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1

Sousa, Ricardo, André Carvalho, Ana Cláudia Santos, and Miguel Araújo Abreu. "Optimal microbiological sampling for the diagnosis of osteoarticular infection." EFORT Open Reviews 6, no. 6 (June 2021): 390–98. http://dx.doi.org/10.1302/2058-5241.6.210011.

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Infection is a dire complication afflicting every field of orthopaedics and traumatology. If specific clinical, laboratory and imaging parameters are present, infection is often assumed even in the absence of microbiological confirmation. However, apart from confirming infection, knowing the exact infecting pathogen(s) and their antimicrobial susceptibility patterns is paramount to help guide treatment. Every effort should therefore be undertaken with that goal in mind. Not all microbiological findings carry the same relevance, and knowing exactly how and where a sample was collected is key. Several different sampling techniques are available, and one must be aware of both advantages and limitations. Microbiological sampling alternatives in some of the most common clinical scenarios such as native and prosthetic joint infections, osteomyelitis and fracture-related infections, spinal and diabetic foot infections will be discussed. Orthopaedic surgeons should also be aware of basic laboratory sample processing techniques as they have a direct impact on the way specimens should be dealt with and transported to the laboratory. Only by knowing these basic principles will surgeons be able to participate in the multidisciplinary discussion and decision making around how to interpret microbiological findings in each specific patient. Cite this article: EFORT Open Rev 2021;6:390-398. DOI: 10.1302/2058-5241.6.210011
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Valladares Díaz, Carlos Diego, Erika Lucía Pilco Guerra, and Mary Isabel Ttito Condori. "Reporte de caso de tuberculosis osteoarticular: dificultad diagnóstica y probable infección primaria." Horizonte Médico (Lima) 17, no. 1 (May 31, 2017): 76–80. http://dx.doi.org/10.24265/horizmed.2017.v17n1.13.

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3

Narasimhan, Ramani. "Pediatric Osteoarticular Infections." Indian Journal of Orthopaedics 47, no. 3 (June 2013): 321. http://dx.doi.org/10.1007/bf03545545.

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4

Shah, Aditya S., Prakhar Vijayvargiya, Sarah Jung, and John W. Wilson. "Postoperative Hardware-Related Infection from Kytococcus schroeteri: Its Association with Prosthetic Material and Hematological Malignancies—A Report of a Case and Review of Existing Literature." Case Reports in Infectious Diseases 2019 (March 24, 2019): 1–4. http://dx.doi.org/10.1155/2019/6936472.

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Introduction. Kytococcus schroeteri is an infrequently isolated Gram-positive coccus often encountered as a commensal bacterium. Only eighteen cases of human infection associated with this organism have been previously reported. Most of these cases involved patients with implanted prosthetic materials or patients with immunosuppressive conditions. It has been described in prosthetic valve endocarditis and in select patients with hematologic diseases but only one prior report as being involved in osteoarticular infections. Case Presentation. We describe a case of postsurgical osteoarticular hardware-related infection by K. schroeteri and discuss a possible association with implanted prosthetic material. Conclusion. Other clinical presentations of K. schroeteri, including reported infection syndromes, antimicrobial susceptibility profiles, and treatment outcomes, are also reviewed.
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Coulin, Benoit, Giacomo Demarco, Vanessa Spyropoulou, Celine Juchler, Tanguy Vendeuvre, Céline Habre, Anne Tabard-Fougère, Romain Dayer, Christina Steiger, and Dimitri Ceroni. "Osteoarticular infection in children." Bone & Joint Journal 103-B, no. 3 (March 1, 2021): 578–83. http://dx.doi.org/10.1302/0301-620x.103b3.bjj-2020-0936.r2.

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Aims We aimed to describe the epidemiological, biological, and bacteriological characteristics of osteoarticular infections (OAIs) caused by Kingella kingae. Methods The medical charts of all children presenting with OAIs to our institution over a 13-year period (January 2007 to December 2019) were reviewed. Among these patients, we extracted those which presented an OAI caused by K. kingae and their epidemiological data, biological results, and bacteriological aetiologies were assessed. Results K. kingae was the main reported microorganism in our paediatric population, being responsible for 48.7% of OAIs confirmed bacteriologically. K. kingae affects primarily children aged between six months and 48 months. The highest prevalence of OAI caused by K. kingae was between seven months and 24 months old. After the patients were 27 months old, its incidence decreased significantly. The incidence though of infection throughout the year showed no significant differences. Three-quarters of patients with an OAI caused by K. kingae were afebrile at hospital admission, 11% had elevated WBCs, and 61.2% had abnormal CRPs, whereas the ESR was increased in 75%, constituting the most significant predictor of an OAI. On MRI, we noted 53% of arthritis affecting mostly the knee and 31% of osteomyelitis located primarily in the foot. Conclusion K. kingae should be recognized currently as the primary pathogen causing OAI in children younger than 48 months old. Diagnosis of an OAI caused by K. kingae is not always obvious, since this infection may occur with a mild-to-moderate clinical and biological inflammatory response. Extensive use of nucleic acid amplification assays improved the detection of fastidious pathogens and has increased the observed incidence of OAI, especially in children aged between six months and 48 months. We propose the incorporation of polymerase chain reaction assays into modern diagnostic algorithms for OAIs to better identify the bacteriological aetiology of OAIs. Cite this article: Bone Joint J 2021;103-B(3):578–583.
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Sunagawa, Hideyuki, Fuminori Kanaya, Chojo Futenma, Kunio Ibaraki, and Jun Asato. "Atypical Mycobacterial Osteoarticular Infection." Orthopedics & Traumatology 49, no. 4 (2000): 1011–14. http://dx.doi.org/10.5035/nishiseisai.49.1011.

