Septic arthritis risk factors: Difference between revisions

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!Rheumatoid arthritis
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* Staphylococcus aureus<ref name="pmid9449882">Goldenberg DL (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9449882 Septic arthritis.] ''Lancet'' 351 (9097):197-202. [http://dx.doi.org/10.1016/S0140-6736(97)09522-6 DOI:10.1016/S0140-6736(97)09522-6] PMID: [https://pubmed.gov/9449882 9449882]</ref><ref name="pmid19665261">Frazee BW, Fee C, Lambert L (2009) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19665261 How common is MRSA in adult septic arthritis?] ''Ann Emerg Med'' 54 (5):695-700. [http://dx.doi.org/10.1016/j.annemergmed.2009.06.511 DOI:10.1016/j.annemergmed.2009.06.511] PMID: [https://pubmed.gov/19665261 19665261]</ref><ref name="pmid3883171">Goldenberg DL, Reed JI (1985) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3883171 Bacterial arthritis.] ''N Engl J Med'' 312 (12):764-71. [http://dx.doi.org/10.1056/NEJM198503213121206 DOI:10.1056/NEJM198503213121206] PMID: [https://pubmed.gov/3883171 3883171]</ref><ref name="pmid18525361">Mathews CJ, Coakley G (2008) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18525361 Septic arthritis: current diagnostic and therapeutic algorithm.] ''Curr Opin Rheumatol'' 20 (4):457-62. [http://dx.doi.org/10.1097/BOR.0b013e3283036975 DOI:10.1097/BOR.0b013e3283036975] PMID: [https://pubmed.gov/18525361 18525361]</ref>
* Staphylococcus aureus<ref name="pmid9449882">Goldenberg DL (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9449882 Septic arthritis.] ''Lancet'' 351 (9097):197-202. [http://dx.doi.org/10.1016/S0140-6736(97)09522-6 DOI:10.1016/S0140-6736(97)09522-6] PMID: [https://pubmed.gov/9449882 9449882]</ref><ref name="pmid19665261">Frazee BW, Fee C, Lambert L (2009) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=19665261 How common is MRSA in adult septic arthritis?] ''Ann Emerg Med'' 54 (5):695-700. [http://dx.doi.org/10.1016/j.annemergmed.2009.06.511 DOI:10.1016/j.annemergmed.2009.06.511] PMID: [https://pubmed.gov/19665261 19665261]</ref><ref name="pmid3883171">Goldenberg DL, Reed JI (1985) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=3883171 Bacterial arthritis.] ''N Engl J Med'' 312 (12):764-71. [http://dx.doi.org/10.1056/NEJM198503213121206 DOI:10.1056/NEJM198503213121206] PMID: [https://pubmed.gov/3883171 3883171]</ref><ref name="pmid18525361">Mathews CJ, Coakley G (2008) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18525361 Septic arthritis: current diagnostic and therapeutic algorithm.] ''Curr Opin Rheumatol'' 20 (4):457-62. [http://dx.doi.org/10.1097/BOR.0b013e3283036975 DOI:10.1097/BOR.0b013e3283036975] PMID: [https://pubmed.gov/18525361 18525361]</ref><ref name="pmid8849354">{{cite journal| author=Kaandorp CJ, Van Schaardenburg D, Krijnen P, Habbema JD, van de Laar MA| title=Risk factors for septic arthritis in patients with joint disease. A prospective study. | journal=Arthritis Rheum | year= 1995 | volume= 38 | issue= 12 | pages= 1819-25 | pmid=8849354 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8849354  }} </ref>
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!Immunocompromised patients
!Immunocompromised patients

Revision as of 21:28, 12 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Jumana Nagarwala, M.D., Senior Staff Physician, Department of Emergency Medicine, Henry Ford Hospital; Cafer Zorkun, M.D., Ph.D. [2]

Overview

Risk Factors

Common Risk Factors

Most common risk factors that predisposes septic arthritis are rheumatoid arthritis, prosthetic joint or joint replacement and skin infections.[1][2][3][4]

Other common risk factors that predispose septic arthritis are as follows:[5][4][6][7][8]

Type of risk factor Examples
Host phagocytic defects
  • Complement deficiencies especially C7 and C8
  • Inherited disorders of chemotaxis
Impaired host defense mechanisms
  • Age >80 years[9]
  • Cancer
  • Immunosuppressive drugs (e.g. azathioprine, methotrexate, or cyclophosphamide)
  • Glucocorticosteroids
Direct penetration
  • Intravenous drug use
  • Puncture wonds
  • Intra articular steroid injection
Joint damage
  • Prosthetic joint surgery
  • Degenerative joint diseases such as rheumatoid arthritis ( Prosthetic joint > Rheumatoid arthritis > Osteoarthritis)[4]
Other risk factors
  • Recent history of bacteremia
  • Cirrhosis
  • Chronic kidney disease
  • Hypogammaglobulinemia
  • Systemic lupus erythematosis
  • Gout
  • Psuedo gout[10]
  • Charcot's arthropathy[11]

