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May 2025 DOI 10.14302/issn.2694-2283.jsem-25-5529
Background Septic arthritis is a potentially limb or life-threatening joint infection that requires prompt recognition and intervention to reduce morbidity and mortality. While intra-articular joint injections are commonly performed for osteoarthritis and other arthropathies, they carry a rare but significant risk of iatrogenic infection, particularly when performed in the presence of unrecognized joint or periarticular infection. Case Presentation We report a case of a 52-year-old female with a history of traumatic brain injury and chronic right knee pain who developed severe knee swelling, pain, and systemic symptoms following an intra-articular corticosteroid injection performed without ultrasound evaluation/guidance. Post-procedure, she presented with fever, elevated inflammatory markers, and purulent knee effusion. Operative washout revealed a purulent tract extending from the knee joint capsule to the lateral thigh. Cultures from joint aspiration and intraoperative samples grew Streptococcus dysgalactiae. Blood cultures were negative. The patient reported frequent cat scratches to the affected knee and described an unusual sensation of the injection needle tracking laterally during the joint injection. She was treated with surgical drainage and a four-week course of amoxicillin, with full clinical recovery. Discussion This case highlights an unusual presentation of septic arthritis with extra-capsular extension likely due to iatrogenic needle tracking during joint injection. The causative organism, S. dysgalactiae, is an uncommon pathogen in septic arthritis, and the presumed source was contiguous spread from untreated cellulitis, possibly related to cat scratches/bites. The absence of predisposing comorbidities and negative blood cultures further support a local rather than hematogenous source. The case emphasizes the importance of thorough clinical evaluation and consideration of infection prior to joint injections, as well as the potential benefits of ultrasound guidance to minimize procedural complications. Conclusion Careful history, physical examination, and appropriate imaging are essential prior to joint interventions to avoid iatrogenic complications. This case illustrates the rare but serious risk of extra-capsular extension of septic arthritis following intra-articular injection and emphasizes the need for vigilance in identifying underlying infection before proceeding with invasive procedures.
Apr 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3770
Ofloxacin is an antibiotic, useful against the number of bacterial infections. This scientific investigation was performed to identify the impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of ofloxacin using sophisticated analytical techniques. Ofloxacin sample was divided into control and treated parts. Only the treated ofloxacin received the Consciousness Energy Healing Treatment remotely by a well-known Biofield Energy Healer, Mr. Mahendra Kumar Trivedi. The LC-MS spectra of both the samples of ofloxacin at retention time 3 minutes exhibited the mass of the protonated molecular ion peak at m/z 362.17 (M+H)+. The chromatographic peak area% of the treated ofloxacin (52.4%) was increased by 2.03% compared to the control sample (51.36%). The LC-MS based isotopic abundance ratio of PM+1/PM in the Biofield Treated ofloxacin was significantly increased by 22.43% compared with the control sample. Similarly, the GC-MS based isotopic abundance ratio of PM+1/PM in the Biofield Treated ofloxacin was significantly increased by 19.24% compared with the control sample. The LC-MS and GC-MS based isotopic abundance ratio of PM+1/PM (2H/1H or 15N/14N or 13C/12C or 17O/16O) was significantly increased in the Biofield Treated ofloxacin as compared to the control sample. Thus,2H, 15N, 13C, and17O contributions from (C18H21FN3O4)+ to m/z 363.17 in the treated ofloxacin were significantly increased compared with the control sample. The increased isotopic abundance ratio of the Trivedi Effect®-Consciousness Energy Healing Treated ofloxacin may increase the intra-atomic bond strength and increase its physical stability. The new form of treated ofloxacin would be more stable, better soluble, and bioavailable compared to the control sample. It would be more useful to design efficacious pharmaceutical formulations that might offer better therapeutic response against infections in the urethra, urinary tract, gonorrhoea, pneumonia, infectious diarrhoea, bronchitis, cellulitis, bacterial infection of the eye and ear, multidrug-resistant tuberculosis, prostatitis, otitis media, plague, etc.
Nov 2019 DOI 10.14302/issn.2377-2549.jndc-19-3080
Ofloxacin is a class of fluorinated quinolone antibiotics, useful against most of the Gram-positive and Gram-negative bacterial infections. This study was designed to investigate the impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of ofloxacin using LC-MS and GC-MS spectroscopy. Ofloxacin sample was divided into control and treated parts. The control ofloxacin did not receive the Consciousness Energy Healing Treatment, while the treated ofloxacin receives the Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The LC-ESI-MS spectra of both the samples of ofloxacin at the retention time 3.05 minutes exhibited the mass of the protonated molecular ion peak at m/z 362.17 (M+H)+ (calculated for C18H21FN3O4+, 362.15). The LC-MS based isotopic abundance ratio of PM+1/PM in the treated ofloxacin was significantly increased by 56.57% compared with the control sample. Thus, 2H, 15N, 13C, and 17O contributions from (C18H21FN3O4)+ to m/z 363.17 in the treated ofloxacin were considerably increased compared with the control sample. The GC-MS based isotopic abundance ratios of PM+1/PM and PM+2/PM in the treated ofloxacin was significantly increased by 9.53% and 12.94%, respectively compared with the control sample. Hence, 2H, 15N, 13C, 17O, and 18O contributions from (C18H21FN3O4)+ to m/z 318 and 319 in the treated ofloxacin were significantly increased compared with the control sample. The LC-MS and GC-MS based isotopic abundance ratios of PM+1/PM (2H/1H or 15N/14N or 13C/12C or 17O/16O), and PM+2/PM (18O/16O) in the treated ofloxacin were considerably improved compared to the control sample. The increased isotopic abundance ratio of the treated ofloxacin would increase the chemical bond strength and increase the stability in the body. The new form of treated ofloxacin would be more stable compared to the control sample and would be very useful to design improved pharmaceutical formulations that might offer better therapeutic response against infections of the urethra and cervix, infectious diarrhoea, urinary tract infections, cellulitis, chronic bronchitis, pneumonia, prostatitis, multidrug-resistant tuberculosis, plague, otitis media, etc.
Jun 2016 DOI 10.14302/issn.2471-2175.jdrt-15-836
Cellulitis is an acute, spreading pyogenic inflammation of the dermis and subcutaneous tissue, usually complicating a wound, ulcer, or dermatosis. Inappropriate diagnosis of cellulitis is a problem and would need prospective rather than retrospective studies to quantify the extent. There is one national guideline for the management of patients with cellulitis. The aim of this study is to determine the validity of Crest guideline in the patients with non-facial cellulitis. This prospective cohort study was conducted on all Adult patients with cellulites who were admitted at Resole-Akram and Sina emergency department between November 2013 and January 2014. Based on admission duration, the patients were randomly divided into two groups including primary and secondary outcome, <24-hours or >24-hours admission, respectively. Out of 89 admitted patients, 55% were hospitalized over 24 hours and 20% of them had significant systemic symptoms. The most patients (n= 42) had either systemically ill or systemically well or class II followed by classes I (n=28), III (n=18), and IV (n=1). There was significant relevancy between age, fever, PR, infected organ, leukocytosis, diabetes mellitus, IUDA, human bite, and primary outcome. In conclusion, factors associated with admission were age, presence of multiple comorbid conditions, diabetes mellitus, human bite, IUDA, infected organ, leukocytosis and fever. These results showed that the decision in the emergency department was mostly the same as Crest guideline and the prospection of admission and discharge of these patients was almost according to the educations of Crest guideline.