Concomitant septic and XXXX --an analysis of 30 cases.

@entity1 @entity5414 @entity3811 @entity794 @entity6101 @entity397 @entity583 @entity221 @entity414
OBJECTIVES: To analyse the clinical features and outcomes of gouty @entity1 with concomitant @entity5414 in a medical centre. METHODS: From the hospital database, we collected 30 hospitalized cases with concomitant @entity5414 and @entity3811 from 1987 to 2001. All @entity1 had positive bacterial culture and @entity414 crystals in the affected joints. Medical records of the @entity1 were analysed in detail. RESULTS: The mean age of @entity1 was 52.8+/-12.5 yr. One-third of @entity1 were afebrile at presentation, 30% had a normal blood leucocyte count and 10% had a synovial fluid leucocyte count less than 6000/mm3. The knee joint was the most common site of involvement, followed by the ankle, shoulder and wrist joints. Most @entity1 had long-standing disease and subcutaneous tophi. Subcutaneous @entity397 with secondary wound infection is the most common route of infection. Causative micro-organisms were @entity794 (16 cases, 7 of whom were @entity6101 -resistant), Streptococcus sp. (5 cases), Pediococcus sp. (1 case), and Gram-negative bacilli (9 cases). Fourteen @entity1 received surgical debridement, among them two @entity1 had an arthrodesis owing to severe joint destruction and one received above-knee amputation. Two @entity1 died. One died of septic complications and the other died of acute @entity583 . CONCLUSIONS: @entity5414 coexistent with gout presented a diagnostic difficulty. An early diagnosis requires a high level of suspicion. Prompt aspiration and analysis of the synovial fluid is imperative, regardless of the absence of @entity221 or leucocytosis. Culture of the aspirated synovial fluid is warranted in gouty attack, even when it has a low white cell count or the Gram stain reveals no organisms.
