Histopathologie und Mikrobiologie bei Gelenkinfekten

Abstract

In patients with rheumatoid arthritis the combination of histopathology and microbiology significantly increased the safety of detecting an infection or contamination.

Histopathological Osteomyelitis Evaluation Score (HOES) – an innovative approach to histopathological diagnostics and scoring of osteomyelitis

“…The situation is the opposite for osteomyelitis diagnostics: Only orientating [ 12 ] or no diagnostic criteria have hitherto existed here, in particular no classification criteria exist for bacterial acute and chronic osteomyelitis. The aim of this work is therefore to develop a diagnostic score which reflects the disease of osteomyelitis in a precise manner by defined criteria and gives a reliable, reproducible diagnostic score.…”

“…The histopathological criteria for the soft tissue, peri-implant infection and for bacterial synovialitis and their differential diagnoses have been laid down [ 9 ], [ 10 ], [ 11 ]. Diagnostic criteria for osteomyelitis, however, are non-existent or only orientating [ 12 ].…”

“…Histopathological diagnostics of bacterial infections is generally to be regarded as diagnostics which supplement microbiology. These primarily are performed by evaluating the tissue reaction pattern caused by the pathogen (so-called pathological infection substrate) and are therefore an indirect form of infection diagnostics [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ]. These diagnostics are based on evaluation of the leukocyte infiltration pattern and the tissue changes in connective tissue and bone tissue.…”

Die komplizierte Gicht

“…Intraoperativ sollten mehrere Gewebeproben entnommen werden. Bei unklaren Befunden empfehlen wir zusätzlich eine histologische Untersuchung, um auf der einen Seite bei Low-grade-Infektionen falsch-negative mikrobiologische Nachweise von wenig virulenten Keimen aufzudecken, auf der anderen Seite aber gerade beim Nachweis von nicht oder wenig pathogenen Keimen oder fehlendem Keimwachstum einen solche Infekt nicht zu übersehen [4][5][6]. Bei immungeschwächten Patienten können durchaus atypische oder nicht virulente Keime relevante Infektionen verursachen [1,7].…”

Assay of Blood and Synovial Fluid of Patients With Rheumatoid Arthritis for Staphylococcus aureus Enterotoxin D: Absence of Bacteria But Presence of Its Toxin

“…In the last decade, bacterial infections were reported as the etiology of the RA disease ( 26 ), but attempts to isolate the organism failed and in some cases it was necessary for the diagnosis of the histopathological findings ( 27 ). Since then, numerous studies have focused on superantigens and their cellular targets ( 28 ) that indirectly demonstrate the role of S. aureus superantigens as the etiology of RA.…”