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7

Montgomery, Nicole I., and Scott Rosenfeld. "Pediatric Osteoarticular Infection Update." Journal of Pediatric Orthopaedics 35, no. 1 (January 2015): 74–81. http://dx.doi.org/10.1097/bpo.0000000000000237.

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8

Oliveira Guilarde, Adriana, Ricardo Vieira Teles Filho, Daniella Da Mata Padilha, Aderrone Vieira Mendes, Kely Tiemi Matsunaga, André Kipnis, and Ariana Rocha Romão Godoi. "YOKENELLA REGENSBURGEI osteoarticular infection: a case report." Revista de Patologia Tropical / Journal of Tropical Pathology 50, no. 4 (December 22, 2021): 337–41. http://dx.doi.org/10.5216/rpt.v50i4.69205.

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Yokenella regensburgei belongs to the family Enterobacteriaceae and is an opportunistic agent rarely associated with infections in humans. We report a case of osteoarticular knee infection caused by Y. regensburgei in a patient under treatment for rheumatoid arthritis, using corticosteroids, with complication in primary total arthroplasty of the knee. Y. regensburgei was identified using the VITEK2 system. Antimicrobial susceptibility testing was performed using the disk-diffusion method, according to the guidelines from the Clinical and Laboratory Standards Institute. The patient presented favorable clinical evolution after the second debridement, with complete removal of the prosthesis and antibiotic therapy with sulfamethoxazole/trimethoprim. This is the first case of Y. regensburgei infection described d in Brazil. KEY WORDS: Yokenella regensburgei; osteoarticular; infection; sulfamethoxazole; trimethoprim; prosthesis.
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De Nicolò, Amedeo, Giacomo Stroffolini, Miriam Antonucci, Jacopo Mula, Elisa Delia De Vivo, Jessica Cusato, Alice Palermiti, et al. "Long-Term Pharmacokinetics of Dalbavancin in ABSSSI and Osteoarticular Settings: A Real-Life Outpatient Context." Biomedicines 9, no. 10 (September 22, 2021): 1288. http://dx.doi.org/10.3390/biomedicines9101288.

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Dalbavancin is a lipoglycopeptide approved for treatment of Gram-positive infections of skin and skin-associated structures (ABSSSI). Currently, off-label use at high dosages for osteoarticular infections deserves attention. This work aimed to study the long-term plasma pharmacokinetics of dalbavancin in outpatients with ABSSSI or osteoarticular infections, treated either with one or two 1500 mg doses of dalbavancin. A liquid chromatography-tandem mass spectrometry method was used to measure total dalbavancin concentrations in plasma samples. The results were analyzed through a non-compartmental analysis (NCA). Breakpoint minimum inhibitory concentration (MIC) was used to calculate AUC/MIC and T > MIC parameters, adjusted by 93% protein binding. A total of 14 patients were enrolled, 11 with osteoarticular infection and 3 with ABSSSI. Long-term pharmacokinetics showed median T > MIC (0.125 mg/L) of 11.9 and 13.7 weeks for single and dual dose, respectively. Similarly, median AUC0-2w/MIC ratios of 20,590 and 31,366 were observed for single and dual dose regimens, respectively. No adverse events were observed, and treatment success was achieved in 12/14 patients. Failure was associated with the worst clinical conditions, bone infections, and single dose. The results of this study show that dalbavancin exposure exceeds previously suggested pharmacodynamic targets. Optimization of these targets is needed for the osteoarticular setting.
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DeMarco, Giacomo, Moez Chargui, Benoit Coulin, Benoit Borner, Christina Steiger, Romain Dayer, and Dimitri Ceroni. "Kingella kingae Osteoarticular Infections Approached through the Prism of the Pediatric Orthopedist." Microorganisms 10, no. 1 (December 24, 2021): 25. http://dx.doi.org/10.3390/microorganisms10010025.

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Nowadays, Kingella kingae (K. kingae) is considered as the main bacterial cause of osteoarticular infections (OAI) in children aged less than 48 months. Next to classical acute hematogenous osteomyelitis and septic arthritis, invasive K. kingae infections can also give rise to atypical osteoarticular infections, such as cellulitis, pyomyositis, bursitis, or tendon sheath infections. Clinically, K. kingae OAI are usually characterized by a mild clinical presentation and by a modest biologic inflammatory response to infection. Most of the time, children with skeletal system infections due to K. kingae would not require invasive surgical procedures, except maybe for excluding pyogenic germs’ implication. In addition, K. kingae’s OAI respond well even to short antibiotics treatments, and, therefore, the management of these infections requires only short hospitalization, and most of the patients can then be treated safely as outpatients.
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Benavent, Eva, Laura Morata, Francesc Escrihuela-Vidal, Esteban Alberto Reynaga, Laura Soldevila, Laia Albiach, Maria Luisa Pedro-Botet, Ariadna Padullés, Alex Soriano, and Oscar Murillo. "Long-Term Use of Tedizolid in Osteoarticular Infections: Benefits among Oxazolidinone Drugs." Antibiotics 10, no. 1 (January 8, 2021): 53. http://dx.doi.org/10.3390/antibiotics10010053.

