Septic arthritis

Arthritis - septic Benign cerebellar ataxis Dehydration... 

Arthritis - immune complex Arthritis - septic Congestive heart failure Conjunctivitis Deafness... 

Inflammatory and immune diseases Autoimmune disease (A,I), asthma (A), osteoarthritis (I), rheumatoid arthritis (I), septic shock (A,I), infections (A,I), familial cold auto-inflammatory syndrome (I), Muckle Wells syndrome (I), chronic infantile neurological cutaneous and articular syndrome/neonatal onset multisystemic inflammatory disease (CINCA/NOMID) (I), Crohn s disease (I), gout (I), acute renal failure (A,l)... 

Complications of infected bite wounds include lymphangitis, abscess, septic arthritis, tenosynovitis, and osteomyelitis. Bites to the hand are particularly complication-prone.43,44... 

Extraintestinal C. jejuni infection, including septic arthritis, cholecystitis, pancreatitis, meningitis, endocarditis, osteomyelitis, and neonatal sepsis, can present in three different ways ... 

Schutyser E, Struyf S, Wuyts A, et al. Selective induction of CCL18/PARC by staphylococcal enterotoxins in mononuclear cells and enhanced levels in septic and rheumatoid arthritis. Eur J Immunol 2001 31(12) 3755—3762. 

Damage to connective caused by leakage of elastases leads to damage associated with inflammatory diseases, such as pulmonary emphysema, adult respiratory distress syndrome, septic shock, cystic fibrosis, carcinogenesis, chronic bronchitis, and rheumatoid arthritis. Compounds that directly inhibit elastase or its release from human neutrophils are of enormous pharmaceutical and cosmetological interest in the development of new anti-inflammatory drugs. A possible source for elastase inhibitors are the medicinal Asteraceae and Droseraceae, particularly those used as traditional medicine in Asia. 

Although used as a simulant, it can cause acute bacterial meningitis, pneumonia, intraabdominal infections, enteric infections, urinary tract infections, septic arthritis, endophthalmitis, suppurative thyroiditis, sinusitis, osteomyelitis, endocarditis, and skin and soft tissue infections. There are also strains of E. coli (C17-A015) that produce lethal cytotoxins (C16-A052). ... 

Lincosamides are a good alternative to beta-lactam antibiotics for treating infections caused by S. aureus or streptococci. It is useful in treating osteomyelitis and septic arthritis because of the large concentration attainable in the bones. 

Locai injections Intra-articular injection may produce systemic and local effects. A marked increase in pain accompanied by local swelling, further restriction of joint motion, fever, and malaise is suggestive of septic arthritis. Frequent intra-articular injection may damage joint tissues. 

Do not treat severe pneumonia, empyema, bacteremia, pericarditis, meningitis, or purulent or septic arthritis with an oral penicillin during the acute stage. 

A variety of medical conditions are now believed to be caused or exacerbated by overproduction of certain cytokines in the body. A variety of pro-inflammatory cytokines, including IL-6 and IL-8 as well as TNF, have been implicated in the pathogenesis of both septic shock and rheumatoid arthritis. Inhibiting the biological activity of such cytokines may provide effective therapies for such conditions. This may be achieved by administration of monoclonal antibodies raised against the target cytokine, or administration of soluble forms of its receptor which will compete with cell surface receptors for cytokine binding. 

Chronic tuberculous arthritis is not at all rare in developing countries. Mycobacterial tuberculosis can directly or indirectly affect the musculoskeletal system. Most commonly there is a direct musculoskeletal involvement of M. tuberculosis which may lead to spondylitis, osteomyelitis, septic arthritis and tenosynovitis. M. tuberculosis has become an important pathogen in rheumatic diseases since the use of anti-TNF-a biopharmaceuticals was introduced. 

Drainage, debridement, and large volume irrigation by 3-directional arthroscopic surgery may become standard treatment for septic arthritis of the hip with concomitant intravenous antibiotics for at least 3 weeks followed by oral antibiotics for at least another 3 weeks. After infectious arthritis is eradicated a follow-up period of 1 years is advised. 

Nusem 1, Jabur MK, Playford EG. Arthroscopic treatment of septic arthritis of the hip. Arthroscopy 2006 22 902-3. 

For parenteral therapy, nafciUin and oxacillin offer comparable efficacy and antimicrobial spectra of activity. Although both drugs undergo hepatic metabolism, only nafcillin requires dose adjustment in patients with combined hepatic and renal insufficiency. Other pharmacokinetic data for nafcillin and oxacillin appear in Table 45.1. Indications for nafcillin or oxacillin include severe staphylococcal infections like cellulitis, empyema, endocarditis, osteomyelitis, pneumonia, septic arthritis, and toxic shock syndrome. 

Rare reactions include hypersensitivity reactions, malignancies, respiratory tract infections, bronchitis, UTls, and more serious infections (such as pneumonia, tuberculosis, cellulitis, pyelonephritis, and septic arthritis). 

Infections (such as pyelonephritis, cellulitis, osteomyelitis, wound infection, leg ulcer, septic arthritis, diarrhea, bronchitis, and pneumonia) occur in 38%-29% of patients. 

Mycobacterium avium septic arthritis has been reported in two patients with pre-existing rheumatic disease (scleroderma and polymyositis) who were taking prednisolone and azathioprine the infection was in the left shoulder in one patient and in the knee in the other (323). 

Bridges MJ, McGarry F. Two cases of Mycobacterium avium septic arthritis. Ann Rheum Dis 2002 61(2) 186-7. 

Tosyliminothiochromone-2-carboxylates 585 are inhibitors of interleukin-1 and are thus useful for the treatment of rheumatoid arthritis, multiple sclerosis, diabetes mellitus, atherosclerosis and septic shock <1995WO9514670>, and thiochromones possessing a sulfamoyloxy side chain at either C-6 or C-7 behave as steroid sulfatase inhibitors < 1999W O9952890>. 

NOS is an important signaling enzyme that synthesizes L-citrulline and nitric oxide (NO) from L-arginine and O2 via two turnovers in a P450-like catalytic cycle (Scheme 2). NOS participates in physiological processes such as neurotransmission, vasodilation, and immune response [54,55]. Improper regulation of NO production can lead to diseases such as septic shock, heart disease, arthritis, and diabetes. 

Nuclear factor kappa B (NF-kB) serves as a central regulator of the human immune and inflammatory response, and is a family of inducible transcription factors found virtually ubiquitously in all cells and functions in a variety of human diseases including those related to inflammation, cancer, asthma, atherosclerosis, AIDS, septic shock, and arthritis. Due to its role in a wide variety of diseases, NF-kB has become one of the major targets for drug development. Inhibition of NF-kB activity potentially contributes to cancer chemoprevention [27,28]. 

Nitration of phenolic compounds leads to the formation of 3-nitrotyrosine (molar extinction coefficient = 14 400 at 428 nm) (Figure 7.11). The reaction is very specific for phenolic compounds. Chemical nitration of functionally important tyrosine residues by tetranitromethane has often been found to inactivate or alter the enzyme properties. It was only after the detection of in vivo nitrotyrosine formation under inflammatory conditions that the physiological aspects of nitrotyrosine metabolism came to light. Abundant production (1-120 /uM) of nitrotyrosine has been recorded under a number of pathological conditions such as rheumatoid arthritis, liver transplantation, septic shock, and amyotrophic lateral sclerosis (Balabanli etal. 1999). 

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