Pneumococcal septic arthritis of the knee in a patient with multiple myeloma

Article Abstract:

Multiple myeloma is a progressive and usually fatal illness, characterized by the development of multiple tumor masses of bone and bone marrow. Patients suffering from this disease have been reported to be particularly susceptible to infections with the bacteria Streptococcus pneumoniae. Most S. pneumoniae infections involve the meninges (lining of the brain and spinal cord) or the respiratory tract. More recent studies have indicated that other types of bacteria, such as Escherichia coli, are more likely to cause infection in these patients. The leading cause of death in 50 percent of patients with multiple myeloma is infection; poor immune function may play a role in this apparent increased susceptibility to infection. Septic arthritis (joint infection) caused by S. pneumoniae is very unusual, in fact, since 1966 only one such case has been reported in a patient with multiple myeloma. A detailed case report describes a 69-year-old man with multiple myeloma, who developed pneumococcal septic arthritis of the knee following a fall. He was admitted to the hospital with fever and flu-like symptoms two days after falling on his thigh. Two days later he complained of knee pain and pus was withdrawn from the joint. After 6.5 weeks of antibiotic treatment, he was discharged. Previous knee surgery (because of infection with a different bacteria), the fall and poor immune function associated with multiple myeloma increased his risk of pneumococcal arthritis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Joints, Infection, Joints (Anatomy), Streptococcal infections, Risk factors, Arthritis, Infectious, Infectious arthritis, Streptococcus pneumoniae, Multiple myeloma

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Malassezia furfur fungemia associated with central venous catheter lipid emulsion infusion

Article Abstract:

Malassezia furfur is a fungus that causes tinea versicolor, a skin infection characterized by itchy tan or white patches on the body, arms, neck, abdomen, thighs and genitalia. It is commonly found on the skin of infants in neonatal intensive care, often without any symptoms of disease. M. furfur requires a supply of fats for growth, and therefore finds a congenial environment in catheters used for long-term intravenous fat emulsion. It can cause lung infections in infants receiving therapy, resulting in breathing stoppage, slowed heartbeat, low-grade fever, and bleeding problems. Forty such cases have been reported. A case of M. furfur fungemia in a premature infant who became ill after receiving fat emulsion therapy for 33 days is described. In this case, once the fat emulsion was stopped, the infant improved, although the catheter was left in place. Antibiotic therapy was given, and the infant's temperature returned to normal the next day. Other researchers tested the catheters from 25 newborn infants, and found that eight of them were contaminated with M. furfur, although only one infant showed signs of illness caused by the fungus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Parenteral feeding, Parenteral nutrition, Intravenous catheterization, Mycoses

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Haemophilus parainfluenzae bacteremia associated with a pacemaker wire localized by gallium scan

Article Abstract:

Infections involving permanent pacemakers occur in about 5 percent of patients with pacemakers. Treatment usually includes antibiotic therapy, and removal of the pacemaker and its stimulating wire. A case history of infection of this wire that was treated only by antibiotics is reported. A college student had been given a permanent pacemaker six months previously. Two weeks before developing fever and chills, her dental braces had been cleaned, but no prophylactic antibiotics had been given. The patient was treated with cefotaxime intravenously, and a gallium scan showed an inflammation of the pacemaker wire. After the fever subsided, and the patient was discharged with oral antibiotics. The case suggests that the wire was probably seeded with bacteria during the dental work. Haemophilus parainfluenzae, the bacteria that caused the infection, is commonly found in the mouth or upper respiratory tract. (Consumer Summary produced by Reliance Medical Information, Inc.)

Pacemaker, Artificial (Heart), Pacemakers, Bacteremia, Hemophilus influenzae, Haemophilus influenzae

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