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Background: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. Methods: Multicentric retrospective study (January 2017–March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. Results: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15–44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. Conclusions: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.
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Benavent, Eva, Laura Morata, Francesc Escrihuela-Vidal, Esteban Alberto Reynaga, Laura Soldevila, Laia Albiach, Maria Luisa Pedro-Botet, Ariadna Padullés, Alex Soriano, and Oscar Murillo. "Long-Term Use of Tedizolid in Osteoarticular Infections: Benefits among Oxazolidinone Drugs." Antibiotics 10, no. 1 (January 8, 2021): 53. http://dx.doi.org/10.3390/antibiotics10010053.

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Background: To evaluate the efficacy and safety of long-term use of tedizolid in osteoarticular infections. Methods: Multicentric retrospective study (January 2017–March 2019) of osteoarticular infection cases treated with tedizolid. Failure: clinical worsening despite antibiotic treatment or the need of suppressive treatment. Results: Cases (n = 51; 59% women, mean age of 65 years) included osteoarthritis (n = 27, 53%), prosthetic joint infection (n = 17, 33.3%), and diabetic foot infections (n = 9, 18%); where, 59% were orthopedic device-related. Most frequent isolates were Staphylococcus spp. (65%, n = 47; S. aureus, 48%). Reasons for choosing tedizolid were potential drug-drug interaction (63%) and cytopenia (55%); median treatment duration was 29 days (interquartile range -IQR- 15–44), 24% received rifampicin (600 mg once daily) concomitantly, and adverse events were scarce (n = 3). Hemoglobin and platelet count stayed stable throughout treatment (from 108.6 g/L to 116.3 g/L, p = 0.079; and 240 × 109/L to 239 × 109/L, p = 0.942, respectively), also in the subgroup of cases with cytopenia. Among device-related infections, 33% were managed with implant retention. Median follow-up was 630 days and overall cure rate 83%; among failures (n = 8), 63% were device-related infections. Conclusions: Long-term use of tedizolid was effective, showing a better safety profile with less myelotoxicity and lower drug-drug interaction than linezolid. Confirmation of these advantages could make tedizolid the oxazolidinone of choice for most of osteoarticular infections.
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13

Thapa, Surya Bahadur. "Delayed recognition of acase of osteoaritcularinfection of left humerus and ipsilateral shoulder joint." Journal of Patan Academy of Health Sciences 5, no. 2 (December 30, 2018): 66–69. http://dx.doi.org/10.3126/jpahs.v5i2.24014.

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Osteoarticular infection of humerus and shoulder joint are uncommon. Prompt diagnosis and management of acute osteoarticular infection with early antibiotic and sometimes surgery is required to prevent chronic osteomyelitis and sequalae of septic arthritis. This case illustrates how a treatable case of acute osteoarticular infection was missed and progressed to chronic osteomyelitis. The aim of reporting this case is to present a rare site of osteoarticular infection of humerus and shoulder joint was complicated due to failure in recognition and management
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14

Sy, Alexander M., Jagbir Sandhu, and Theodore Lenox. "Salmonella entericaSerotype Choleraesuis Infection of the Knee and Femur in a Nonbacteremic Diabetic Patient." Case Reports in Infectious Diseases 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/506157.

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Osteoarticular infections caused bySalmonellaare rare. The rates of osteomyelitis and septic arthritis due toSalmonellaare estimated to be less than 1% and 0.1%-0.2%, respectively (Kato et al., 2012).Salmonella entericaserotype Choleraesuis is anontyphoidal Salmonella, highly pathogenic in humans, usually causing septicemic disease with little or no intestinal involvement. Serotype Choleraesuis accounts for a small percentage of published studies ofSalmonellainfections in the United States. It is not commonly reported in joint fluid and bones in contrast to serotype Enteritidis and Typhi, where a considerable number of cases have been published. Chen et al. in Taiwan found that 21% of bacteremic patients with this infection subsequently develop focal infections such as septic arthritis, pneumonia, peritonitis, and cutaneous abscess (Chen et al., 1999, Chiu et al., 2004). In contrast, our patient presented with localized osteoarticular infection withSalmonella enterica serotype Cholerasuis, but without evidence of bacteremia.
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Darraj, Majid. "Delayed Presentation of Shoulder Tuberculosis." Case Reports in Infectious Diseases 2018 (September 24, 2018): 1–4. http://dx.doi.org/10.1155/2018/8591075.

