septic arthritis Flashcards
what is always septic arthritis until proven otherwise
any acute onset mono arthritis
presentation
severely painful, hot, swollen joint which is excruciating painful on movement
how does the pathogen get into the joint most commonly
spread to joint via bloodstream (haematogenous) or from an infection of adjacent tissue
how does the pathogen get into the joint more rarely
from a direct penetrating sharp wound i.e. a bite or a rose thorn, can also occur following intra-articular surgery
why is it an emergency
bacterial infections cause irreversible damage to hyaline cartilage within a few days and it can kill
who is septic arthritis most common in
young, immunocompromised, PWIDS, immunocompromised
why might septic arthritis occur in neonates and infants
they still have intra-capsular metaphases so can spread from metaphysical osteomyelitis into joint
if more than one joint or bone is infected what should you suspect
infective endocarditis
most common bacterias cultures
- staph aureus= most common
- streptococcus= second most common
- haemophilia influenza= used to be most common in children but western world vaccinate so rarer
- neisseria gonnorhoea= more common in young sexually active adults
- escherichia coli= occurs in elderly, IVDU ad the seriously ill
any joint suspected of septic arthritis
should be aspirated under aseptic technique for gram stain and culture
what happens if you give antibiotics before aspirating
you may get a false negative
if frank pus is aspirated
requires surgical washout
general management
surgical washout and IV antibiotics
