Septic Arthritis Flashcards Preview

Rheumatology > Septic Arthritis > Flashcards

Flashcards in Septic Arthritis Deck (18):
1

Definition:

Piogenic arthritis characterized by supurative inflamatory process in the sinovial membrane

2

Epidemiology:

Incidence of 2-10/100.000/year

3

Etiologia:

S. aureus, N. gonorrheae, Beta-hemolytic streptococcus, Gram-negative aerobic and anaerobic bacteria

4

Pathophysiology:

Contiguous spread or via the bloodstream -> Sinovial membrane -> Bacterial proliferation -> Loss of glycosaminoglycans -> Hydrolysis of essential collagen -> non reversible joint destruction

5

Classification:

Gonococcal and Nongonococcal

6

Quadro Clínico:

Monoartrite aguda, tenossinovite, limitação acentuada dos movimentos, claudicação, febre e pústulas indolores

*Joelhos, quadris, ombros, tornozelos, punhos e cotovelos

7

Critérios Diagnósticos (Kocher, 1999):

Impossibilidade de apoiar membro, febre, VHS+40, Leuc +12.000

8

Exames Complementares:

HC, VHS, PCR, Hemocultura, eletrólitos, ácido úrico, função renal, função hepática, *Rx articular bilateral, US, **Artrocentese , Coloração Gram, Hemocultura e Cultura do líquido sinovial

*Edema de partes moles periarticulares, osteopenia periarticular e redução do espaço articular difusamente
**Líquido sinovial turvo ou purulento com baixa viscosidade e Leucócitos +50.000

9

Diagnóstico Diferencial:

Gota, Pseudogota, Febre reumática, Artrite reumatóide e Púrpura de Henoch-Schoenlein

10

Tratamento (Current, 2014):

Internar por 1-2d -> Repouso, Imobilização articular, Drenagem articular, Lavagem artroscópica, Debridamento e *Ceftriaxona 1000mg IM 24/24h por 1-2d -> Fluorquinolona VO por 4sem ---> **Artrotomia

*Oxacilina 2000mg IV 4/4h

**1ª linha no Quadril

11

Risk factors:

Trauma, Atividade sexual desprotegida, use of prosthetic joints, uso de glicocorticoides e uso de drogas injetáveis

12

Diseases that are risk factors:

Osteomielite, Osteoartrite, Artrite reumatóide and Gota

13

Most common pathogen (75% of cases) among younger sexually active individuals:

N. gonorrhoeae

14

Most common pathogen in adults and in children older than 2 years:

S. aureus

15

The increased incidence of S. aureus is directly proportional to:

the increase of prosthetic joints and the use of immunosuppressive agents

16

The pathogen in 80% of infected joints affected by rheumatoid arthritis:

S. aureus

17

Polymicrobial joint infections (5-10% of cases) and infection with anaerobic organisms (5% of cases) are usually a consequence of:

Trauma or Abdominal infection

18

Most common route that the pathogens invade the joint:

Via bloodstream