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Infections caused by Mycobacterium tuberculosis (MTb) have a global distribution, with infections occurring most frequently in persons residing in or who have resided in developing nations. Pulmonary tuberculosis (Tb) is the most common form of infection caused by MTb. Osteoarticular Tb is a far less common condition than pulmonary Tb and is frequently overlooked in the differential diagnosis of persons with joint pathology. Osteoarticular Tb infections are far less common than pulmonary Tb and are usually not considered in the differential diagnosis. We describe a case of a 57-year-old immigrant African male who presented with 5 years of right shoulder pain and a restricted range of movement. Magnetic resonance imaging (MRI) concluded right shoulder septic arthritis, for which he underwent operative drainage and debridement was undertaken. The thick purulent joint fluid subsequently yielded MTb, establishing the diagnosis of osteoarticular Tb. We conclude that Tb should be suspected in cases of long-standing joint pain and stiffness, particularly in persons from endemic areas with Tb as well as patients with a previous history of Tb exposure.
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Alhinai, Zaid, Morvarid Elahi, Bill Foo, Brian Lee, Kimberle C. Chapin, Penelope H. Dennehy, Michael Koster, Pablo J. Sanchez, and Ian C. Michelow. "The Spectrum of Pediatric Osteoarticular Infections: A Comparative Study." Open Forum Infectious Diseases 4, suppl_1 (2017): S91. http://dx.doi.org/10.1093/ofid/ofx163.055.

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Abstract Background There is a paucity of data relating to pediatric subacute or chronic hematogenous osteomyelitis (SCHO), non-hematogenous osteoarticular infections (NHO), and osteoarticular hardware infections (HI). A comparative analysis of the entire spectrum of pediatric osteoarticular infections was conducted to identify distinguishing clinical features and biological markers. Methods Using ICD9/10 code searches, we identified pediatric patients ≤18 years of age at Hasbro Children’s Hospital (2006–2016) and Nationwide Children’s Hospital (2015–2016) with osteoarticular infections. Cases of Lyme arthritis or ENT-related infections were excluded. Eligibility criteria were confirmed by reviewing medical records and clinical and laboratory data were collected systematically. Results 428 children met inclusion criteria: 211 (49%) had acute hematogenous osteomyelitis (AHO), 61 (14%) suppurative arthritis (SA), 42 (10%) SCHO, 60 (14%) NHO, and 54 (13%) HI. The age distribution differed significantly across the five infection types: AHO (median, 9.2 years), SA (5.0), SCHO (10.2), NHO (11.5), and HI (14.5); P < 0.001. Median initial CRP values were significantly higher (P < 0.001) in AHO (65 mg/dl) and SA (44) compared with SCHO (15), NHO (15) and HI (24). An ESR >19 mm/hours at presentation was more sensitive than a CRP >8.0 mg/dl in identifying SCHO (80% vs. 64%; P = 0.035). Bacteremia occurred more frequently in AHO (42%) and SA (25%) compared with SCHO (7%), NHOI (5%) and OHI (4%); P < 0.001. Patients with HI had significantly more complications as reflected by more ICU admissions (33% vs. ≤3% for other groups), and longer antibiotic treatment durations (median, 65 vs. ≤37 days for other groups); P < 0.001 for each comparison. S. aureus was the most common organism isolated for all infections, but the proportion of other Gram- and Gram-negative pathogens was significantly higher in SCHO, NHO, and HI compared with AHO and SA (P < 0.001). The ratio of MSSA to MRSA among isolates was 3:1, and did not differ significantly across the infection types. Conclusion SCHO, NHO, and HI commonly present with minimal evidence of inflammation, and differ in the spectrum of causative pathogens compared with AHO and SA. Further studies are required to optimize the diagnosis and management of non-acute, non-hematogenous osteoarticular infections. Disclosures All authors: No reported disclosures.
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Alvares, Paula Andrade, and Marcelo Jenné Mimica. "Osteoarticular infections in pediatrics." Jornal de Pediatria 96 (March 2020): 58–64. http://dx.doi.org/10.1016/j.jped.2019.10.005.

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Alvares, Paula Andrade, and Marcelo Jenné Mimica. "Osteoarticular infections in pediatrics." Jornal de Pediatria (Versão em Português) 96 (March 2020): 58–64. http://dx.doi.org/10.1016/j.jpedp.2019.10.005.

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19

Rajapakse, Chula N. A. "Bacterial infections: osteoarticular brucellosis." Baillière's Clinical Rheumatology 9, no. 1 (February 1995): 161–77. http://dx.doi.org/10.1016/s0950-3579(05)80153-0.

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20

Rammaert, B., M. N. Gamaletsou, V. Zeller, C. Elie, R. Prinapori, S. J. Taj-Aldeen, E. Roilides, et al. "Dimorphic fungal osteoarticular infections." European Journal of Clinical Microbiology & Infectious Diseases 33, no. 12 (June 18, 2014): 2131–40. http://dx.doi.org/10.1007/s10096-014-2149-0.

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21

Arnold, John C., and John S. Bradley. "Osteoarticular Infections in Children." Infectious Disease Clinics of North America 29, no. 3 (September 2015): 557–74. http://dx.doi.org/10.1016/j.idc.2015.05.012.

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22

Houzou, Prénam, Kodjo Kakpovi, Eyram Fianyo, Viwalé Etonam S. Koffi-Tessio, Komi Cyrille Tagbor, Dadja Essoya Landoh, Owonayo Oniankitan, and Moustafa Mijiyawa. "Profil Des Infections Ostéoarticulaires En Consultation Rhumatologique Au CHU- Kara (Togo)." European Scientific Journal, ESJ 13, no. 27 (September 30, 2017): 251. http://dx.doi.org/10.19044/esj.2017.v13n27p251.

