissemination and gonococcal re-infection.

An unusual manifestation in a patient with adult-onset Still's disease: Minimal glomerular lesion.

Adult-onset Still's disease (AOSD) is a multisystem inflammatory disease of unknown etiology. It is characterized by arthritis, hectic fever, transient rash and visceral lesions such as pleuropericarditis, lymphadenopathy and hepato splenomegaly. Although kidney involvement may appear in some cases of AOSD, minimal glomerular lesion (MGL) has not been described. We describe a female patient, who presented with multisystemic manifestations, including high spiking fever, arthralgias, striking hyperferritinemia, and proteinuria. Renal biopsy showed classic MGL. A diagnosis of AOSD was made on the basis of Yamaguchi's criteria. The patient was treated with steroids, resulting in remission of the rheumatological condition closely paralleled by remission of proteinuria, thereby strongly suggesting a causative link between AOSD and MGL in this patient. Renal involvement in the AOSD was rarely reported in the literature. MGL may be a cause of unexplained proteinuria in AOSD. In this situation, renal biopsy is necessary to establish a definitive diagnosis.

A successful treatment of juvenile idiopathic arthritis with rituximab: A report of two cases.

Juvenile idiopathic arthritis (JIA) is defined as arthritis of unknown cause that starts before 16 years of age and lasts at least 6 weeks. It is the most common chronic inflammatory disease in childhood and often persists through adulthood and can lead to severe disability. Biologics are an important therapeutic option for treating patients with JIA. The efficiency of rituximab has not been proven for this indication. Its use has rarely been reported in the literature. We report two new cases of severe and refractory polyarticular JIA with positive rheumatoid factor affecting two African females aged 17 and 18 years successfully treated with rituximab. According to our experience, the use of rituximab in the treatment of JIA, especially in severe polyarticular forms with positive rheumatoid factor, might be a good alternative. Larger therapeutic trials should be conducted in this direction in order to prove the effectiveness of this biotherapy for this indication.