Subject(s)
Arthritis, Infectious/diagnosis , Arthritis, Rheumatoid/diagnosis , Sporotrichosis/diagnosis , Antifungal Agents/therapeutic use , Arthritis, Infectious/microbiology , Arthritis, Infectious/pathology , Arthritis, Rheumatoid/drug therapy , Arthritis, Rheumatoid/pathology , Diagnosis, Differential , Humans , Immunosuppressive Agents/therapeutic use , Itraconazole/therapeutic use , Male , Metacarpophalangeal Joint/microbiology , Metacarpophalangeal Joint/pathology , Middle Aged , Sporotrichosis/pathologySubject(s)
Arthritis, Reactive/pathology , Metacarpophalangeal Joint , Thumb , Tuberculosis, Osteoarticular/pathology , Accidental Falls , Arthritis, Reactive/diagnostic imaging , Finger Injuries/etiology , Humans , Male , Metacarpophalangeal Joint/diagnostic imaging , Metacarpophalangeal Joint/injuries , Metacarpophalangeal Joint/microbiology , Metacarpophalangeal Joint/pathology , Middle Aged , Radiography , Thumb/diagnostic imaging , Thumb/injuries , Thumb/microbiology , Thumb/pathology , Tuberculosis, Osteoarticular/diagnostic imagingABSTRACT
This report describes a patient who presented with fever, weight loss, diarrhea, and adenopathy. At the time of presentation he had a 28-year history of unusually severe destructive polyarthritis. Duodenal biopsy revealed periodic acid-Schiff-positive macrophages. Polymerase chain reaction studies showed positivity for Tropheryma whipplei in synovial fluid, synovial tissue, and lymph node specimens, and Whipple's disease was diagnosed. T whipplei was successfully cultivated from the synovial fluid by both cell culture and axenic culture. This strain (named ART1) was subcultured and subsequently established and genotyped. Antibiotic treatment was instituted in the patient, after which his symptoms remitted. These findings show for the first time that Whipple's arthritis may be, at least in some cases, a septic arthritis.
Subject(s)
Actinobacteria/isolation & purification , Synovial Fluid/microbiology , Whipple Disease/diagnosis , Whipple Disease/microbiology , Actinobacteria/genetics , Aged , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/diagnosis , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Carpal Joints/diagnostic imaging , Carpal Joints/microbiology , DNA, Bacterial/genetics , Humans , Male , Metacarpophalangeal Joint/diagnostic imaging , Metacarpophalangeal Joint/microbiology , Polymerase Chain Reaction , Radiography , Whipple Disease/drug therapyABSTRACT
Mycobacterium marinum is a rare cause of soft tissue infections. The imposing MR appearance of the soft tissue involvement is in contrast to the chronic painless clinical manifestation.
Subject(s)
Metacarpophalangeal Joint/microbiology , Mycobacterium Infections, Nontuberculous/diagnosis , Mycobacterium marinum , Adult , Diagnosis, Differential , Humans , Magnetic Resonance Imaging , Male , Metacarpophalangeal Joint/pathology , Metacarpophalangeal Joint/surgery , Mycobacterium Infections, Nontuberculous/surgeryABSTRACT
We describe an 18-year-old man with a renal transplant who developed septic metacarpophalangeal arthritis due to Mycobacterium gastri. He had several episodes of crystal induced synovitis, and treatment with intraarticular steroids was complicated 3 months later by iatrogenic septic arthritis. Appropriate treatment based on in vitro drug susceptibility was successful. This seems to be the first case of articular infection and the third report of human infection caused by this atypical mycobacteria.
Subject(s)
Arthritis, Infectious/etiology , Kidney Transplantation/adverse effects , Mycobacterium Infections, Nontuberculous , Adolescent , Arthritis, Infectious/pathology , Humans , Male , Metacarpophalangeal Joint/microbiology , Metacarpophalangeal Joint/pathologyABSTRACT
Articular infection with Blastomyces dermatitidis frequently is difficult to diagnose as it resembles bacterial arthritis in several ways. This report of an elderly man who had initially monoarticular and eventually polyarticular arthritis illustrates the clinical and laboratory findings that should suggest blastomycosis. Treatment with amphotericin B and ketoconazole in sequence led to complete resolution of the infection.