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Introduction: Osteoarticular infections remain public health problems in Africa. We aim at determining the clinical forms, topographic and etiological osteoarticular infections in a rheumatology unit of northern Togo. Methods: We conducted a cross-sectional study from April 2012 to March 2015 on inpatient records having suffered from musculoskeletal infection. Results: Of the 1813 patients admitted to the department in three years, 86 (4.74%) suffered from musculoskeletal infection. Of them, 36 (41.86%) were men and 50 (58.1% 4) were women, with a sex ratio (M/F) of 0.72. The mean age of the patients was 45 years. The mean duration of disease progression was 3.5 months. The different clinical forms observed were: spondylitis (47 patients, 54.65%), infectious arthritis (31 cases, 36.05%) and osteomyelitis (eight cases; 9.30%). The infection was likely tuberculous in 53 patients (61.63%), including 44 cases of Pott's disease. A banal germ was mentioned in the 33 others patients (38.37%). In four cases, the germ was isolated: Staphylococcus aureus (three cases) and Staphylococcus epidermidis (one case). The joints most affected by the infection were the hip (nine patients) and the knee (eight patients). Infection was multifocal in 14 cases (16.27%). The main risk factors for the infection identified were: promiscuity and poor hygiene (59.30%), alcoholism (26.74%) and retroviral infection (12.79%). Conclusion: This study and joint infections are a common reason for rheumatology consultation in northern Togo with a significant share of multifocal forms.
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Vlahakis, Nicholas E., Zelalem Temesgen, Elie F. Berbari, and James M. Steckelberg. "Osteoarticular Infection Complicating Enterococcal Endocarditis." Mayo Clinic Proceedings 78, no. 5 (May 2003): 623–28. http://dx.doi.org/10.4065/78.5.623.

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24

Davies, E. G., and F. Monsell. "Managing osteoarticular infection in children." Current Paediatrics 10, no. 1 (March 2000): 42–48. http://dx.doi.org/10.1054/cupe.1999.0066.

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Ilharreborde, B. "Sequelae of pediatric osteoarticular infection." Orthopaedics & Traumatology: Surgery & Research 101, no. 1 (February 2015): S129—S137. http://dx.doi.org/10.1016/j.otsr.2014.07.029.

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26

Nade, Sydney. "Acute osteoarticular infection in childhood." Current Orthopaedics 8, no. 4 (October 1994): 213–19. http://dx.doi.org/10.1016/0268-0890(94)90021-3.

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Mohamad, Morad, Christina Steiger, Vasiliki Spyropoulou, Benoit Coulin, Tanguy Vendeuvre, Céline Habre, Amira Dhouib, Giacomo De Marco, Romain Dayer, and Dimitri Ceroni. "Clinical, biological and bacteriological characteristics of osteoarticular infections in infants less than 12 months of age." Future Microbiology 16, no. 6 (April 2021): 389–97. http://dx.doi.org/10.2217/fmb-2020-0070.

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Aim: This retrospective study’s objective was to evaluate osteoarticular infection in infants less than 12 months of age, with a particular focus on biological features and bacteriological etiology. Material & methods: We retrospectively reviewed the medical records of every infant younger than 12 months old admitted in our institution for a suspected osteoarticular infection between January 1980 and December 2016. Results: Sixty-nine patients records were reviewed, including eight neonates, 16 infants from 1 to 5 months old, and 45 from 6 to 12 months old. Conclusion: Neonates and infants aged from 6 to 12 months old were more exposed to infections. Staphylococcus aureus remained the main pathogen in children <6 months, whereas Kingella kingae has become the most frequently isolated microorganism in infants aged from 6 to 12 months old.
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JAÑA NETO, FREDERICO CARLOS, CAROLINE SARTORI ORTEGA, and ELLEN DE OLIVEIRA GOIANO. "EPIDEMIOLOGICAL STUDY OF OSTEOARTICULAR INFECTIONS IN CHILDREN." Acta Ortopédica Brasileira 26, no. 3 (June 2018): 201–5. http://dx.doi.org/10.1590/1413-785220182603145650.

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ABSTRACT Objective To analyze the characteristics of patients diagnosed with pediatric osteoarticular infections treated in a level III trauma center in São Paulo, Brazil. Methods We retrospectively analyzed patients admitted between September 2012 and August 2014. The outcomes analyzed were: age, sex, diagnosis, etiologic agent, anatomic location, time to diagnosis, history of previous trauma and infection, laboratory tests, treatment, and complications. Results Twenty patients were included, 50% with septic arthritis, 35% with osteomyelitis, and 15% with both. Boys were predominant (80%), and the mean age was 6.6 years. The most common etiologic agent was Staphylococcus aureus. C-reactive protein value and erythrocyte sedimentation rate were elevated. The infections were treated with antibiotic therapy (intravenous and oral) and oxacillin was most frequently used. Most patients underwent at least one surgical procedure, and 35% of patients had complications. Conclusion This epidemiological mapping identified clinical and demographic characteristics which are useful for improving preparation for care. Future prospective studies with longer patient follow-up and the development of treatment protocols are needed to improve therapeutic decision-making and the prognosis of children with suspected osteoarticular infections. Evidence Level II; Prognostic studies - Investigation of the effect of patient characteristics on the outcome of the disease.
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Dehority, Walter, Valerie J. Morley, Daryl B. Domman, Seth M. Daly, Kathleen D. Triplett, Kylie Disch, Rebekkah Varjabedian, et al. "Genomic characterization of Staphylococcus aureus isolates causing osteoarticular infections in otherwise healthy children." PLOS ONE 17, no. 8 (August 29, 2022): e0272425. http://dx.doi.org/10.1371/journal.pone.0272425.

