Reactive arthritis

Acute septic arthritis

Acute septic arthritis may develop as a result of hematogenous seeding, direct introduction, or extension from a contiguous focus of infection. The pathogenesis of acute septic arthritis is multifactorial and depends on the interaction of the host immune response and the adherence factors, toxins, and immunoavoidance strategies of the invading pathogen. Neisseria gonorrhoeae and Staphylococcus aureus are used in discussing the host-pathogen interaction in the pathogenesis of acute septic arthritis. While diagnosis rests on isolation of the bacterial species from synovial fluid samples, patient history, clinical presentation, laboratory findings, and imaging studies are also important. Acute nongonococcal septic arthritis is a medical emergency that can lead to significant morbidity and mortality. Therefore, prompt recognition, rapid and aggressive antimicrobial therapy, and surgical treatment are critical to ensuring a good prognosis. Even with prompt diagnosis and treatment, high mortality and morbidity rates still occur. In contrast, gonococcal arthritis is often successfully treated with antimicrobial therapy alone and demonstrates a very low rate of complications and an excellent prognosis for full return of normal joint function. In the case of prosthetic joint infections, the hardware must be eventually removed by a two-stage revision in order to cure the infection.

Exposure to culturable microorganisms in paper mills and presence of symptoms associated with infections

BACKGROUND

Previous studies of paper machine operators have to a large extent focused on endotoxins as a possible health hazard, but not culturable micro-organisms (MOs).

METHODS

Based on exposure assessment in 11 paper mills workers exposed to culturable bio-aerosols were grouped in three exposure groups. 781 exposed and 285 unexposed workers completed a questionnaire that provided data pertaining to infections and associated symptoms.

RESULTS

Concentrations of culturable bacteria in process waters varied in the range 10(4)-10(6) colony forming units (cfu)/ml, and in bio-aerosols concentrations varied typically in the range 10(4)-->10(5) cfu/m3. Operators exposed to bio-aerosols reported higher cumulative incidence of symptoms associated with infections compared to the reference population (ORs = 1.7-5.9), and the group of highest exposed workers reported higher cumulative incidence than the group of lowest exposed (ORs = 1.2-3.6).

CONCLUSION

Exposure to bio-aerosols containing culturable MOs may induce symptoms associated with infections among operators in paper mills.