ABSTRACT
Antitumour necrosis factor (TNF) monoclonal antibodies have become an invaluable treatment against chronic inflammatory diseases such as rheumatoid arthritis (RA). However, due to increased risk of opportunistic infections, patients receiving antiTNF therapy should be closely monitored for serious infections. Here, we describe a case of acute Salmonella enteritidis infection of a joint arthroplasty that previously was functioning well, in a patient receiving infliximab treatment for RA. After prolonged antimicrobial chemotherapy and interrupted infliximab treatment, reimplantation of a new prosthesis was successfully performed two years after Salmonella septic arthritis. Therefore, because of the possibility of extraintestinal salmonellosis, screening for fecal colonization could be advisable in patients undergoing antiTNF treatment. Moreover, we emphasize the importance of appropriate counselling of these patients concerning food hygiene.
Los anticuerpos monoclonales del factor de necrosis antitumoral (FNT) se han convertido en un valioso tratamiento contra las enfermedades inflamatorias crónicas como la artritis reumatoide (AR). Sin embargo, debido al mayor riesgo de infecciones oportunistas, los pacientes que reciben terapia antiFNT se deben se monitoreados muy de cerca con respecto a la posibilidad de infecciones serias. Aquí describimos un caso de infección aguda por Salmonella enteritidis de una artroplastia de articulación que anteriormente funcionaba bien, en un paciente que recibía tratamiento con infliximab por RA. Después de prolongadas quimioterapias antimicrobianas y tratamiento interrumpido con infliximab, se realizó exitosamente la reimplantación de una nueva prótesis, dos años después de la artritis séptica por Salmonella. Por lo tanto, debido a la posibilidad de una salmonelosis extraintestinal, podría ser aconsejable el tamizaje de la colonización fecal en pacientes sometidos a tratamiento antiFNT. Por otra parte, hacemos hincapié en la importancia de aconsejar apropiadamente a estos pacientes con respecto a la higiene de los alimentos.
Subject(s)
Humans , Female , Middle Aged , Arthritis, Rheumatoid/drug therapy , Salmonella Infections/complications , Arthritis, Infectious/microbiology , Prosthesis-Related Infections/microbiology , Salmonella enterica , Immunocompromised Host , Antirheumatic Agents/therapeutic use , Arthroplasty, Replacement, Knee , Knee Prosthesis , Antibodies, Monoclonal/therapeutic useABSTRACT
Anti-tumour necrosis factor (TNF) monoclonal antibodies have become an invaluable treatment against chronic inflammatory diseases such as rheumatoid arthritis (RA). However, due to increased risk of opportunistic infections, patients receiving anti-TNF therapy should be closely monitored for serious infections. Here, we describe a case of acute Salmonella_enteritidis infection of a joint arthroplasty that previously was functioning well, in a patient receiving infliximab treatment for RA. After prolonged antimicrobial chemotherapy and interrupted infliximab treatment, reimplantation of a new prosthesis was successfully performed two years after Salmonella septic arthritis. Therefore, because of the possibility of extraintestinal salmonellosis, screening for fecal colonization could be advisable in patients undergoing anti-TNF treatment. Moreover we emphasize the importance of appropriate counselling of these patients concerning food hygiene.
Subject(s)
Antibodies, Monoclonal/adverse effects , Antirheumatic Agents/adverse effects , Arthritis, Infectious/immunology , Arthritis, Rheumatoid/drug therapy , Immunocompromised Host , Prosthesis-Related Infections/immunology , Salmonella Infections/immunology , Salmonella enterica , Arthritis, Infectious/complications , Arthritis, Rheumatoid/complications , Arthroplasty, Replacement, Knee , Female , Humans , Infliximab , Knee Prosthesis , Middle Aged , Prosthesis-Related Infections/complications , Salmonella Infections/complications , Tumor Necrosis Factor-alpha/antagonists & inhibitors , Tumor Necrosis Factor-alpha/immunologyABSTRACT
The femoral neck anteversion angle is an important factor for hip stability and normal walking. It is multifactoral result of evolution, heredity, fetal development, intrauterine position, and mechanical forces. Abnormal FNA sometimes can be associated with many clinical problems ranging from harmless intoeing gait in the early childhood, to disabling osteoarthritis of the hip and the knee in the adults. In most cases is associated with minor functional problems in children during growth, but cause a concern in parents for children future. The child must be examined carefully and an accurate diagnosis must be established. The most important part of care is observation of the children. If abnormal femoral neck anteversion produces severe functional disability, derotational osteotomy should be done, but delayed until late childhood.