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Background Pediatric osteoarticular infections are commonly caused by Staphylococcus aureus. The contribution of S. aureus genomic variability to pathogenesis of these infections is poorly described. Methods We prospectively enrolled 47 children over 3 1/2 years from whom S. aureus was isolated on culture—12 uninfected with skin colonization, 16 with skin abscesses, 19 with osteoarticular infections (four with septic arthritis, three with acute osteomyelitis, six with acute osteomyelitis and septic arthritis and six with chronic osteomyelitis). Isolates underwent whole genome sequencing, with assessment for 254 virulence genes and any mutations as well as creation of a phylogenetic tree. Finally, isolates were compared for their ability to form static biofilms and compared to the genetic analysis. Results No sequence types predominated amongst osteoarticular infections. Only genes involved in evasion of host immune defenses were more frequently carried by isolates from osteoarticular infections than from skin colonization (p = .02). Virulence gene mutations were only noted in 14 genes (three regulating biofilm formation) when comparing isolates from subjects with osteoarticular infections and those with skin colonization. Biofilm results demonstrated large heterogeneity in the isolates’ capacity to form static biofilms, with healthy control isolates producing more robust biofilm formation. Conclusions S. aureus causing osteoarticular infections are genetically heterogeneous, and more frequently harbor genes involved in immune evasion than less invasive isolates. However, virulence gene carriage overall is similar with infrequent mutations, suggesting that pathogenesis of S. aureus osteoarticular infections may be primarily regulated at transcriptional and/or translational levels.
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Rakhmatillaev, Sh N., N. V. Tursunova, and N. V. Stavitskaya. "The Incidence of Osteoarticular Tuberculosis in the Siberian and Far Eastern Federal Districts in 2018-2020." Tuberculosis and Lung Diseases 100, no. 10 (November 9, 2022): 37–43. http://dx.doi.org/10.21292/2075-1230-2022-100-10-37-43.

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The incidence of osteoarticular tuberculosis in 15 regions of the Siberian and Far Eastern Federal Districts from 2018 to 2020 was assessed. The incidence of osteoarticular tuberculosis and co-infection of osteoarticular tuberculosis with HIV and osteoarticular tuberculosis with hepatitis B/C was analyzed. Variants of osteoarticular tuberculosis with respiratory tuberculosis, variants of tuberculosis sites in the bone articular system and the most typical neurological disorders in those patients were presented.
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Johnson, Royce H., Rupam Sharma, Rasha Kuran, Isabel Fong, and Arash Heidari. "Coccidioidomycosis: a review." Journal of Investigative Medicine 69, no. 2 (January 25, 2021): 316–23. http://dx.doi.org/10.1136/jim-2020-001655.

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Coccidioidomycosis is a fungal infection of the Western hemisphere that is endemic to the soil in areas with limited rainfall. Human and animal infections result with inhalation of arthroconidia. Most often, this is an asymptomatic event. When illness occurs, it is primarily a pneumonic presentation. A small minority of infections eventuate in disseminated disease. Predominately, this presents as meningitis or osteoarticular or integumentary disease. Treatment may not be required for the mildest illness. Azoles are commonly prescribed. Severe infections may require amphotericin B.
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Samara, Eleftheria, Vasiliki Spyropoulou, Anne Tabard-Fougère, Laura Merlini, Raimonda Valaikaite, Amira Dhouib, Sergio Manzano, Céline Juchler, Romain Dayer, and Dimitri Ceroni. "Kingella kingae and Osteoarticular Infections." Pediatrics 144, no. 6 (November 13, 2019): e20191509. http://dx.doi.org/10.1542/peds.2019-1509.

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33

Esteban, Jaime, and José Cordero-Ampuero. "Treatment of prosthetic osteoarticular infections." Expert Opinion on Pharmacotherapy 12, no. 6 (March 15, 2011): 899–912. http://dx.doi.org/10.1517/14656566.2011.543676.

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34

Spencer, Jonathan, Giles Cattermole, Tony Andrade, Matthew Dryden, and John Fowler. "Salmonella Osteoarticular Infection without Predisposing Factors." Journal of the Royal Society of Medicine 92, no. 7 (July 1999): 363–64. http://dx.doi.org/10.1177/014107689909200711.

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35

Houghton, John. "Salmonella osteoarticular infection without predisposing factors." Journal of the Royal Society of Medicine 92, no. 9 (September 1999): 493. http://dx.doi.org/10.1177/014107689909200928.

