• Embed Doc
  • Copy Link
  • Readcast
  • Collections
  • CommentGo Back
Download
 
Septic ArthritisDefinition:
Septic arthritis is thepurulentinvasion of a jointby aninfectiousagent which producesarthritis. The infection can be caused by bacteria, viruses, fungi, or parasites. Joint infection caused by fungi or parasites is much less common thanthat caused by bacteria or viruses. Typically, septic arthritis affects a single large joint, such as thekneeor hip, but it is possible for several joints to be infected.
 
Causes of Septic Arthritis:The infection can originate anywhere in the body. The infection may also beginas the result of an open wound, surgery, or unsterile injection. Whatever the initialsource of infection, septic arthritis occurs when the infective organism travels throughthe bloodstream to the joint.Points of Interest About Septic Arthritis:
•
The most common type of bacteria involved in septic arthritis is Stahylococcusaureus, usually referred to as Staph.
•
The bacteria that causes gonorrhea used to be a common cause of septic arthritis,but safe sex has made it less common.
•
When viruses attack joints, it is calledviral arthritis, and the condition usuallyresolves on its own.
•
Joint infection caused by a fungus, known asfungal arthritis, is considered veryrare.
A.K.A.
Septic arthritis is also referred to asinfectious arthritisand pyogenic arthritis.Septic arthritis is considered a medical emergency because of the serious damage thatcan occur to bone andcartilage. Septic arthritis can causeseptic shock, which can be fatal.The term "suppurative arthritis" is a near synonym for septic arthritis. ("Suppurative"refers to the production of pus, without necessarily implyingsepsis.) 3. Incidence rateFrequencyUnited StatesApproximately 20,000 cases of septic arthritis occur each year in the United States (7.8cases per 100,000 person-years).
4 
The incidence of arthritis due to disseminatedgonococcal infection is 2.8 cases per 100,000 person-years. Septic arthritis is becomingincreasingly common among people who are immunosuppressed and elderly persons;these groups are more likely to have various comorbid disease states. The incidence of PJI among all prosthesis recipients ranges from 2-10%.InternationalThe incidence of septic arthritis in Europe is identical to that in the United States.Mortality/MorbidityThe primary morbidity of septic arthritis is significant dysfunction of the joint, even if treated properly. The mortality rate depends primarily on the causative organism. N
 
gonorrhoeae septic arthritis carries an extremely low mortality rate, while that of Saureus can approach 50%.
14 
RaceSeptic arthritis has no recognized racial predisposition.SexFifty-six percent of patients with septic arthritis are male.AgeForty-five percent of people with septic arthritis are older than 65 years.Septic arthritis can affect anyone at any age -- including infants and children. In adults,weightbearing joints (hips, knees,ankles) are most affected. In children, shoulders, hips, and knees are commonly affected. As the population ages, doctors are seeingmore patients with septic arthritis.4.risk/predisposing factorsSeptic arthritis develops when bacteria spreads through the bloodstream to a joint. Itmay also occur when the joint is directly infected with bacteria during injury or surgery.Acuteseptic arthritis tends to be caused by organisms such as staphylococcus,streptococcus pneumoniae and group B streptococcus.Chronic septic arthritis (which occurs less frequently) is caused by organisms such asMycobacterium tuberculosisand Candida albicans. The knee and the hip are the mostcommonly infected joints.The following increase your risk for septic arthritis:
•
Artificial joint implants
•
Bacterial infection
•
Chronicillness or disease
•
Intravenous (IV)drug abuse 
•
Medications that suppress theimmune system 
•
Recent joint trauma
•
Recent jointarthroscopyor other surgery
•
Rheumatoid arthritis
•
Sickle cell diseaseSeptic arthritis may be seen at any age. In children, it occurs most often in those lessthan 3 years old. The hip is a frequent site of infection in infants.Septic arthritis is uncommon from age 3 to adolescence. Children with septic arthritisare more likely than adults to be infected withgroup B streptococcusand Haemophilusinfluenza5.ManifestationsThe onset of the symptoms is usually rapid with joint swelling, intense joint pain, and low-grade fever .Symptoms in newborns or infants:
•
Unable to move the limb with the infected joint (pseudoparalysis)
 
•
Cries when infected joint is moved (example: diaper change causes crying if hipinfected)
•
Irritability
•
Fever Symptoms in children and adults:
•
Intense joint pain
•
Joint swelling
•
Joint redness
•
Unable to move the limb with the infected joint
•
Low-grade fever Chills may occur, but are uncommon6.typeNone7.pathophysiologyOrganisms may invade the joint by direct inoculation, by contiguous spread frominfected periarticular tissue, or via the bloodstream (the most common route)When joint infection occurs as a result of bacteremia, the initial growth of microorganisms is either in the synovial membrane or in the adjacent bone. In either case, an inflammation of the synovial membrane is quickly established and results in amarked increase in leukocytes in the synovial fluid, even though the fluid itself is sterile.When the microorganisms have spread into the joint fluid, culture of the fluid reveals theetiology of the infection. The pathologic findings are varied and depend on the durationof the infection, the organism and the resistance of the host. Early in the infection, onlyinflammatory changes in the synovium are seen. Late in the course of untreated septicarthritis, destruction of joint structures is marked. Articular cartilage is particularlyvulnerable because it is an avascular tissue.In acute, pyogenic arthritis, the cartilage characteristically dissolves first at points of articular contact to expose the underlying bone. As destructive changes occur severalabnormalities appear in the synovial fluid:Increased pressureLow pHLow concentration of glucoseActivation of proteolytic enzymesIncreased turbidityPresence of mucin precipitate8.dx studiesHow is septic arthritis diagnosed?Prompt diagnosis of septic arthritis is necessary to prevent permanent damage to the joint.In addition to a complete medical history and physical examination, diagnosticprocedures for septic arthritis may include:
of 00

Leave a Comment

You must be to leave a comment.
Submit
Characters: ...
You must be to leave a comment.
Submit
Characters: ...