title: Synovial fluid muramic acid in acute inflammatory arthritis.
abstract: Presence of muramic acid, a bacterial cell wall component, was analysed by gas chromatography-mass spectrometry in synovial fluid (SF) of 40 patients with acute inflammatory arthritis. SF muramic acid was observed in 4/14 patients with acute, culture negative inflammatory arthritis of unclear origin. Each of these four patients had a history of a recent bacterial disease (pansinuitis, purulent leg ulcer, erysipelas, unexplained fever with suspicion of cholecystitis and urinary tract infection). In the bacterial arthritis, SF muramic acid was detected in 6/12 patients (in 2/6 culture negative cases). In the reactive arthritis due to Salmonella or Yersinia, the rate of positivity was 2/14. Nineteen samples of traumatic SF effusion were muramic acid negative. These findings indicate that several cases of undefined acute inflammatory arthritis are of bacterial origin.
authors.affiliation: Department of Medical Microbiology, Turku University, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Lehtonen
authors.forename: P
authors.initials: P
authors.lastname: Kortekangas
authors.forename: P
authors.initials: P
authors.lastname: Oksman
authors.forename: E
authors.initials: E
authors.lastname: Eerola
authors.forename: H
authors.initials: H
authors.lastname: Aro
authors.forename: A
authors.initials: A
authors.lastname: Toivanen
mesh_terms: D000208:Acute Disease; D016918:Arthritis, Reactive / Q000378:metabolism*; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D009112:Muramic Acids / Q000032:analysis* / Q000378:metabolism; D012480:Salmonella Infections / Q000378:metabolism*; D013582:Synovial Fluid / Q000737:chemistry*; D015007:Yersinia / Q000378:metabolism*
chemical_list: D009112:Muramic Acids