Donald W. Palmer, M.D.; Michael H. Ellman, M.D.; Sergio Jacobelli, M.D.
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Two patients with septic arthritis and sickle-cell disorders responded poorly to therapy. Although prompt responses are reported in nonsicklers, Escherichia coli and Salmonella enteritidis persisted in joints of sicklemic patients for 53 and 42 days in spite of extraordinary doses of parenteral antibiotics. Synovial fluid gases were measured in one patient before, during, and after septic arthritis. The O2 saturation of articular capillary blood in equilibrium with the joint fluid was calculated, and the percentage of sickled cells and resultant increase in viscosity were predicted for local capillary blood. The ratio of articular blood flow to articular oxygen consumption was
Palmer DW, Ellman MH, Jacobelli S. Septic Arthritis in Sickle-Cell States: Pathophysiology of Impaired Response to Infection and Implications for Management.. Ann Intern Med. 1972;76:870. doi: https://doi.org/10.7326/0003-4819-76-5-870_4
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Published: Ann Intern Med. 1972;76(5):870.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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