The outcome of bacterial arthritis. A prospective community‐based study

Abstract

Objective. To assess the outcome and adverse prognostic factors of bacterial arthritis (BA). Methods. In a prospective community survey of BA, data were collected at the time of diagnosis and at a mean of 2 years later. A poor patient outcome was defined as death due to BA or severe overall functional deterioration. A poor joint outcome was defined as amputation, arthrodesis, prosthetic surgery, or severe functional deterioration. Possible prognostic factors were analyzed by univariate analysis. Results. BA was diagnosed in 154 patients, 121 adults and 33 children. One‐half of the adults had a preexisting joint disease and 29% of the infected joints contained synthetic material. The patient outcome was poor in 21% of all patients, and the joint outcome was poor in 33% of the surviving patients. Adverse prognostic factors were an older age, preexisting joint disease, and an infected joint containing synthetic material. These factors were interrelated. There was no association between a poor outcome and young age, comorbidity, immunosuppressive medication, functional class, multiple infected joints, type of microorganism, or treatment delay. Conclusion. BA had a poor outcome in almost one‐half of the patients. Patients who were older, had a preexisting joint disease, and/or had an infected joint containing synthetic material had the poorest prognosis.

Hematogenous Septic Ankle Arthritis

“…According to one report septic arthritis has an annual incidence of two to 10 per 100,000 individuals, although that study did not report data on the incidence of ankle septic arthritis [6]. Untreated joint infection can lead to irreversible destruction of articular cartilage, disability, systemic sepsis and death [3,4,7]. A retrospective study of septic arthritis in the United Kingdom reported 23.8% of patients had considerable loss of function in the affected joint and 11.5% of patients died as a result of their illness [18].…”

A case of sudden death due to septic pulmonary embolism

“…If treatment is delayed, septic arthritis has a mortality rate between 5% and 15 % often as a result of septic shock [4]. Septicemia is a known complication resulting from the transient or chronic bacteremia associated with most cases of septic arthritis.…”

“…Septicemia is a known complication resulting from the transient or chronic bacteremia associated with most cases of septic arthritis. [4] However, such deaths usually have a more progressively deteriorating course rather than a sudden deterioration of seemingly improving condition. Sudden deterioration of her condition points towards pulmonary thrombo embolism; another well known complication of septic arthritis [5].…”

Staphylococcus Infection Associated with Arthroplasty

“…Postoperative risk factors include woundhealing complications (e.g., superficial infection, hematoma, delayed healing, wound necrosis, and dehiscence), atrial fibrillation, myocardial infarction, urinary tract infection, prolonged hospital stay, and S. aureus bacteremia [12][13][14][15], [18][19][20][21]. An increased rate of infection occurs in the pre-damaged joint and is also associated with particular predispositions of the patients (Table 1) [22][23][24]. In articular, a joint prosthesis is a high risk predisposition for an infection.…”