tetracycline and Joint-Diseases

A seropositive white man had follow-up for 16 years with a diagnosis of palindromic rheumatism. Treatment had included parenteral gold, methotrexate, prednisone, hydroxychloroquine sulfate, and penicillamine before diarrhea led to a biopsy-proven diagnosis of Whipple's disease. Clinical and radiographic criteria for ankylosing spondylitis were met. In addition to classic Whipple's arthropathy, he had the combined but singular findings of pancarpal destruction and cervical apophyseal fusion. HLA typing revealed the B7 antigen. This case illustrates the pitfalls in diagnosis of a chronic polyarthritis that has, as a typical feature, a long latency before manifesting its more specific signs and symptoms (ie, diarrhea, malabsorption, and hyperpigmentation). Care should be taken during evaluation of any disease with atypical and nonspecific features (eg, positive rheumatoid factor in a patient with polyarthritis) and one should continue to reevaluate the original impression while confirmatory evidence is lacking. Moreover, the roentgenographic findings of pancarpal narrowing, apophyseal fusion, and advanced iliofemoral joint disease, in addition to sacroiliitis and syndesmophyte formation, challenge the generally held notion that Whipple's arthropathy is a nondestructive joint disease.

Topics: Adult; Arthritis, Rheumatoid; Diagnosis, Differential; Humans; Joint Diseases; Male; Radiography; Recurrence; Rheumatoid Factor; Tetracycline; Whipple Disease

Whipple's disease is a systemic bacterial infection that once was uniformly fatal and now is treatable with several different antibiotics in most cases. The exact nature of the Whipple's bacillus is unknown, since the organism cannot consistently be cultured. There is also controversy concerning the role of immunologic dysfunction in patients with Whipple's disease. In addition to the small intestine, Whipple's disease can involve the remainder of the gastrointestinal tract, as well as the lymph nodes, joints, nervous system, heart, eyes, hematopoietic system, lungs, liver, and other organs. The clinical manifestations, diagnosis, and treatment of this rare but fascinating disease will be reviewed in this article.

Topics: Bacterial Infections; Diagnosis, Differential; Drug Combinations; Eye Diseases; Heart Diseases; Hematologic Diseases; Humans; Joint Diseases; Lung Diseases; Lymphatic Diseases; Muscular Diseases; Nervous System Diseases; Penicillins; Skin Diseases; Streptomycin; Sulfamethoxazole; Tetracycline; Trimethoprim; Trimethoprim, Sulfamethoxazole Drug Combination; Whipple Disease

Topics: Absorptiometry, Photon; Adult; Aged; Aging; Bone Diseases; Bone Resorption; Calcium; Child; Estrogens; Female; Humans; Hydroxyproline; Hyperparathyroidism; Joint Diseases; Male; Microradiography; Middle Aged; Osteitis Deformans; Osteomalacia; Osteoporosis; Parathyroid Glands; Physical Therapy Modalities; Spine; Tetracycline

The aim of this study was to determine the rates, types, clinical features and treatment of osteoarthricular involvement of brucellosis in Turkey. In a restrospective study in adults, we investigated 238 patients diagnosed with brucellosis over a period of 6 years. A diagnosis of brucellosis was established by isolation of Brucella species in blood or by a compatible clinical picture together with a standard tube agglutination titre of > or = 1/160 of antibodies for brucellosis and/or demonstration of an at least four-fold rise in antibody titre in serum specimens taken over 2 or 3 weeks. Osteoarthricular involvement was defined by inflammatory signs in peripheral joints or by unrelieved pain at rest together with radiological alterations and/or radionuclide uptake in any deep joint. Eighty-seven patients (36.5%) had osteoarthricular involvement (58.6% female, 41.4% male), 47 (54.1%) of whom were reported to consume unpasteurised dairy products. The mean age was 32.3 +/- 16 years. Sacroiliitis was the most common involvement (n = 53, 60.9%) followed by peripheral arthritis (n = 17, 19.5%), spondylitis (n = 12, 13.8%) and bursitis (n = 5, 5.7%). During the observation period, 60 (69%) patients with osteoarthricular involvement and radiographic abnormalities. A bone scan was positive in 15 patients with no radiographic abnormalities. All patients received merely medical treatment and relapse occurred in five (5.7%) patients. Sacroiliitis has been determined as the most frequently observed type of osteoarthricular involvement in brucellosis in Turkey.

