Aspergillus septic arthritis is a rare and serious medical and surgical problem. It occurs mainly in immunocompromised patients. Aspergillus fumigatus is the most common causative organism followed by Aspergillus flavus. The most common site affected is knee followed by shoulder, ankle, wrist, hip and sacroiliac joint. Debridement and voriconazole are primary treatment of articular aspergilosis. To the best of our knowledge, there are no reported cases of co-infection of tuberculosis (TB) and Aspergillus infecting joints. We report a case of co-infection of TB and A. flavus of hip and knee of a 60-year-old male, with type 2 diabetes mellitus. He was treated with debridement, intravenous voriconazole, and antitubercular drugs.
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http://dx.doi.org/10.4103/0019-5413.181783 | DOI Listing |
Ann Rheum Dis
January 2025
Rheumatology Center, Toulouse University Hospital, Toulouse, France.
Objectives: To compare two strategies-a hydrocortisone replacement strategy and a prednisone tapering strategy-for their success in glucocorticoid discontinuation in patients with rheumatoid arthritis (RA) with low disease activity (LDA).
Methods: The Strategies for glucocorticoid TApering in Rheumatoid arthritis (STAR) study was a double- blind, double-placebo randomised controlled trial including patients with RA receiving a stable dose of glucocorticoid 5 mg/day for ≥3 months and were in LDA for ≥3 months. Patients were randomly assigned in a 1:1 ratio to either replace prednisone with 20 mg/day of hydrocortisone for 3 months, then reduce to 10 mg/day for 3 months before discontinuation or to taper prednisone by 1 mg/day every month until complete discontinuation, contingent on maintaining LDA.
Front Immunol
January 2025
Translational Research Unit, National Institute for Infectious Diseases Lazzaro Spallanzani-IRCCS, Rome, Italy.
Background: Subjects with immune-mediated inflammatory diseases (IMID), such as rheumatoid arthritis, with tuberculosis infection (TBI), have a high probability of progressing to tuberculosis disease (TB). We aim to characterize the impact of IMID on the immune response to (Mtb) in patients with TBI and TB disease.
Methods: We enrolled TBI and TB patients with and without IMID.
Autoimmun Rev
January 2025
Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Electronic address:
Tuberculosis (TB), caused by Mycobacterium TB, is the most significant infectious cause of mortality across the globe. While TB disease can prey on immunocompetent individuals, it is more likely to occur in immunocompromised individuals. Immune-mediated inflammatory diseases (IMIDs) are a group of diseases (rheumatoid arthritis, inflammatory bowel disease, ankylosing spondylitis, psoriasis, hidradenitis suppurative, autoimmune blistering diseases, and others) where there may be a need for systemic immunosuppression to control the disease manifestations, treat symptoms and improve long term outcomes.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Orthopedic Surgery, Iwate Medical University, Shiwa-gun, Iwate Prefecture, Japan.
Background: Septic arthritis of the lumbar facet joint (SALFJ) is a rare condition that can lead to serious complications. The authors present an uncommon case in which SALFJ resulted in bacterial meningitis (BM) with hydrocephalus and pyogenic ventriculitis, causing a disturbance of consciousness. Reports describing perforation of the dura mater by an epidural abscess are rare, and the present case offers valuable insights into the management of complex and severe complications arising from SALFJ.
View Article and Find Full Text PDFJ Pediatric Infect Dis Soc
January 2025
Department of Pediatrics, University of Connecticut School of Medicine, Farmington, CT, USA.
Background: Studies of pediatric osteoarticular infections (OAIs) mostly focus on acute hematogenous osteomyelitis (AHO) and acute bacterial arthritis (ABA). A comprehensive descriptive analysis of pediatric OAIs, including subacute, chronic, and non-hematogenous types, is lacking.
Methods: A detailed analysis of all pediatric OAIs was undertaken at two academic centers, Hasbro Children's Hospital, Providence, RI, and Nationwide Children's Hospital, Columbus, OH.
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