Secondary haematogenous joint involvement is seen in less than 1% of patients with Salmonella infections. These atypical infections are frequently encouraged by pre-existing local or systemic disease. We present a case of a patient with known alcohol abuse who developed a septic infection of her right hip requiring resection of the femoral head. Histologic analysis showed signs of pre-existing osteonecrosis probably induced by alcohol intake. Cartilage and bone were invaded and destructed by an aggressive granulation tissue. Initially, a biopsy evaluated without knowledge of the positive bacteriological result had been interpreted as indicative of a tumour. The onset, clinical course, diagnosis and therapy of joint involvement by Salmonella are discussed with regard to our case and the relevant literature. This case illustrates the necessity for clinicians to share all their information about the patient with the pathologist.
EinleitungArthritiden können Folge einer Bacterium-Calmette-GuØrin-Schutzimpfung sein [8], vorübergehende Störungen der Immunabwehr stellen eventuell einen prädisponierenden Faktor für die zugrunde liegende "BCG-Sepsis" dar [2]. Arthritiden können sich aber auch bei der BCG-Therapie maligner Tumoren entwickeln, insbesondere wird über ihr Vorkommen bei Patienten nach der von Morales u. Mitarb. [9] empfohlenen intravesikalen Therapie von Harnblasenkarzinomen berichtet.
KasuistikKlinischer Befund 1 Bei dem 70-jährigen Patienten wurde nach der diagnostischen transurethralen Resektion eines oberflächlichen multilokulären Urothelkarzinoms zur Rezidivprophylaxe eine intravesikale BCG-Therapie durchgeführt. Während der ambulanten Behandlung
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