Gonococcal osteomyelitis

Article Abstract:

Gonorrhea, the most common sexually transmitted disease, is characterized by fever, rash, inflammation of the tendon sheath (tenosynovitis), and arthritis, often affecting the knee. Arthritis caused by gonorrhea could be as mild as painful joints (arthralgia) or as severe as purulent (pus-forming) arthritis and osteomyelitis (bone or bone marrow infection). Before the era of antibiotics, arthritis occurred in about 85 percent of patients with gonorrhea, but since then there have been only 10 cases of gonococcal osteomyelitis of which the authors are aware. This is a report on the eleventh case of gonococcal osteomyelitis, which is similar to the other 10. The median age of the 10 patients was 25 years, and seven of the patients were women. The small joints of the hands and feet were most often affected, and in only one case was a large joint, the hip, involved. Unlike gonococcal arthritis or disseminated infection, where other symptoms are apparent, osteomyelitis causes only joint pain and no other symptoms of gonorrhea are present. In these cases, diagnosis took from two to eight weeks, and was finally made by bone or joint fluid culture or positive culture from the throat or genitourinary tract. All the patients were treated with intravenous (or intravenous followed by oral) antibiotics. Pain in the joints of the fingers or toes lasting longer than three weeks with no systemic symptoms is the classic presentation of gonococcal osteomyelitis. Of the eight patients whose outcome is known, four recovered completely, and four had lasting limitation of motion. Only one of the strains of gonorrhea was resistant to antibiotics, but it is expected that more will be resistant in future. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Complications and side effects, Gonorrhea

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Pyogenic, tuberculous, and brucellar vertebral osteomyelitis: a descriptive and comparative study of 219 cases

Article Abstract:

Vertebral osteomyelitis (VO) is a serious infectious inflammation of the spine, with variable clinical progressions depending on the causative organism. Researchers in Spain studied 219 patients with pyogenic (PVO), tuberculous (TVO), or brucellar (BVO) vertebral osteomyelitis. Diabetes, immunosuppression, and recent back surgery were more common in those with PVO. Prolonged disease, spinal deformity and neurological deficits were associated with TVO. Patients with BVO had the best prognosis. Clinical features may indicate the likely organism and may guide treatment.

Analysis, Infection, Vertebrae

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