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This publication is made possible by an educational grant from Amgen
Inc.
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Volume 51, Number 1
Septic Arthritis Update
George Ho Jr., MD
Division of Allergy, Immunology and Rheumatology
Department of Internal Medicine
Brody School of Medicine at East Carolina
University
Greenville, NC
Summary
- The most common pathogenesis of septic
arthritis is bacteremic seeding.
- In the evaluation of a patient with acute
monoarthritis, think sepsis first.
- Once septic arthritis is suspected and
cultures are performed, antibiotic treatment should begin immediately.
- The cost-effectiveness of antibiotic
prophylaxis to prevent late infections in prosthetic joints is controversial.
Introduction
Bacterial infections are the most serious
infections affecting the joints. Normal joints, diseased joints, and prosthetic
joints are all vulnerable to bacterial infection. Mortality rates among adults
range from 10% to greater than 50%. Full recovery is possible, but poor outcome
is common among those with preexisting arthritis, especially rheumatoid
arthritis.
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