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John J. Ross - One of the best experts on this subject based on the ideXlab platform.
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Septic Arthritis and the opioid epidemic 1465 cases of culture positive native joint Septic Arthritis from 1990 2018
Open Forum Infectious Diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P < .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA Septic Arthritis included injection drug use (P < .001), bacteremia (P < .001), health care exposure (P < .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P < .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic Arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of <50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for Septic Arthritis in our patient population. Septic Arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of <50 000 cells/mm3 are common in culture-positive Septic Arthritis.
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Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990-2018.
Open forum infectious diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P
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Septic Arthritis of native joints
Infectious Disease Clinics of North America, 2017Co-Authors: John J. RossAbstract:Septic Arthritis is a rheumatologic emergency that may lead to disability or death. Prompt evacuation of the joint, either by arthrocentesis at the bedside, open or arthroscopic drainage in the operating room, or imaging-guided drainage in the radiology suite, is mandatory. Methicillin-resistant Staphylococcus aureus (MRSA) has become a major cause of Septic Arthritis in the United States. MRSA joint infection seems to be associated with worse outcomes. Antibiotic courses of 3 to 4 weeks in duration are usually adequate for uncomplicated bacterial Arthritis. Treatment duration should be extended to 6 weeks if there is imaging evidence of accompanying osteomyelitis.
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Pneumococcal Septic Arthritis: Review of 190 Cases
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2003Co-Authors: John J. Ross, Charles L. Saltzman, Philip Carling, Daniel S. ShapiroAbstract:This article reports 13 cases of pneumococcal Septic Arthritis and reviews another 177 cases reported since 1965. Of 2407 cases of Septic Arthritis from large series, 156 (6%) were caused by Streptococcus pneumoniae. Mortality was 19% among adults and 0% among children. Pneumococcal bacteremia was the strongest predictor of mortality. At least 1 knee was involved in 56% of adults. Polyarticular disease (36%) and bacteremia (72%) were more common among adults with Septic Arthritis caused by S. pneumoniae than among adults with other causative organisms. Only 50% of adults with pneumococcal Septic Arthritis had another focus of pneumococcal infection, such as pneumonia. Functional outcomes were good in 95% of patients. Uncomplicated pneumococcal Septic Arthritis can be managed with arthrocentesis and 4 weeks of antibiotic therapy; most cases of pneumococcal prosthetic joint infection can be managed without prosthesis removal. A fatal case of Septic Arthritis caused by a beta-lactam-resistant strain of S. pneumoniae is also presented.
Narath Carlile - One of the best experts on this subject based on the ideXlab platform.
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Septic Arthritis and the opioid epidemic 1465 cases of culture positive native joint Septic Arthritis from 1990 2018
Open Forum Infectious Diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P < .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA Septic Arthritis included injection drug use (P < .001), bacteremia (P < .001), health care exposure (P < .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P < .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic Arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of <50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for Septic Arthritis in our patient population. Septic Arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of <50 000 cells/mm3 are common in culture-positive Septic Arthritis.
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Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990-2018.
Open forum infectious diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P
Kevin L Ard - One of the best experts on this subject based on the ideXlab platform.
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Septic Arthritis and the opioid epidemic 1465 cases of culture positive native joint Septic Arthritis from 1990 2018
Open Forum Infectious Diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P < .0000005). Overall, methicillin-sensitive Staphylococcus aureus (MSSA) caused 41.5% of cases, and methicillin-resistant Staphylococcus aureus (MRSA) caused 17.9%. Gram-negative rods caused only 6.2% of cases. Predictors of MRSA Septic Arthritis included injection drug use (P < .001), bacteremia (P < .001), health care exposure (P < .001), and advancing age (P = .01). Infections with MSSA were more common in PWID (56.3% vs 38.8%; P < .00001), as were infections with MRSA (24% vs 16.8%; P = .01) and Serratia sp. (4% vs 0.4%; P = .002). Septic Arthritis in the setting of injection drug use was significantly more likely to involve the sacroiliac, acromioclavicular, and facet joints; 36.8% of patients had initial synovial fluid cell counts of <50 000 cells/mm3. Conclusions Injection drug use has become the most common risk factor for Septic Arthritis in our patient population. Septic Arthritis in PWID is more often caused by MRSA, MSSA, and Serratia sp., and is more prone to involve the sacroiliac, acromioclavicular, sternoclavicular, and facet joints. Synovial fluid cell counts of <50 000 cells/mm3 are common in culture-positive Septic Arthritis.
