Fungal arthritis simulating juvenile rheumatoid arthritis.

Abstract

25 J AHLQVIST, MD, head turia. The fungus was sensitive to ketoconazole, and treatment with this drug cured the infection. With the introduction of ketoconazole it is of practical importance to recognise fungal infections.

High prevalence of Kingella kingae in joint fluid from children with septic arthritis revealed by the BACTEC blood culture system

“…False-negative culture rates were reduced by 40% by use of this novel technique (47). In addition, culture of joint fluid aspirates in blood culture bottles allowed recovery of a wide range of organisms, including fungi, coagulase-negative staphylococci, S. aureus, streptococci, Neisseria spp., and K kingae in one case (20,39,47).…”

“…In the last decade, use of blood culture systems for the detection of organisms from joint fluid aspirates from patients with suspected arthritis has been recommended by Finnish investigators (20,39,47). Experience with this strategy remains, however, limited.…”

Scedosporium apiospermum: changing clinical spectrum of a therapy-refractory opportunist*

“…In the 39 reported cases of osteoarticular infections, one of the most common manifestations of Scedosporium -related disease, 17 different therapeutic regimens have been applied. Surgery alone [165,321] or combined with one [163,165,176,255] or more antifungals [161,168] were the most common treatments; although in numerous occasions the patients only received medical treatment with one drug, such as AMB [159,160], ITC [161,167,170,173], KTC [169,255], MCZ [160,176] or combinations of them [158,177]. With the exception of three cases [167,170,177] all these treatment regimens resulted in a partial or total recovery of the infection.…”

“…Haapasaari et al . [169] cultured S. apiospermum from synovial fluid but not from aspirate. Occasionally fungal structures were reported to be absent; this may be due to the fact that most such diagnoses were by fine needle aspiration of synovial fluid which is followed by repeatedly positive culture [158].…”

Arthritis caused by Haemophilus paraphrophilus and isolation of the organism by using an improved culture protocol

“…But since the culture conditions employed are not provided, it is not possible to unconditionally equate lack of recovery with absence of the microbe. By the supplementary use of blood culture bottles, we have on two occasions been able to isolate slow-growing and fastidious organisms from SF in spite of negative results by conventional methods of isolation in previous attempts (5,15). Also, 20% of ordinary pathogens would have been missed without this strategy, and 40% of SF specimens from patients on antibiotics would have been false-negatives (19).…”