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Septic arthritis: patients with or without isolated infectious agents have similar characteristics.
- Source :
-
Infection [Infection] 2014 Apr; Vol. 42 (2), pp. 385-91. Date of Electronic Publication: 2013 Dec 07. - Publication Year :
- 2014
-
Abstract
- Purpose: Septic arthritis can be disabling and life-threatening, requiring prompt diagnosis and treatment. The infectious agent is not always identified in these patients. We revaluate septic arthritis cases discharged from our department, describing the affected population, causative microorganisms and antibiotic therapy used, and characterised differences between patients with and without isolated pathogenic agents.<br />Methods: Sixty-eight septic arthritis patients were included in this study. Diagnosis was based on clinical findings, and/or the presence of joint purulent material, and/or bacterial pathogen isolation from joint fluid/synovial membrane/blood cultures and response to antibiotics. Data analysis was performed using SPSS 20.<br />Results: Patients had a mean age of 61.1 ± 18.8 years, without sex predominance. 26.5 % had an infection ≤ 15 days before septic arthritis diagnosis. Besides previous infection, 57.4 % had ≥ 1 risk factors for septic arthritis, most commonly pharmacological immunosuppression (20.6 %), diabetes mellitus type 2 (19.1 %) and rheumatoid arthritis (17.6 %). The knee was the most often affected (54.3 %). Only 39.7 % presented fever from clinical onset until hospital admission (mean 13.4 ± 18.9 days). Leucocytosis was present in 45.6 % of patients, elevated erythrocyte sedimentation rate (ESR) in 75 % and elevated C-reactive protein (CRP) in 97.1 %. 5.9 % had articular damage attributable to septic arthritis. An infectious agent was isolated in 41.2 % of patients, with Staphylococcus aureus being the most frequent. 38.7 % of synovial fluid and 23.5 % of synovial membrane cultures were positive. Patients with an identified infectious agent have no significant differences other than more days of hospitalisation (p = 0.003) and in-hospital antibiotic treatment (p = 0.017).<br />Conclusion: Synovial fluid and synovial membrane cultures more often identified pathogens compared to blood or urine cultures. Patients with and without an identified infectious agent have similar demographic, clinical, laboratory and radiographic characteristics.
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Arthritis, Infectious diagnosis
C-Reactive Protein metabolism
Female
Humans
Male
Middle Aged
Portugal
Retrospective Studies
Risk Factors
Sex Factors
Staphylococcal Infections diagnosis
Synovial Fluid metabolism
Synovial Fluid microbiology
Anti-Bacterial Agents therapeutic use
Arthritis, Infectious drug therapy
Arthritis, Infectious microbiology
Staphylococcal Infections drug therapy
Staphylococcal Infections microbiology
Staphylococcus aureus isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 1439-0973
- Volume :
- 42
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Infection
- Publication Type :
- Academic Journal
- Accession number :
- 24318567
- Full Text :
- https://doi.org/10.1007/s15010-013-0567-z