Open AccessClinical problem‐solving: ‘persistent knee arthritis and prolonged fever in a lupus patient’
Author(s) -
PEREZ Emmanuel C.,
NAVARRA Sandra V.
Publication year - 2006
Publication title -
aplar journal of rheumatology
Language(s) - English
Resource type - Journals
eISSN - 1479-8077
pISSN - 0219-0494
DOI - 10.1111/j.1479-8077.2006.00242.x
Subject(s) - medicine , septic arthritis , arthritis , systemic lupus erythematosus , typhoid fever , arthropathy , gout , systemic lupus , hemarthrosis , immunology , pediatrics , intensive care medicine , surgery , osteoarthritis , disease , pathology , alternative medicine
Salmonella infections occur more frequently among immunocompromised patients such as those with systemic lupus erythematosus (SLE), with high propensity for extra‐intestinal, including osteoarticular, involvement. Hemarthrosis following trauma, typhoid fever and septic arthritis of the knee developed in a 20‐year‐old female lupus patient with pulmonary hypertension, maintained on corticosteroids and warfarin. This article takes the reader through the clinical problem‐solving process with an SLE patient whose illness is confounded by prolonged fever, with manifestations indistinguishable from that of either lupus activity and/or an infection. Early diagnosis, appropriate antibiotics, and if necessary, surgical intervention are essential principles of management to improve prognosis and prevent long‐term disabilities such as destructive arthropathy.