amphotericin-b and Joint-Diseases

The objective of this study was to develop a validated, transient, chemically induced lameness model in sows using subjective and objective lameness detection tools. Experiment 1 determined an effective joint injection technique based on volume and placement of dye using feet collected from 9 finisher pigs and 10 multiparity cull sow carcasses. Experiment 2 confirmed the injection technique in live animals and produced a transient clinical lameness in 4 anesthetized sows injected with amphotericin B (15 mg/mL) in the distal interphalangeal joints of the claw. Clinical lameness was assessed by a categorical lameness scoring system, and a postmortem visual confirmation of joint injection technique was obtained. In Exp. 3, 6 sows were injected with 0, 10, or 15 mg/mL amphotericin B in either the left or right hind foot and were monitored until clinical resolution. Treated sows demonstrated elevated clinical lameness scores. These changes resolved by 7 d after lameness induction. Control sows injected with sterile saline developed a clinical lameness score of 0.5, which resolved 72 h post injection. In Exp. 4, 36 sows were injected with 10 mg/mL amphotericin B in 1 of 4 injection sites (left front claws, right front claws, left rear claws, and right rear claws). All injected sows exhibited a decrease in maximum pressure, stance time, and number of sensors activated on the GaitFour (P < 0.05) sensor system. A static force plate also demonstrated a decrease in weight (kg) being placed on the injected foot when all feet were injected (P ≤ 0.05). Injection of amphotericin B induced a predictable acute lameness that resolved spontaneously and is an effective method to model lameness in sows.

Topics: Amphotericin B; Animals; Antifungal Agents; Biomechanical Phenomena; Cadaver; Female; Joint Diseases; Lameness, Animal; Swine; Swine Diseases

We report a case of multiple skin lesions, lymphadenopathy, and osteoarticular sporotrichosis in a man infected with human immunodeficiency virus (HIV). He subsequently died of tuberculosis after successful treatment for osteoarticular sporotrichosis with amphotericin B. We describe the unusual histopathology in disseminated sporotrichosis with acquired immunodeficiency syndrome (AIDS) and compare it with that seen in patients without AIDS. Although the optimal treatment of osteoarticular sporotrichosis in patients with AIDS is unknown, use of amphotericin B in our patient appeared successful. Culture and histologic stains of all tissues taken at autopsy were negative for sporotrichosis. Recent studies of similar cases have shown initial treatment with amphotericin B followed by long-term maintenance with itraconazole to be beneficial.

Topics: Adult; AIDS-Related Opportunistic Infections; Amphotericin B; Antifungal Agents; Biopsy; Bone Diseases, Infectious; Diabetes Complications; Fatal Outcome; Humans; Joint Diseases; Lymphatic Diseases; Male; Sporotrichosis; Substance Abuse, Intravenous; Synovial Fluid; Treatment Outcome; Tuberculosis

Topics: Adult; Amphotericin B; Antifungal Agents; Aspergillosis; Aspergillus fumigatus; Drug Therapy, Combination; Humans; Immunocompromised Host; Joint Diseases; Male; Miconazole; Necrosis

Blastomyces is a pathogen that may infect healthy and immunocompromised hosts. Frequently entering the lungs, the initial pneumonitis usually is followed by skin and bony involvement secondary to hematogenous spread. Infection of the synovium without bone or skin involvement in the pediatric population has not been reported previously. A soft tissue mass of the forearm in a 9-year-old boy was the initial manifestation of blastomycosis. Radiographic images, ultrasound, and magnetic resonance imaging of the forearm could not distinguish inflammation from sarcoma. Frozen section during open biopsy revealed a granulomatous process and several budding yeasts. There was no evidence of a malignancy. Cultures of the tissue grew Blastomyces dermatitidis. The patient was treated successfully with surgical debridement of the mass and amphotericin B followed by itraconazole, for a total therapeutic course of 18 weeks. Although rarely diagnosed in children, blastomycosis must be included in the differential diagnosis of any soft tissue mass.

