ARTHRITIS-SEPTIC

SUMMARY

1. 2 types: non-gonococcal & gonococcal arthritis.

2. Septic (bacterial) arthritis: inflammatory, usually monoarticular, occurs from seeding during bacteremia, assoc. with fever.

3. Joint aspirate is inflammatory (average WBCs = 100,000 cells/mm³) with predominance of neutrophils, and a Gram stain frequently shows the infecting organism.

4. S. aureus, S. viridans: usual cause (60-70%) of septic native joints in adults, especially in RA patients. Portal of entry: skin, wound infection.

5. Adolescents and young adults: N. gonorrhoeae (most common cause of infectious arthritis in this age group!) often with concomitant Chlamydia trachomatis. Portal of entry: oropharynx and genitourinary tract.

6. IVDU: staph, strep, gram negatives (Pseudomonas); predilection for axial disease (SCJ & SIJ).

Reference(s)

Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].