Micrbiological Clue Based on Risk factors

Type of risk factor Examples
Rheumatoid arthritis
Immunocompromised patients
  • Staphylococcus aureus
  • Streptococci
  • Enteric gram-negative bacilli
  • Listeria monocytogenes
Recent joint surgery
  • Staphylococcus aureus
Intravenous drug use
  • Staphylococcus aureus
  • Pseudomonas aeruginosa
Diabetes mellitus
  • Staphylococcus aureus
  • Streptococcus agalactiae
Sexually active young adults

Menstruating females

  • Neisseria gonorrhea
Animal bite (e.g.Cat or dog)
  • Pasteurella multocida
  • Capnocytophaga spp
  • Anaerobes
Human bite
  • Eikenella corrodens
  • Viridans streptococci
  •  Anaerobes
Rat bite
  • Streptobacillus moniliformis
Neonates and children age < 4 years
  • Kingella kingae
  • Gram-negative bacilli
Unvaccinated children
  • Haemophilus influenza
Ingestion of unpasteurized dairy products
  • Brucella spp


The following conditions increase the risk for septic arthritis:

Septic arthritis may be seen at any age. In children, it occurs most often in those younger than 3 years. The hip is often the site of infection in infants. Septic arthritis is uncommon from age 3 to adolescence. Children with septic arthritis are more likely than adults to be infected with Group B streptococcus or Haemophilus influenza, if they have not been vaccinated.

References

  1. ↑ Esterhai JL, Gelb I (1991) Adult septic arthritis. Orthop Clin North Am 22 (3):503-14. PMID: 1852426
  2. ↑ Dubost JJ, Fis I, Soubrier M, Lopitaux R, Ristori JM, Bussière JL et al. (1994) [Septic arthritis in rheumatoid polyarthritis. 24 cases and review of the literature.] Rev Rhum Ed Fr 61 (3):153-65. PMID: 7920511
  3. ↑ Gristina AG, Giridhar G, Gabriel BL, Naylor PT, Myrvik QN (1993) Cell biology and molecular mechanisms in artificial device infections. Int J Artif Organs 16 (11):755-63. PMID: 8150521
  4. ↑ 4.0 4.1 4.2 4.3 Kaandorp CJ, Van Schaardenburg D, Krijnen P, Habbema JD, van de Laar MA (1995) Risk factors for septic arthritis in patients with joint disease. A prospective study. Arthritis Rheum 38 (12):1819-25. PMID: 8849354
  5. ↑ Dickie AS (1986) Current concepts in the management of infections in bones and joints. Drugs 32 (5):458-75. PMID: 3792229
  6. ↑ Morgan DS, Fisher D, Merianos A, Currie BJ (1996) An 18 year clinical review of septic arthritis from tropical Australia. Epidemiol Infect 117 (3):423-8. PMID: 8972665
  7. ↑ Rozadilla A, Nolla JM, Mateo L, del Blanco J, Valverde J, Roig D (1992) [Septic arthritis induced by pyogenic germs in patients without parenteral drug addiction. Analysis of 44 cases.] Med Clin (Barc) 98 (14):527-30. PMID: 1602850
  8. ↑ 8.0 8.1 Goldenberg DL, Reed JI (1985) Bacterial arthritis. N Engl J Med 312 (12):764-71. DOI:10.1056/NEJM198503213121206 PMID: 3883171
  9. ↑ Lagaay AM, van Asperen IA, Hijmans W (1992) The prevalence of morbidity in the oldest old, aged 85 and over: a population-based survey in Leiden, The Netherlands. Arch Gerontol Geriatr 15 (2):115-31. PMID: 15374369
  10. ↑ Lurie DP, Musil G (1983) Staphylococcal septic arthritis presenting as acute flare of pseudogout: clinical, pathological and arthroscopic findings with a review of the literature. J Rheumatol 10 (3):503-6. PMID: 6887177
  11. ↑ Rubinow A, Spark EC, Canoso JJ (1980) Septic arthritis in a Charcot joint. Clin Orthop Relat Res (147):203-6. PMID: 6989540
  12. ↑ Goldenberg DL (1998) Septic arthritis. Lancet 351 (9097):197-202. DOI:10.1016/S0140-6736(97)09522-6 PMID: 9449882
  13. ↑ Frazee BW, Fee C, Lambert L (2009) How common is MRSA in adult septic arthritis? Ann Emerg Med 54 (5):695-700. DOI:10.1016/j.annemergmed.2009.06.511 PMID: 19665261
  14. ↑ Mathews CJ, Coakley G (2008) Septic arthritis: current diagnostic and therapeutic algorithm. Curr Opin Rheumatol 20 (4):457-62. DOI:10.1097/BOR.0b013e3283036975 PMID: 18525361


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