Accurate diagnosis of orthopedic infection is crucial in guiding both antimicrobial therapy and surgical management in order to optimize patient outcomes. A variety of microbiological and nonmicrobiological methods are used to establish the presence of a musculoskeletal infection. In this minireview, we examine traditional culture-based and newer molecular methodologies for pathogen detection, as well as systemic and localized assays to assess host response to maximize diagnostic yield.

In 2022 the largest global outbreak of mpox to date emerged. In the immunocompetent host, mpox is generally presents as a self-limiting illness. However immunosuppression such as that seen with advanced human immunodeficiency virus (HIV) has been associated with significant morbidity and mortality related to mpox infection. To evaluate the impact of immunosuppression related to solid organ transplantation on clinical features and outcomes of mpox we established a multicenter case registry. 11 cases from 7 participating centers in the USA were submitted. All cases occurred in males. The majority were kidney transplant recipients (91%, n=10). Median duration of symptoms at presentation was 6 days (range 3-14 days). Rates of hospitalization were high (73%, n=8) with a median length of stay of 4.5 days (range 1-10). Mpox in solid organ transplant recipients (SOTRs) was associated with a high burden of skin lesions and systemic symptoms. Fever, fatigue, pharyngitis and proctitis were commonly reported. Other clinical features included headache, myalgia, epididymorchitis, urinary retention, hemetemesis, pneumonitis and circulatory shock. All patients received treatment with tecovirimat. There was one mpox related mortality in the cohort. Infection was reported to have resolved at 30 day follow up in all other cases.

Pasteurella species are facultatively anaerobic Gram-negative coccobacilli residing in the upper respiratory tract of mammals, fowl and domestic animals including cats and dogs. Localized infections with Pasteurella species are common but invasive infections are rare. There is a paucity of data available on risk factors, clinical presentations and outcomes with Pasteurella bloodstream infection. We conducted a retrospective review of patients with Pasteurella bacteremia presenting to our institution. There were 63 presentations (61 patients) with Pasteurella bacteremia. Immunosuppression, malignancy and alcohol misuse were common. Rates of admission to intensive care (n = 18, 29.5%) and death prior to hospital discharge (n = 7, 11.5%) were high.