Topics: Amphotericin B; Blastomycosis; Child; Forearm; Humans; Joint Diseases; Male; Soft Tissue Infections; Synovial Membrane

Coccidioides immitis infections of bones and joints pose difficult problems in diagnosis and treatment. To evaluate further the diagnosis and treatment of this disease, a retrospective review was conducted of 24 patients with 44 separate skeletal lesions of C. immitis infection, as determined by positive culture. Patients treated with combined medical and surgical treatment are more likely to have a successful outcome than those treated with medical therapy alone (p less than 0.005). Although immunosuppression did not appear to prevent a satisfactory response to therapy, patients with a high complement fixation titer (greater than or equal to 1:128) were more likely to fail to respond to medical therapy alone (p less than 0.01).

Topics: Adult; Aged; Amphotericin B; Bone Diseases; Child, Preschool; Coccidioidomycosis; Complement Fixation Tests; Female; Humans; Infant; Joint Diseases; Ketoconazole; Male; Middle Aged; Radiography; Retrospective Studies

Of 38 heroin addicts treated for systemic candidal infections, 36 had metastatic cutaneous lesions (deep-seated scalp nodules and pustulosis in hairy zones), 15 had ocular localizations (mainly chorioretinitis), and 10 had osteoarticular involvement (vertebrae, costal cartilage, knees, and sacroiliac). Such cutaneous lesions have not previously been described in classical systemic candidiasis; we also observed hair invasion by candidal hyphae. Candida albicans was the exclusive species isolated, in contrast to other visceral candidiases in heroin addicts. All isolates were sensitive to amphotericin B, flucytosine, and ketoconazole. Thirty-one visceral localizations were treated only with ketoconazole. Results were favorable in 15 of 18 cutaneous, 6 of 6 ocular, and 4 of 7 osteoarticular cases of involvement. This outbreak coincided with introduction of a new heroin on the drug market in the Paris area. C. albicans was not isolated from the drug. Pathogenesis of this syndrome is unclear.

Topics: Adult; Aged; Amphotericin B; Bone Diseases; Candida albicans; Candidiasis; Candidiasis, Cutaneous; Eye Diseases; Female; Flucytosine; France; Heroin Dependence; Humans; Joint Diseases; Ketoconazole; Male; Middle Aged; Osteoarthritis; Scalp; Syndrome

A 28 year old male heroin addict developed Candida tropicalis infection of the knee joint in association with candidemia. Assessment of amphotericin B therapy was facilitated by the determination of serum and synovial fluid amphotericin B concentrations using a radiometric bio-assay method. The results indicate that adequate synovial fluid drug levels were achieved with intravenous systemic therapy.

Topics: Adult; Amphotericin B; Arthritis, Infectious; Candidiasis; Drug Evaluation; Humans; Joint Diseases; Knee Joint; Male

Topics: Amphotericin B; Humans; Joint Diseases; Male; Middle Aged; Sporotrichosis

Topics: Adult; Amphotericin B; Congo; Hip Joint; Histoplasma; Histoplasmosis; Humans; Joint Diseases; Lung Diseases, Fungal; Lymphatic Diseases; Male; Shoulder Joint; Skin Manifestations

Topics: Amphotericin B; Arthritis; Candida albicans; Candidiasis; Female; Humans; Infant, Newborn; Infant, Newborn, Diseases; Joint Diseases; Meconium; Meningitis; Periostitis; Radiography

Topics: Adult; Amphotericin B; Asian People; Body Temperature; Bone Diseases; Cryptococcosis; Granulation Tissue; Humans; Injections, Intravenous; Joint Diseases; Malaysia; Male; Pulse; Radiography; Sternum

Topics: Adult; Amphotericin B; Bacteriological Techniques; Biopsy; Brain Abscess; Cerebrospinal Fluid Proteins; Hemiplegia; Humans; Isoniazid; Joint Diseases; Lung Diseases; Male; Meningitis; Nocardia Infections; Polymyxins; Prednisone; Pseudomonas Infections; Sarcoidosis; Skin Diseases; Sporotrichosis; Tetracycline

Topics: Age Factors; Aged; Amphotericin B; Complement Fixation Tests; Female; Histoplasmosis; Humans; Joint Diseases; Knee Joint; Skin Tests; Vaginitis