joint, bone and muscle infection

Question 1

CASE 1: Mr Quek, a 47 year old Chinese man with sudden onset of left knee pain for 4 days.

He has no hair loss, no dandruff.
He has no dry eyes or dry mouth symptoms, and no mouth ulcer.
He has some rashes over his arms. What does this signify?

Answer 1

Not autoimmune

Question 2

CASE 1: Mr Quek, a 47 year old Chinese man with sudden onset of left knee pain for 4 days.

He has no hair loss, no dandruff.
He has no dry eyes or dry mouth symptoms, and no mouth ulcer.
He has some rashes over his arms.

There was fever, chills and rigors, T max was 38.7 degree Celsius. He has painful micturition for 3 days.

Sexual history – he has a girlfriend in Batam.

Pustules present.

Diagnosis?

Answer 2

Infection - septic arthritis

Question 3

CASE 1: Mr Quek, a 47 year old Chinese man with sudden onset of left knee pain for 4 days.

Diagnosis: Septic Arthiritis

What do you see under the microscope?

Answer 3

Gram negative diploccocci - Gonoccocus (monoarticular points to septic arthiritis)

Question 4

CASE 1: Mr Quek, a 47 year old Chinese man with sudden onset of left knee pain for 4 days.

Diagnosis: Septic Arthiritis
Organism: Gonoccocus
Treatment?

Answer 4

IM/IV ceftriaxone

Question 5

CASE 2: Mr Ong, a 57 year old Chinese man with
sudden onset of left knee pain for 4 days. Loves to eat (IMPTTTTT) raw fish.

What do you see under microscope?

Answer 5

Gram Positive (purple) pairs/ chains - Group B Strep/ Strep Agalaticae