Osteomyelitis presenting as a swollen elbow in a patient with the acquired immune deficiency syndrome.

Goh, B T; Jawad, Ali; Chapman, David; Winceslaus, S J; Forster, G E; Perry, Janet

doi:10.1136/ard.47.8.695

Cited by 9 publications

(3 citation statements)

References 3 publications

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“…In 16 of the 21 non-IVDAs with osteoarticular infections a predisposing factor was found. Six had previous skin or wound infections, and rheumatoid arthritis, diabetes mellitus, pneumonia, and alcoholism were each present in two patients, one had systemic lupus erythematosus, and another had multiple myeloma.…”

Section: Ivdasmentioning

confidence: 96%

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

Muñóz-Fernández

Macı́a

Pantoja

et al. 1993

Annals of the Rheumatic Diseases

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Objectives-To determine (a) the influence of HIV in developing osteoarticular infections in intravenous drug abusers (IVDAs) and (b) the differences between the clinical features of osteoarticular infections in IVDAs and a control group of non-IVDAs. Methods-A comparative study of the clinical features of osteoarticular infections in all HIV positive and HIV negative IVDAs admitted to the departments of rheumatology and internal medicine during a 10 year period was carried out.

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Section: Ivdasmentioning

confidence: 96%

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

Muñóz-Fernández

Macı́a

Pantoja

et al. 1993

Annals of the Rheumatic Diseases

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“…Arthritis in patients infected with HIV is usually septic and caused by a variety of secondary pathogens, although bacterial septic arthritis is more commonly encountered 2. Reactive arthritis has also been described in AIDS, with HIV being isolated from the synovial fluid 3.…”

mentioning

confidence: 99%

Reactive arthritis May develop in patients with HIV infection

Winceslaus¹

1994

BMJ

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“…One patient had radiologic evidence of osteomyelitis of the olecranon process during an episode of S aureus bacteremia (9), and the other had osteomyelitis in an unspecified bone as a late complication of S aureus sepsis (10). Osteomyelitis from opportunistic infections in AIDS patients has been reported; 1 patient had Mycobacteriurn kansasii osteomyelitis of the tibia (4), and another had Nocardia asreroides osteomyelitis of the cervical spine ( 3 ) .…”

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confidence: 99%

Septic acromioclavicular arthritis and osteomyelitis in a patient with acquired immunodeficiency syndrome

Zimmermann

Erickson

Mikolich

1989

Arthritis & Rheumatism

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We describe a patient with acquired immunodeficiency syndrome who developed Staphylococcus aureus septic arthritis and osteomyelitis of the acromioclavicular joint. The case is unusual because of the rarity of reported bone and joint infections in patients with acquired immunodeficiency syndrome and because of the indolent nature of the infection.Patients with acquired immunodeficiency syndrome (AIDS) may develop a variety of systemic and localized infections. Frequently, these infections have clinical features that are rarely seen in immunocompetent hosts. Bone and joint infections in patients with AIDS have been reported only rarely. There are a few case reports of fungal septic arthritis (1,2) and osteomyelitis (3,4) in these patients; however, we are aware of no previous reports of well-documented bacterial septic arthritis in AIDS patients. We describe a patient with AIDS who developed septic arthritis and osteomyelitis involving the acromioclavicular (AC) joint. A review of the literature and discussion of treatment are presented. Case report. The patient, a homosexual man, was diagnosed as having AIDS in August 1986 at the age of 25. There was no history of intravenous drug abuse. He experienced 2 episodes of Pneumocystis carinii pneumonia, but was doing well on a regimen of zidovudine (azidothymidine; AZT) until January 1988, when a dull ache developed in his right shoulder. The shoulder pain initially improved with nonsteroidal antiinflammatory drug treatment. Four months later, he again reported having shoulder pain, especially while playing tennis or lifting weights, and he noticed warm swelling in the area of the AC joint. He denied having fever, chills, or constitutional symptoms.There had been no peripheral intravenous lines, indwelling catheters, or other skin invasion near the AC joint.In August 1988, a bronchoscopy and gallium scan were performed to evaluate a persistent, productive cough. There was increased uptake of the gallium tracer in the distal end of the right clavicle and in the acromion, suggestive of osteomyelitis. He was referred to the rheumatology service. On physical examination, the vital signs were normal, and there was no evidence of skin rash, heart murmur, or systemic illness. The lungs were clear to auscultation. Musculoskeletal examination results were remarkable only for warm, tender swelling anterior to the AC joint. There was normal range of motion of the shoulder, but adduction across the chest produced pain in the anterior shoulder region.Laboratory evaluation revealed a white blood cell count of 6,400/mm3 (12.2% lymphocytes, 9.4% monocytes, 78% granulocytes), a hemoglobin level of 13.8 gm/dl, and a hematocrit value of 39.5%. Attempted aspiration of the right AC joint yielded < 1 cc

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Osteomyelitis presenting as a swollen elbow in a patient with the acquired immune deficiency syndrome.

Cited by 9 publications

References 3 publications

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

Osteoarticular infection in intravenous drug abusers: influence of HIV infection and differences with non drug abusers.

Reactive arthritis May develop in patients with HIV infection

Septic acromioclavicular arthritis and osteomyelitis in a patient with acquired immunodeficiency syndrome

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