Patients with surgically treated culture-negative native joint septic arthritis have less severe disease and better outcomes

Similar Efficacy of Arthroscopy and Arthrotomy in Infection Eradication in the Treatment of Septic Knee: A Systematic Review and Meta-Analysis

“…Culture-negative infection was identified as a protective factor for reinfection, which may be explained by lower bacteria load (13). Paz and his colleagues also concluded patients with culturenegative native joint septic arthritis have less severe disease and better treatment outcomes in their study (34). However, whether septic knee with negative joint culture should specifically receive arthroscopy or arthrotomy to achieve better infection eradication efficacy remains unknown.…”

Three Episodes of Presumed Culture-Negative Septic Arthritis Following Intramuscular Antipsychotic Injections

“…This patient experienced multiple distinct episodes of presumed culture-negative septic arthritis. The recurrence of septic arthritis is reported to occur in 9.8% to 12% of cases of septic arthritis 6,15,17 but, to our knowledge, has not been reported after intramuscular injections. To our knowledge, this is the first reported association between the intramuscular injection of antipsychotic medications (fluphenazine decanoate and paliperidone) with presumed septic arthritis.…”

“…It has been reported that antimicrobial therapy before aspiration does not alter the incidence of negative culture results in septic arthritis 15 . Culture-negative septic arthritis has been reported to occur in up to 78.4% of cases of septic arthritis 2-4,6,15 . Potential reasons for negative cultures in septic arthritis include poor sampling and laboratory techniques, incorrect diagnosis, fastidious growth requirements of infecting bacteria, and prompt neutrophil phagocytosis 1,4,18 .…”

“…Septic arthritis can be difficult to distinguish from similar pathologies because blood tests can be unreliable 1,[3][4][5][12][13][14] . The diagnosis of septic arthritis does not require positive cultures, with negative cultures occurring in 16.7% to 78.4% of cases of septic arthritis [2][3][4]6,15 . There is an equivalent or lower morbidity and mortality reported in culture-negative compared with culture-positive septic arthritis 6,15,16 .…”

“…The diagnosis of septic arthritis does not require positive cultures, with negative cultures occurring in 16.7% to 78.4% of cases of septic arthritis [2][3][4]6,15 . There is an equivalent or lower morbidity and mortality reported in culture-negative compared with culture-positive septic arthritis 6,15,16 . However, 14% to 28.6% of patients diagnosed with culture-negative septic arthritis receive an alternate diagnosis within 12 months 15,16 , suggesting that they did not suffer from septic arthritis; hence, the term "presumed culture-negative septic arthritis" is preferred in cases of diagnostic uncertainty.…”