Advances in the Management of Septic Arthritis

Torre, Ignacio García‐De La

doi:10.1016/j.idc.2006.09.005

Cited by 22 publications

(9 citation statements)

References 57 publications

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“…Although the knee is most commonly affected, other large and medium joints can also be affected. 6,8,18 Fluid from the joint should be aspirated if the flare is more severe than usual, if there is a significant loss of joint function (e.g., the patient requires crutches), if the joint is red, or if the patient has systemic symptoms (e.g., fever, night sweats). The presentation may be more subtle in patients who are taking glucocorticoids, disease-modifying antirheumatic drugs or biologic agents.…”

mentioning

confidence: 99%

“…20,21 The leukocyte count (from synovial fluid) is considered elevated if it is greater than 20 × 10 9 /L, and markedly elevated if it is greater than 50 × 10 9 /L (Table 1). 18,22 If septic arthritis is suspected, a negative result of Gram's staining should not delay the start of empiric antibiotic therapy. If the initial bacterial culture is negative, a biopsy may be considered to test for slower growing organisms such as mycobacteria or fungi.…”

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confidence: 99%

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Septic arthritis in patients with pre-existing inflammatory arthritis

Kherani¹,

Shojania²

2007

Canadian Medical Association JournalHas erratum 2007-10-9 Comment 2007-10-9

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The case: A 56-year-old woman presents to her family physician with a 7-day history of tenderness, swelling and redness of 2 metacarpophalangeal joints and 1 proximal interphalangeal joint in her right hand. She also reports pain and redness of her right knee that makes it difficult to walk. On examination, her right knee appears swollen and red. The patient has a 10-year history of rheumatoid arthritis with intermittent polyarticular flares, primarily involving her wrists, fingers (metacarpophalangeal and proximal interphalangeal joints), feet (metatarsophalangeal joints) and occasionally her knees. However, the condition has been well managed with methotrexate and hydroxychloroquine therapy. She had no flares in the year before presentation and is able to perform household chores and to work as a dry-cleaning attendant. What other history, physical examination and laboratory investigations would you seek to distinguish a simple flare of inflammatory polyarthritis from a superimposed infection?

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confidence: 99%

mentioning

confidence: 99%

Septic arthritis in patients with pre-existing inflammatory arthritis

Kherani¹,

Shojania²

2007

Canadian Medical Association JournalHas erratum 2007-10-9 Comment 2007-10-9

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“…In a review by García-De la Torre9, it is reported that the yearly incidence of native joint bacterial arthritis varies from 2 to 10 per 100 000 in the general population. Irreversible loss of joint function has been postulated to occur in up to 50% of affected patients and the case fatality rate is 11% 10 Despite improved antimicrobial agents and hospital care, the mortality and morbidity of septic arthritis have not changed appreciably in the past two to three decades.…”

Section: Discussionmentioning

confidence: 99%

A hot, swollen joint in a cirrhotic patient

Omakobia

Hossain²,

J³

et al. 2010

Case Reports

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Septic arthritis in the elderly carries a high mortality. Underlying risk factors, such as diabetes, malignancy, chronic renal failure, rheumatoid arthritis, hepatobiliary disease and AIDS, should be assessed. Rare causative organisms are occasionally encountered. Here, we describe a case of an 80-year-old diabetic patient with liver cirrhosis who developed Klebsiella pneumoniae septic arthritis, which is a rare cause of joint infection. We postulate that this case supports the notion that the patient's knee effusion seeded during a primary K pneumoniae bacteraemia of intestinal origin and related to liver cirrhosis.

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“…Although avascular necrosis (AVN) is not generally recognised as a risk factor for acute bacterial arthritis, (1,2) the relationship between the two is clinically significant, as it may be difficult to distinguish the two pathologies based on clinical history and physical examination findings. (3) A high index of suspicion is needed in order to avoid a delay in the diagnosis and treatment of an acutely infected joint, which can potentially result in significant morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

Concomitant early avascular necrosis of the femoral head and acute bacterial arthritis by enteric Gram-negative bacilli in four oncologic patients

Tan¹,

Tan²

2013

smedj

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We present four cases of concomitant early (modified Ficat-Arlet stage I) avascular necrosis of the femoral head and acute bacterial arthritis of the hip joint by Gram-negative enteric bacilli. This was found in immunosuppressed oncologic patients whose clinical presentations and radiological findings were not entirely specific for joint sepsis. It is important to recognise the coexistence of these two pathologies, so as to avoid a delay in diagnosis and prevent significant morbidity and mortality.

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Advances in the Management of Septic Arthritis

Cited by 22 publications

References 57 publications

Septic arthritis in patients with pre-existing inflammatory arthritis

Septic arthritis in patients with pre-existing inflammatory arthritis

A hot, swollen joint in a cirrhotic patient

Concomitant early avascular necrosis of the femoral head and acute bacterial arthritis by enteric Gram-negative bacilli in four oncologic patients

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