Septic Arthritis
a.k.a. Infectious arthritis or Pyogenic arthritis
Septic arthritis, also known as
infectious arthritis or pyogenic arthritis, is a serious infection of the joints
characterized by pain, fever, chills, inflammation and swelling in one or more
joints, and loss of function in those joints.
Septic arthritis is considered a
medical emergency because of the damage it causes to bone as well as cartilage,
and its potential for creating septic shock, which is a potentially fatal
condition.
Septic arthritis can strike any age
group, including infants and children.
In adults, it most commonly affects
weight-bearing joints such as the knee, while in children it is more common in
the shoulders, hips, and knees.
Risk factors include patients
diagnosed with chronic rheumatoid arthritis, certain systemic infections,
certain types of cancer,
diabetes, sickle cell anemia, or systemic lupus erythematosus (SLE), IV drug
abusers and alcoholics, and patients with artificial (prosthetic) joints.
Patients with recent joint injuries
or surgery, or patients receiving medications injected directly into a joint are
also at a greater risk for developing septic arthritis.
Typically, women and male homosexuals
are at greater risk for septic arthritis than are male heterosexuals.
What causes it?
Septic arthritis occurs when some
type of infecting organism, most often bacteria, reaches a joint. Bacteria can
get into a joint through the bloodstream, or through surgery, an injection, or
injury that directly contaminates the joint.
The cause of septic arthritis in
babies and young children is usually staphylococci, hemophilus influenzae, and
gram-negative bacilli.
In adults and older children, septic
arthritis is more commonly caused by gonococci, staphylococci, and streptococci.
Mycobacteria, which causes tuberculosis, and the bacteria that causes Lyme
disease can also cause septic arthritis.
Intravenous drug users and people
with diseases that weaken the immune system, such as HIV, are more likely to
have septic arthritis caused by gram-negative bacteria. The staphylococcus
organism can also be introduced to a joint during arthroscopic surgery and
prosthetic joint surgery.
What are the symptoms?
Symptoms of septic arthritis occur
suddenly and are characterized by severe pain, swelling in the affected joint
along with acute pain. Chills and fever are also common symptoms.
Septic arthritis in the hip may be
experienced as pain in the groin area that becomes much worse if the patient
tries to walk.
In the majority of cases, there is
some leakage of tissue fluid into the affected joint. The joint is sore to the
touch, and may or may not be warm to the touch, depending on how deep the
infection lies within the joint.
Children sometimes develop nausea and
vomiting.
What is the treatment?
Septic arthritis must be diagnosed
quickly and treated with antibiotics. Your doctor may first give these
antibiotics intravenously (through a vein) to make sure the infected joint
receives medication to kill the bacteria as quickly as possible. Then, the
remaining course of antibiotics is taken orally.
The doctor may also need to drain the
fluid from the infected joints if it rapidly reaccumulates and causes symptoms.
Immediate surgical drainage is
reserved for septic arthritis of the hip, because that site is inaccessible for
repeated fluid removal.
For most other joints, surgical
drainage is used only if medical therapy fails over two to four days to
alleviate symptoms.
Hot compresses and splinting the
joint to provide it with rest and support can help relieve pain. After a period
of rest, your doctor will recommend gentle exercise to prevent stiffness.
If septic arthritis occurs in an
artificial joint, antibiotic treatment may need to be followed by surgery to
replace the joint. Most patients with no other serious underlying disease
recover fully from septic arthritis with antibiotic therapy.
Recovery from septic arthritis is
usually good with most patients undergoing treatment, although many patients
will develop osteoarthritis or deformed joints.
Children with infected hip joints
sometimes suffer damage to the growth plate.
Patients with severe damage to bone
or cartilage may need reconstructive surgery, but it cannot be performed until
the infection is completely gone.
Self-care tips
While septic arthritis cannot be
prevented in many cases, you can reduce your risk by not indulging in high risk
activities such as intravenous drug use.
Patients receiving corticosteroid
injections into the joints for osteoarthritis may want to weigh this treatment
method against the increased risk of septic arthritis. If you have any symptoms
similar to those listed here, see your doctor immediately. Immediate treatment
is necessary to prevent any long-term damage to the joint.
The above opinionated
views and information serves to educated and informed consumer . The
information provided herein should not be used during any medical emergency or
for the diagnosis or treatment of any medical condition. .It should not replaced
professional advise and consultation. A licensed physician should be
consulted for diagnosis and treatment of any and all medical conditions
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