Abstract:
BACKGROUND:Non-brucellar and non-tuberculous infectious sacroiliitis (ISI) is a rare disease, with misleading clinical signs that delay diagnosis. Most observations are based on isolated case reports or small case series. Our aim was to describe the clinical, bacteriological, and radiological characteristics of ISI, as well as the evolution of these arthritis cases under treatment. METHODS:This retrospective study included all ISI cases diagnosed between 1995 and 2011 in eight French rheumatology departments. ISI was diagnosed if sacroiliitis was confirmed bacteriologically or, in the absence of pathogenic agents, if clinical, biological, and radiological data was compatible with this diagnosis and evolution was favourable under antibiotic therapy. RESULTS:Overall, 39 cases of ISI were identified in adults, comprising 23 women and 16 men, with a mean age at diagnosis of 39.7 ± 18.1 years. The left sacroiliac joint (SI) was affected in 59% of cases, with five cases occurring during the post-partum period. Lumbogluteal pain was the most common symptom (36/39). Manipulations of the SI joint were performed in seven patients and were always painful. Mean score for pain using the visual analogue score was 7.3/10 at admission, while 16 patients were febrile at diagnosis. No risk factor was found for 30.7% of patients. A diagnosis of ISI was only suspected in five cases at admission. The mean time to diagnosis was long, being 43.3 ± 69.1 days on average. Mean C-reactive protein was 149.7 ± 115.3 mg/l, and leukocytosis (leukocytes ≥ 10 G/l) was uncommon (n = 15) (mean level of leukocytes 10.4 ± 3.5 G/l). Radiographs (n = 33) were abnormal in 20 cases, revealing lesions of SI, while an abdominopelvic computed tomography (CT) scan (n = 27) was abnormal in 21 cases, suggesting arthritis of the SI joints in 13 cases (48.1%) and a psoas abscess in eight. Bone scans (n = 14) showed hyperfixation of the SI in 13 cases. Magnetic resonance imaging (MRI) (n = 27), when focused on the SI (n = 25), directed towards the diagnosis to ISI in 25 cases. Pathogenic agents were isolated in 33 cases (84.6%) by means of articular puncture (n = 16), blood culture (n = 14), cytobacteriological examination of urine (n = 2), or puncture of the psoas (n = 1).Gram-positive cocci were the mostly isolated common bacteria, with a predominance of staphylococci (n = 21). The most frequently isolated gram-negative bacillus was Pseudomonas aeruginosa (n = 3). Evolution was favourable in 37 out of 39 patients under prolonged antibiotic therapy (mean duration 3.01 ± 1.21 months). CONCLUSION:Our series confirmed that the clinical manifestations of ISI usually lead to delayed diagnosis. Based on our results, we suggest performing an MRI of the spine and SI in clinical situations characterised by lumbogluteal pain and symptoms of an infectious disease, such as fever.
journal_name
BMC Infect Disjournal_title
BMC infectious diseasesauthors
Hermet M,Minichiello E,Flipo RM,Dubost JJ,Allanore Y,Ziza JM,Gaudin P,Thomas T,Dernis E,Glace B,Regnier A,Soubrier Mdoi
10.1186/1471-2334-12-305subject
Has Abstractpub_date
2012-11-15 00:00:00pages
305issn
1471-2334pii
1471-2334-12-305journal_volume
12pub_type
杂志文章,多中心研究abstract:BACKGROUND:Tuberculosis (TB) is a major global health problem and remains the leading cause of morbidity and mortality in developing countries. Routinely used TB diagnostic methods, in most endemic areas, are time-consuming, often less-sensitive, expensive and inaccessible to most patients. Therefore, there is an urgen...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-016-1864-9
更新日期:2016-09-27 00:00:00
abstract:BACKGROUND:Restricted use of third-generation cephalosporins and fluoroquinolones has been linked to a reduced incidence of hospital-acquired infections with multidrug-resistant bacteria. We implemented an intensified antibiotic stewardship (ABS) programme in the medical service of a university hospital center aiming a...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-14-201
更新日期:2014-04-15 00:00:00
abstract:BACKGROUND:In general, the Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) population has begun to experience the benefits of highly active antiretroviral therapy (HAART); unfortunately, these benefits have not extended equally to Blacks in the United States, possibly due to differences in pa...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-9-127
更新日期:2009-08-11 00:00:00
abstract:BACKGROUND:The low uptake of facility-based HIV counseling and testing (HCT) in South Africa, particularly amongst men and youth has hindered attempts to increase access to effective treatment and prevention strategies. Many barriers to HIV testing have been described including long waiting times, transport to reach fa...
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pub_type: 杂志文章
doi:10.1186/1471-2334-12-73
更新日期:2012-03-29 00:00:00
abstract:BACKGROUND:Data regarding HIV-seronegative pediatric patients with cryptococcal meningitis (CM) have been very limited. METHODS:We retrospectively reviewed non-HIV-infected in patients with CM from January 2002 through December 2013 in Beijing Children's Hospital. Records of the all patients were obtained and compared...
journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/s12879-016-1964-6
更新日期:2016-11-04 00:00:00
abstract:BACKGROUND:one of the World Health Organization Millennium Development Goal is to reduce tuberculosis incidence by 2015. However, more of 8.5 million tuberculosis cases have been reported in 2011, with an increase of multidrug-resistant strains. Therefore, the World Health Organization target cannot be reach without th...
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pub_type: 杂志文章,评审
doi:10.1186/1471-2334-14-S1-S2
更新日期:2014-01-01 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2014-01-13 00:00:00
abstract:BACKGROUND:Hand, foot and mouth disease (HFMD) is a major communicable disease in children ≤6 years old, particularly in several countries in the Asia-Pacific Region, including Thailand. HFMD impacts public health and the economy, especially in northern Thailand. METHODS:A prospective cohort study was conducted to est...
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pub_type: 杂志文章
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更新日期:2018-12-06 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:BMC infectious diseases
pub_type: 杂志文章
doi:10.1186/1471-2334-13-100
更新日期:2013-02-25 00:00:00
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pub_type: 杂志文章
doi:10.1186/s12879-019-4611-1
更新日期:2019-11-20 00:00:00
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pub_type: 杂志文章
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更新日期:2014-11-07 00:00:00
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journal_title:BMC infectious diseases
pub_type: 杂志文章
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更新日期:2012-11-20 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,meta分析
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pub_type: 杂志文章,meta分析,评审
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