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36

Raoult, D., G. Bollini, and H. Gallais. "Osteoarticular Infection Due to Coxiella burnetii." Journal of Infectious Diseases 159, no. 6 (June 1, 1989): 1159–60. http://dx.doi.org/10.1093/infdis/159.6.1159.

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37

Mehsen-Cêtre, Nadia, and Charles Cazanave. "Osteoarticular manifestations associated with HIV infection." Joint Bone Spine 84, no. 1 (January 2017): 29–33. http://dx.doi.org/10.1016/j.jbspin.2016.04.004.

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38

Zychowicz, Michael E. "Osteoarticular Manifestations of Mycobacterium Tuberculosis Infection." Orthopaedic Nursing 29, no. 6 (2010): 400–406. http://dx.doi.org/10.1097/nor.0b013e3181fb9a92.

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&NA;. "Osteoarticular Manifestations of Mycobacterium Tuberculosis Infection." Orthopaedic Nursing 29, no. 6 (2010): 404–8. http://dx.doi.org/10.1097/nor.0b013e3181ff00e7.

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40

Arenívar, Carlos, Yhojan Rodríguez, Alfonso J. Rodríguez-Morales, and Juan-Manuel Anaya. "Osteoarticular manifestations of Mayaro virus infection." Current Opinion in Rheumatology 31, no. 5 (September 2019): 512–16. http://dx.doi.org/10.1097/bor.0000000000000635.

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41

Madigan, Theresa, Scott Cunningham, Poornima Ramanan, Micah Bhatti, and Robin Patel. "Real-Time PCR Assay for Detection of Kingella kingae in Children." Journal of Pediatric Infectious Diseases 13, no. 03 (April 11, 2018): 216–23. http://dx.doi.org/10.1055/s-0038-1641603.

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Background Kingella kingae is a known cause of osteoarticular infections in children younger than 4 years of age, but it is not always recoverable in culture. Molecular methods are increasingly used for diagnosis. Methods To facilitate diagnosis of K. kingae septic arthritis, we developed a real-time polymerase chain reaction (PCR) assay for the detection of K. kingae that targets the repeat-in-toxin gene (rtxB). Results We present three pediatric patients with K. kingae septic arthritis at our institution who were diagnosed using the real-time PCR assay. All underwent arthrotomy with irrigation and debridement and were symptom-free after 3 weeks of therapy with β-lactam antibiotics. Cultures of synovial fluid or tissue grew K. kingae in two of three; K. kingae real-time PCR was positive in all three patients. In addition, 11 cases of K. kingae osteoarticular infection were diagnosed through Mayo Medical Laboratories using this assay. The limit of detection of the real-time PCR assay was 73.7 colony-forming unit (CFU)/µL for tissue and 1.3 CFU/µL for synovial fluid. Conclusions PCR-based detection methods are faster and more sensitive than conventional culture-based methods for the diagnosis of K. kingae osteoarticular infections in children.
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Ramírez-Soto, Max Carlos, Andrés Tirado-Sánchez, and Alexandro Bonifaz. "Ocular Sporotrichosis." Journal of Fungi 7, no. 11 (November 10, 2021): 951. http://dx.doi.org/10.3390/jof7110951.

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Sporotrichosis is a subacute or chronic mycosis predominant in tropical and subtropical regions. It is an infection of subcutaneous tissue caused by Sporothrix fungus species, but occasionally resulting in an extracutaneous condition, including osteoarticular, pulmonary, nervous central system, and ocular disease. Cases of ocular sporotrichosis are rare, but reports have been increasing in recent decades. Ocular infections usually occur in hyperendemic areas of sporotrichosis. For its classification, anatomic criteria are used. The clinical presentation is the infection in the ocular adnexal and intraocular infection. Ocular adnexa infections include palpebral, conjunctivitis, and infections of the lacrimal sac. Intraocular infection includes exogenous or endogenous endophthalmitis. Most infections in the ocular adnexal have been reported in Brazil, China and Peru, and intraocular infections are limited to the USA and Brazil. Diagnosis is performed from Sporothrix isolation in the mycological examination from ocular or skin samples. Both sporotrichosis in the ocular adnexa and intraocular infection can mimic several infectious and non-infectious medical conditions. Ocular adnexa infections are treated with potassium iodide and itraconazole. The intraocular infection is treated with amphotericin B. This review describes the clinical findings and epidemiological, diagnosis, and treatment of ocular sporotrichosis.
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Canbolat Ayhan, Aylin, Korhan Ozkan, Cetin Timur, Birol Aktaş, and Ayse Bahar Ceyran. "As a Rare Site of Invasive Fungal Infection, Chronic Granulomatous Aspergillus Synovitis: A Case Report." Mediterranean Journal of Hematology and Infectious Diseases 5, no. 1 (June 6, 2013): e2013043. http://dx.doi.org/10.4084/mjhid.2013.043.