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Septic Arthritis and the Opioid Epidemic: 1465 Cases of Culture-Positive Native Joint Septic Arthritis From 1990-2018.
Open forum infectious diseases, 2020Co-Authors: John J. Ross, Kevin L Ard, Narath CarlileAbstract:Background The clinical spectrum of Septic Arthritis in the era of the opioid crisis is ill-defined. Methods This is a retrospective chart review of 1465 cases of culture-positive native joint Septic Arthritis at Boston teaching hospitals between 1990 and 2018. Results Between 1990-2008 and 2009-2018, the proportion of Septic Arthritis cases involving people who inject drugs (PWID) rose from 10.3% to 20% (P
Thomas Daikeler - One of the best experts on this subject based on the ideXlab platform.
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serum procalcitonin for discrimination between Septic and non Septic Arthritis
Clinical and Experimental Rheumatology, 2008Co-Authors: Thomas Hugle, Philipp Schuetz, Beat Mueller, G Laifer, Alan Tyndall, S Regenass, Thomas DaikelerAbstract:Background. Early differentiation be- tween Septic and non-Septic Arthritis is diffi cult. A previous study showed promising diagnostic accuracy of se- rum Procalcitonin (PCT) in Septic ar- thritis, limited by a low sensitive PCT test kit. Objective. To investigate the diagnos- tic value of PCT in patients with Septic and non-Septic Arthritis using a novel test with low detection limit. Methods. Forty-two patients, 28 with non-Septic and 14 with Septic Arthritis were prospectively included. For each patient, gram stain, culture and po- larization microscopy of synovial fl uid was done and PCT, C-reactive protein (CRP), white blood cell count, uric acid and blood cultures were taken. Patients with Septic Arthritis, patients with non- Septic Arthritis with and without con- comitant infection were compared. Results. Patients with Septic Arthritis had a signifi cant higher PCT concen- tration than patients with non-Septic Arthritis (p<0.0001). At a cut-off of 0.1 (0.25) ng/ml, sensitivity for Septic Arthritis was 100(93)% and specifi city 46(75)%. Specifi city rose to 93% after exclusion of patients with non-Septic Arthritis and concomitant infection. Both sensitivity and specifi city for the diagnosis of Septic Arthritis were high- er for PCT than CRP. Conclusions. Our data suggest that PCT seems to be a highly sensitive and specifi c marker for Septic Arthritis, de- pending on the clinical setting. Further studies are warranted.
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Serum procalcitonin for discrimination between Septic and non-Septic Arthritis
Clinical and experimental rheumatology, 2008Co-Authors: Thomas Hugle, Philipp Schuetz, Beat Mueller, G Laifer, Alan Tyndall, S Regenass, Thomas DaikelerAbstract:Background. Early differentiation be- tween Septic and non-Septic Arthritis is diffi cult. A previous study showed promising diagnostic accuracy of se- rum Procalcitonin (PCT) in Septic ar- thritis, limited by a low sensitive PCT test kit. Objective. To investigate the diagnos- tic value of PCT in patients with Septic and non-Septic Arthritis using a novel test with low detection limit. Methods. Forty-two patients, 28 with non-Septic and 14 with Septic Arthritis were prospectively included. For each patient, gram stain, culture and po- larization microscopy of synovial fl uid was done and PCT, C-reactive protein (CRP), white blood cell count, uric acid and blood cultures were taken. Patients with Septic Arthritis, patients with non- Septic Arthritis with and without con- comitant infection were compared. Results. Patients with Septic Arthritis had a signifi cant higher PCT concen- tration than patients with non-Septic Arthritis (p
Jason Womack - One of the best experts on this subject based on the ideXlab platform.
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Septic Arthritis of the Sternoclavicular Joint
Journal of the American Board of Family Medicine : JABFM, 2012Co-Authors: Jason WomackAbstract:Septic Arthritis is a medical emergency that requires immediate action to prevent significant morbidity and mortality. The sternoclavicular joint may have a more insidious onset than Septic Arthritis at other sites. A high index of suspicion and judicious use of laboratory and radiologic evaluation can help solidify this diagnosis. The sternoclavicular joint is likely to become infected in the immunocompromised patient or the patient who uses intravenous drugs, but sternoclavicular joint Arthritis in the former is uncommon. This case series describes the course of 2 immunocompetent patients who were treated conservatively for Septic Arthritis of the sternoclavicular joint.
