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Acute Pyelonephritis II: Diagnostic Studies and Management

Acute Pyelonephritis II: Diagnostic Studies and Management

Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...

Acute Pyelonephritis I: Introduction

Acute Pyelonephritis I: Introduction

Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...

Endocarditis I: Introduction

Endocarditis I: Introduction

Introduction:Endocarditis is the infection of the endocardium, the inner lining of the heart and its valves. When the heart muscle is involved, the condition is termed myocarditis, while an infection of the outer lining is called pericarditis. Infective endocarditis (IE) primarily affects the endocardium, where pathogens adhere to the valves or lining, forming vegetation that can lead to severe complications. Infective endocarditis occurs when microorganisms, usually bacteria from other body...

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis II: Clinical Features of Infective Endocarditis

Endocarditis can present various clinical features depending on the causative organism and the patient's underlying health conditions. Initially, the clinical features of infective endocarditis develop gradually, presenting with nonspecific symptoms that can be easily mistaken for other illnesses.General SymptomsEarly symptoms of infective endocarditis are fever, chills, weakness, malaise, fatigue, and weight loss. These symptoms reflect the systemic nature of the infection and the body's...

Pericarditis I: Introduction

Pericarditis I: Introduction

Pericarditis is defined as the inflammation of the pericardium, the thin, sac-like membrane surrounding the heart. This condition can cause significant chest pain and other symptoms, often necessitating medical intervention. The pericardium has two layers: the inner visceral layer and the outer parietal layer, separated by a small amount of fluid that reduces friction during heartbeats.Types of PericarditisPericarditis can be classified into several types based on the duration and nature of the...

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies

The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...

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Updated: Nov 10, 2025

Knee Arthrocentesis in Adults

Knee Arthrocentesis in Adults

Published on: February 25, 2022

Silent Septic Arthritis: A Case Report.

¹Internal Medicine, Rochester Regional Health, Rochester, USA.

|April 5, 2021

Summary

Silent septic arthritis in diabetic patients can be masked by other symptoms. A history of falls may indicate this condition, warranting diagnostic knee taps for early detection and treatment.

Area of Science:

Internal Medicine
Infectious Diseases
Rheumatology

Background:

Septic arthritis is a common hospital diagnosis.
Poorly controlled diabetes mellitus can complicate infections.

Observation:

A case of silent septic shock in a patient with poorly controlled diabetes mellitus is presented.
The patient presented with a history of falls, a potential indicator of undiagnosed septic arthritis.
The source of infection was identified and the lesion was drained.

Findings:

Clinical symptoms of septic arthritis can be masked in diabetic patients.
A history of falls can be a subtle sign of silent septic arthritis.
Diagnostic knee taps are crucial for diagnosing suspected silent sepsis in this population.

Keywords:

case report septic arthritis streptococcal bacteremia

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Knee Arthrocentesis in Adults

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Implications:

Highlights the importance of considering silent septic arthritis in diabetic patients with atypical presentations.
Emphasizes the diagnostic value of knee aspiration when sepsis is suspected but not clinically obvious.
Suggests a need for increased vigilance for joint infections in patients with diabetes mellitus and a history of falls.