title: Septic knee arthritis in Crohn's disease biological therapy-free patient. Case report.
abstract: A 52-year-old woman with Crohn's disease presented with septic arthrtis of the knee. This condition coincided with a symptomatic flare of her Crohn's disease due to an ileal inflammatory stenosis, manifested as a phlegmonous mass palpable in the right lower quadrant and a small bowel obstruction. Results of synovial fluid cultures showed the presence of Gram-negative bacillus, Klebsiella pneumoniae and the CT scan images were highly suggestive of abdominal abscess within Crohn's disease. The patient's condition improved after following an antibiotic treatment and after the initiation of Anti-TNF-alpha agent Adalimumab, with no further exacerbation. Septic arthritis in Crohn's disease should be considered to have a communicating source of sepsis consisting of an abdominal abscess or fistula.
  
  
  BACKGROUND
  Anti-TNF-alpha agent = anti tumor necrosis factor alpha agent, 5-ASA = 5-aminosalicylic acid.
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; Medical Clinic and Gastroenterology, University Emergency Hospital, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Pop
authors.affiliation: Medical Clinic and Gastroenterology, University Emergency Hospital, Bucharest, Romania.
authors.forename: D
authors.initials: D
authors.lastname: Calagiu
authors.affiliation: Medical Clinic and Gastroenterology, University Emergency Hospital, Bucharest, Romania.
authors.forename: P
authors.initials: P
authors.lastname: Jantea
authors.affiliation: "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania ; "Marius Nasta" National Institute of Pneumology, Bucharest, Romania.
authors.forename: R
authors.initials: R
authors.lastname: Nemes
mesh_terms: D001168:Arthritis / Q000150:complications* / Q000188:drug therapy*; D001691:Biological Therapy; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008875:Middle Aged; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000188:drug therapy*; D013582:Synovial Fluid / Q000378:metabolism
keywords: Crohn’s disease; phlegmonous mass; septic arthritis; synovial fluid