Topics: Adolescent; Adult; Age Distribution; Aged; Brucella; Brucellosis; Doxycycline; Female; Humans; Joint Diseases; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Middle Aged; Ofloxacin; Retrospective Studies; Sacroiliac Joint; Technetium Tc 99m Exametazime; Tetracycline; Tomography, X-Ray Computed; Turkey

Topics: Collagen; Doxycycline; Humans; Joint Diseases; Tetracycline

Thirty-eight cases of suspected yersinia arthritis occurring in southern Sweden in 1975-6 were reviewed four to five years later. In 31 cases the diagnosis was confirmed. At follow-up three of the patients had definite ankylosing spondylitis, three radiologically confirmed sacroiliitis, three extensor tenosynovitis, five isolated articular joint disease, and 10 localised arthralgias; one patient had developed seropositive rheumatoid arthritis. Only six of the 31 patients were free of joint symptoms. These results suggest that although the acute symptoms of yersinia arthritis disappear within 12 months, the long-term prognosis may be less favourable than previously thought.

Topics: Acute Disease; Adult; Aged; Arthritis, Infectious; Female; Follow-Up Studies; Humans; Joint Diseases; Male; Middle Aged; Prognosis; Tetracycline; Yersinia Infections

The serology, epidemiologic features and clinical presentation of 39 patients suffering from Brucellosis in Kenya are described. The prevalent species was Brucella melitensis. There was a striking preference in the localisation of the infection for the spine and the hip joint. The disease runs a protracted course. Phenomena due to hypersensitivity and neuropsychiatric disorders are discussed. Advice regarding specific treatment is given.

Topics: Adult; Brucella; Brucellosis; Child; Doxycycline; Drug Therapy, Combination; Female; Humans; Joint Diseases; Kenya; Male; Serologic Tests; Spinal Diseases; Streptomycin; Sulfadiazine; Sulfamethoxazole; Tetracycline; Trimethoprim

Out of 8 patients with Whipple's disease, 7 had roentgenographic findings consisting of slight dilatation of the small bowel, with thickening of the mucosal folds. The eighth patient had no abnormality on roentgenographic study. This series represents the first in which the roentgenographic changes have been quantitatively assessed. Confirmation of the diagnosis by biopsy is important because antibiotic treatment results in marked improvement both clinically and roentgenographically.

Topics: Adult; Aged; Amenorrhea; Biopsy; Body Weight; Diagnosis, Differential; Diarrhea; Duodenum; Edema; Female; Fever; Follow-Up Studies; Humans; Intestinal Mucosa; Intestine, Small; Jejunum; Joint Diseases; Lymphadenitis; Male; Middle Aged; Pain; Pigmentation Disorders; Purpura; Radiography; Tetracycline; Whipple Disease

Topics: Adolescent; Adult; Autopsy; Biopsy; Bone and Bones; Calcification, Physiologic; Calcinosis; Cartilage, Articular; Decalcification Technique; Female; Femur; Fluorescent Dyes; Humans; Joint Diseases; Male; Microradiography; Middle Aged; Patella; Staining and Labeling; Tetracycline

Topics: Acne Vulgaris; Acute Disease; Adolescent; Ampicillin; Anemia; Anti-Bacterial Agents; Cephalosporins; Erythromycin; Female; Fever; Follow-Up Studies; Humans; Joint Diseases; Leukemoid Reaction; Male; Nephritis; Prednisolone; Skin Diseases; Syndrome; Tetracycline; Triamcinolone

Topics: Anesthetics, Local; Finger Joint; Humans; Joint Diseases; Oleandomycin; Osteomyelitis; Paronychia; Tetracycline

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: Agglutination Tests; Animals; Chick Embryo; Joint Diseases; Penicillins; Poultry Diseases; Precipitin Tests; Rats; Streptobacillus; Tetracycline

Topics: Ankle; Biopsy; Blood Chemical Analysis; Bone Diseases; Fluorescence; Genetics, Medical; Hand Deformities; Hypertension; Hypertension, Renal; Joint Diseases; Kidney Diseases; Kidney Function Tests; Osteolysis; Pathology; Radiography; Surgical Procedures, Operative; Tetracycline; Urine; Wrist

Topics: Abscess; Arthritis; Child; Chloramphenicol; Diagnosis, Differential; Drainage; Erythromycin; Humans; Infant; Joint Diseases; Novobiocin; Osteomyelitis; Oxytetracycline; Penicillins; Sepsis; Staphylococcal Infections; Streptococcal Infections; Suppuration; Surgical Procedures, Operative; Tetracycline

Topics: Arthritis, Rheumatoid; Humans; Joint Diseases; Osteoarthritis; Rickettsia Infections; Spinal Diseases; Tetracycline