Clinic of Hope: bridging infectious disease and orthopaedic surgery in prosthetic joint infection management.

Prosthetic joint infections (PJIs) following total joint arthroplasty are a significant and costly complication. To address fragmented care typically seen with separate management, we established a combined infectious disease and orthopaedic surgery clinic at Duke Health in July 2020. This clinic focuses on patients experiencing acute deterioration or multiple PJI episodes, often at the stage where amputation is the only option offered.

Team Approach: Metal Hypersensitivity in Total Joint Arthroplasty.

»: As total joint arthroplasty volume continues to grow nationwide, more uncommon complications such as metal implant hypersensitivity are reported with greater frequency in the literature.

»: Metal hypersensitivity is a challenging diagnosis given the potentially vague symptomology. It should be considered a diagnosis of exclusion, necessitating careful consideration of other potential etiologies of a failing implant before arriving at the final diagnosis of metal hypersensitivity.

D-Dimer, Erythrocyte Sedimentation Rate, and C-Reactive Protein Sensitivities for Periprosthetic Joint Infection Diagnosis.

Background: There is contradicting evidence on the diagnostic value of inflammatory biomarkers for periprosthetic joint infection (PJI). We sought to quantify the sensitivity of D-dimer for acute and chronic PJI diagnosis and evaluate D-dimer lab values in the 90-day postoperative window in a control cohort of primary joint arthroplasty patients for comparison.

Methods: An institutional database was queried for patients undergoing revision procedures for PJI after total hip arthroplasty (THA) and total knee arthroplasty (TKA) from 2014 to present.

Prosthetic Knee Infection With Coagulase-Negative Staphylococcus: A Harbinger of Poor Outcomes.

Background: Coagulase-negative staphylococci (CoNS) are biofilm-producing pathogens whose role in periprosthetic joint infection (PJI) is increasing. There is little data on the prognosis and treatment considerations in the setting of PJI. We sought to evaluate the clinical characteristics, outcomes, and complications in these patients.

Extirpative Cultures Reveal Infectious Pubic Bone Osteomyelitis in Prostate Cancer Survivors With Urinary-Pubic Symphysis Fistulae (UPF).

Objective: To examine the infectious features of patients with urinary pubic symphysis fistula (UPF) and their association with osteomyelitis.

Methods: We conducted a review of our quality improvement database for 36 patients with UPF undergoing bone resection and extirpative surgery from October 2012 to January 2019. An assessment of bone and urine cultures was carried out along with surgical, radiologic, and demographic data.

2018 international consensus meeting on musculoskeletal infection: Summary from the biofilm workgroup and consensus on biofilm related musculoskeletal infections.

Biofilm-associated implant-related bone and joint infections are clinically important due to the extensive morbidity, cost of care and socioeconomic burden that they cause. Research in the field of biofilms has expanded in the past two decades, however, there is still an immense knowledge gap related to many clinical challenges of these biofilm-associated infections. This subject was assigned to the Biofilm Workgroup during the second International Consensus Meeting on Musculoskeletal Infection held in Philadelphia USA (ICM 2018) (https://icmphilly.

Familial Adenomatous Polyposis Manifesting as Endocarditis: A Case Report and Review of the Association of with Underlying Gastrointestinal Disease.

A 45-year-old male with a prosthetic aortic valve presented to the hospital with several months of generalized malaise. On admission, he was noted to have anemia of unclear etiology and subsequently became febrile with multiple blood cultures growing . Inpatient workup was concerning for infectious endocarditis (IE) secondary to .

Executive Summary: 2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults.

These guidelines are intended for use by infectious disease specialists, orthopedic surgeons, neurosurgeons, radiologists, and other healthcare professionals who care for patients with native vertebral osteomyelitis (NVO). They include evidence and opinion-based recommendations for the diagnosis and management of patients with NVO treated with antimicrobial therapy, with or without surgical intervention.

2015 Infectious Diseases Society of America (IDSA) Clinical Practice Guidelines for the Diagnosis and Treatment of Native Vertebral Osteomyelitis in Adults.

These guidelines are intended for use by infectious disease specialists, orthopedic surgeons, neurosurgeons, radiologists, and other healthcare professionals who care for patients with native vertebral osteomyelitis (NVO). They include evidence and opinion-based recommendations for the diagnosis and management of patients with NVO treated with antimicrobial therapy, with or without surgical intervention.

Pubic symphysis osteomyelitis in the prostate cancer survivor: clinical presentation, evaluation, and management.

Objective: To describe pelvic bone osteomyelitis in the prostate cancer survivor, to report on clinical presentation and treatment, and to suggest an algorithmic approach to managing this syndrome complex.

Materials And Methods: A retrospective chart review from January 2011 to June 2014 was performed to identify prostate cancer patients with pubic symphysis osteomyelitis at a tertiary-care academic medical center with emphasis on genitourinary cancer survivorship. Data on clinical presentation and outcomes were reviewed.

An Infection Control Program for a 2009 influenza A H1N1 outbreak in a university-based summer camp.

Objectives: Describe two 2009-H1N1 influenza outbreaks in university-based summer camps and the implementation of an infection control program.

Participants: 7,906 campers across 73 residential camps from May 21-August 2, 2009.

Methods: Influenza-like-illness (ILI) was defined as fever with cough and/or sore throat.

Clinical presentation and response to treatment of novel influenza A H1N1 in a university-based summer camp population.

Background: Little is known about the clinical presentation and course of novel H1N1 influenza in summer camps.

Objectives: To describe the clinical course and evaluate the effect of influenza treatment in a summer camp population.

Study Design: Two large influenza outbreaks occurred in university-based residential camps between May 21 and August 2, 2009.

Scrub typhus and rickettsial diseases in international travelers: a review.

Physicians caring for febrile returned travelers face the difficult task of recognizing the typical and atypical features of more than 16 known rickettsial diseases and separating these diseases from potentially serious nonrickettsial diseases. Currently available diagnostic tools are inadequate for timely diagnosis. This review summarizes the English-language literature concerning imported rickettsial diseases in international travelers and describes important clinical principles in diagnosis and treatment of these illnesses.