Health Tips - Positive blood culture

Tuesday, January 24, 2012

The differential diagnosis of rheumatic fever in the absence of any cardiac abnormality must sometimes be considered when fever and joint pains are principal manifestations of illness. It is a fallacy to assume that rheumatic fever may be excluded because only one joint is involved. It is, however, true that rheumatic fever is unlikely to be responsible for joint symptoms which are not markedly alleviated by salicylates within 48 hours. Diagnosis may be difficult and must include the consideration of acute rheumatoid arthritis, osteomyelitis, tuberculosis, allergic conditions, undulant fever, gonococci arthritis, disseminated lupus erythematosus, bacterial endocarditic and septicemia. In rheumatoid arthritis the onset is rarely so acute, the small joints are principally affected and often assume characteristic abnormality morning stiffness in the affected parts is usual and flitting pains are uncommon. In cases of osteomyelitis careful examination will reveal that pain and tenderness are maximal over the neighboring bone rather than joint. The diagnosis will subsequently be confirmed by radiological examination. In gonococci arthritis the condition is usually monarticular and there is either a history of a discharge or positive smears will be obtained from the urethra or cervix. Brucellosis may be suggested by the temperature chart, a history of a possible source of infection and a positive blood culture or agglutination reaction.