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[Acute arthritis of knee with intra-articular presence of D.medinensis. Comparative clinical and immunologic
Abstract:
The authors report a case of knee acute arthritis with intra-articular presence of microfilariae D. medinensis observed in a black African worker immigrated in France. It is a classical manifestion of dracunculosis articular complications which are however less frequent than intra-articular reaction arthritis without microfilariae, or than pyogenes arthritis due to neibourhood superinfections. The authors emphasize the significance of a double clinical and immunological supervision in the course of a convenient treatment including antibiotics, anti-inflammatory agents, local treatment, and rehabilitation.
Insights
A case of knee arthritis in an immigrant revealed microfilariae, a rare manifestation of dracunculosis. Prompt diagnosis and combined treatment are crucial for managing this parasitic joint complication.
Area of Science:
- Tropical medicine
- Parasitology
- Rheumatology
Background:
- Dracunculiasis (guinea worm disease) is a parasitic infection.
- Articular complications of dracunculiasis are less common than other manifestations.
- Intra-articular involvement can present with or without microfilariae.
Observation:
- A case of acute knee arthritis was observed in a black African worker who immigrated to France.
- Microfilariae of *D. medinensis* were identified within the joint.
- This presentation represents a classical, though infrequent, articular complication of dracunculosis.
Findings:
- The presence of microfilariae within the joint indicates direct parasitic involvement.
- Pyogenic arthritis due to secondary infections is a more common differential diagnosis.
- Distinguishing between parasitic and reactive arthritis is key.
Implications:
- Highlights the importance of considering parasitic infections in immigrants presenting with joint issues.
- Emphasizes the need for combined clinical and immunological monitoring for effective treatment.
- Integrated management including antibiotics, anti-inflammatories, and rehabilitation is recommended.