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Aspergillus can causes invasive disease of various organs especially in patients with weakened immune systems. Aspergillus synovitis and arthritis are uncommon types of involvement due to this infection. Approches to fungal osteoarticular infections are based on only case reports. This paper presents a rare case of chronic granulomatous Aspergillus synovitis in an immunocompromised 5-year old girl who was treated for acute lymphoblastic leukemia.
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Pardo-Pol, Albert, Daniel Pérez-Prieto, Albert Alier, Lucas Ilzarbe, Lluïsa Sorlí, Lluis Puig, Santos Martínez-Díaz, and Joan Gómez-Junyent. "Acute Hematogenous Periprosthetic Hip Infection by Gemella morbillorum, Successfully Treated with Debridement, Antibiotics and Implant Retention: A Case Report and Literature Review of Osteoarticular Gemella morbillorum Infections." Tropical Medicine and Infectious Disease 7, no. 8 (August 18, 2022): 191. http://dx.doi.org/10.3390/tropicalmed7080191.

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Gemella morbillorum is a facultative anaerobic, catalase-negative and non-spore forming Gram-positive cocci. It can be found as part of the normal oropharyngeal flora, in the gastrointestinal tract and the female genital tract. However, it can be a causal agent of infections such as endocarditis, meningitis or brain abscesses, and very rarely can cause osteoarticular infections. Herein, a case report of an acute hematogenous prosthetic hip infection caused by Gemella morbillorum, successfully treated with a DAIR and beta-lactam antibiotic therapy, is presented. We provide a literature review of the other orthopedic-related infections caused by this microorganism.
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45

Zueter, AbdelRahman Mohammad, Mahmoud Abumarzouq, Mohd Imran Yusof, Wan Faisham Wan Ismail, and Azian Harun. "Osteoarticular and soft-tissue melioidosis in Malaysia: clinical characteristics and molecular typing of the causative agent." Journal of Infection in Developing Countries 11, no. 01 (January 30, 2017): 28–33. http://dx.doi.org/10.3855/jidc.7612.

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Introduction: Melioidosis involving bone, joints, and soft tissue is rare and reported usually following dissemination of disease from infection elsewhere in the body; to a lesser degree, it can also be reported as the primary manifestation of melioidosis. Methodology: The orthopedic registry at Hospital University Sains Malaysia from 2008 until 2014 was retrospectively reviewed and was followed by molecular typing of Burkholderia pseudomallei. Results: Out of 20 cases identified, 19 patients were confirmed to have osteoarticular and/or soft-tissue melioidosis. The majority of the patients were males (84%), and 16 patients had underlying diabetes mellitus with no significant estimated risk with the disease outcomes. Bacterial genotype was not associated with the disease as a risk. Death was a significant outcome in patients with bacteremic infections (p = 0.044). Conclusion: Patients with lung or skin melioidosis require careful treatment follow-up to minimize the chance for secondary osteoarticular infection. Human risk factors remain the leading predisposing factors for melioidosis. Early laboratory and clinical diagnosis and acute-phase treatment can decrease morbidity and mortality.
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Basmaci, Romain, Philippe Bidet, and Stéphane Bonacorsi. "Kingella kingae and Viral Infections." Microorganisms 10, no. 2 (January 21, 2022): 230. http://dx.doi.org/10.3390/microorganisms10020230.

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Kingella kingae (K. kingae) is an oropharyngeal commensal agent of toddlers and the primary cause of osteoarticular infections in 6–23-month-old children. Knowing that the oropharynx of young children is the reservoir and the portal of entry of K. kingae, these results suggested that a viral infection may promote K. kingae infection. In this narrative review, we report the current knowledge of the concomitance between K. kingae and viral infections. This hypothesis was first suggested because some authors described that symptoms of viral infections were frequently concomitant with K. kingae infection. Second, specific viral syndromes, such as hand, foot and mouth disease or stomatitis, have been described in children experiencing a K. kingae infection. Moreover, some clusters of K. kingae infection occurring in daycare centers were preceded by viral outbreaks. Third, the major viruses identified in patients during K. kingae infection were human rhinovirus or coxsackievirus, which both belong to the Picornaviridae family and are known to facilitate bacterial infections. Finally, a temporal association was observed between human rhinovirus circulation and K. kingae infection. Although highly probable, the role of viral infection in the K. kingae pathophysiology remains unclear and is based on case description or temporal association. Molecular studies are needed.
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Wang, Hongmei, Min Lei, Baoxing Huang, Jikui Deng, Lei Zheng, and Qian Wang. "Osteoarticular Salmonella infections in healthy children." Medicine: Case Reports and Study Protocols 2, no. 12 (December 2021): e0200. http://dx.doi.org/10.1097/md9.0000000000000200.

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48

Chaouch, C., S. Kacem, L. Tilouche, S. Ketata, O. Bouallegue, and N. Boujaafar. "Panton-Valentine leukocidin-positive osteoarticular infections." Médecine et Santé Tropicales 25, no. 2 (April 2015): 184–88. http://dx.doi.org/10.1684/mst.2015.0441.

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Hazelton, Briony J., Matthias W. Axt, and Cheryl A. Jones. "Pasteurella canis Osteoarticular Infections in Childhood." Journal of Pediatric Orthopaedics 33, no. 3 (2013): e34-e38. http://dx.doi.org/10.1097/bpo.0b013e318287ffe6.

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Al-Qwbani, Mohammed, Nan Jiang, and Bin Yu. "Kingella kingae–Associated Pediatric Osteoarticular Infections." Clinical Pediatrics 55, no. 14 (September 30, 2016): 1328–37. http://dx.doi.org/10.1177/0009922816629620.

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