Septic arthritis causes: Difference between revisions
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==Overview== | ==Overview== | ||
==Etiology== | |||
Bacteria are carried by the bloodstream from an infectious focus elsewhere, introduced by a [[skin]] [[lesion]] that penetrates the joint, or by extension from adjacent tissue (e.g. bone or bursae). | |||
Micro-organisms must reach the [[synovial membrane]] of a joint. This can happen in any of the following ways: | |||
* dissemination of [[pathogen]]s via the blood, from [[abscess]]es or wound infections, | |||
* dissemination from an [[osteomyelitis|acute osteomyelitic focus]], | |||
* dissemination from adjacent [[soft tissue]] infection, | |||
* entry via [[penetrating trauma]] | |||
* entry via [[iatrogenic]] means.<ref name=Axford/> | |||
Bacteria that are commonly found to cause septic arthritis are: | |||
* [[Staphylococcus aureus]] - the most common cause in adults | |||
* ''Streptococci'' - the second most common cause <ref name=Kaandorp>{{cite journal |author=Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA |title=Incidence and sources of native and prosthetic joint infection: a community based prospective survey |journal=Ann Rheum Dis. |volume=56 |issue=8 |pages=470–5 |year=1997 |month=August |pmid=9306869 |pmc=1752430 |doi= |url=}}<br/>{{cite journal |author=Weston VC, Jones AC, Bradbury N, Fawthrop F, Doherty M |title=Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991 |journal=Ann Rheum Dis. |volume=58 |issue=4 |pages=214–9 |year=1999 |month=April |pmid=10364899 |pmc=1752863 |doi= |url=}}</ref> | |||
* [[Haemophilus influenzae]] - was the most common cause in children but is now uncommon in areas where Haemophilus vaccination is practised<ref>{{cite journal |author=Bowerman SG, Green NE, Mencio GA |title=Decline of bone and joint infections attributable to haemophilus influenzae type b |journal=Clin Orthop Relat Res. |volume= |issue=341 |pages=128–33 |year=1997 |month=August |pmid=9269165 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0009-921X&volume=341&spage=128}}<br/>{{cite journal |author=Peltola H, Kallio MJ, Unkila-Kallio L |title=Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment |journal=J Bone Joint Surg Br. |volume=80 |issue=3 |pages=471–3 |year=1998 |month=May |pmid=9619939 |doi= |url=http://www.jbjs.org.uk/cgi/pmidlookup?view=long&pmid=9619939}} | |||
</ref> | |||
* [[gonorrhea|Neisseria gonorrhoea]] - in young adults (although this is now thought rare in western europe <ref name=Kaandorp/> | |||
* [[Escherichia coli]] - in the elderly, IV drug users and the seriously ill | |||
* [[M. tuberculosis]], [[Salmonella]] spp. and [[Brucella]] spp. - cause septic spinal arthritis <ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref> | |||
In bacterial infection, [[Pseudomonas aeruginosa]] has been found to infect joints, especially in children who have sustained a puncture wound. This bacteria also causes [[endocarditis]].<ref>[http://wordnet.com.au/Products/topics_in_infectious_diseases_Aug01.htm Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.]</ref> | |||
==References== | ==References== | ||
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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
Etiology
Bacteria are carried by the bloodstream from an infectious focus elsewhere, introduced by a skin lesion that penetrates the joint, or by extension from adjacent tissue (e.g. bone or bursae).
Micro-organisms must reach the synovial membrane of a joint. This can happen in any of the following ways:
- dissemination of pathogens via the blood, from abscesses or wound infections,
- dissemination from an acute osteomyelitic focus,
- dissemination from adjacent soft tissue infection,
- entry via penetrating trauma
- entry via iatrogenic means.[1]
Bacteria that are commonly found to cause septic arthritis are:
- Staphylococcus aureus - the most common cause in adults
- Streptococci - the second most common cause [2]
- Haemophilus influenzae - was the most common cause in children but is now uncommon in areas where Haemophilus vaccination is practised[3]
- Neisseria gonorrhoea - in young adults (although this is now thought rare in western europe [2]
- Escherichia coli - in the elderly, IV drug users and the seriously ill
- M. tuberculosis, Salmonella spp. and Brucella spp. - cause septic spinal arthritis [1]
In bacterial infection, Pseudomonas aeruginosa has been found to infect joints, especially in children who have sustained a puncture wound. This bacteria also causes endocarditis.[4]
References
- ↑ 1.0 1.1 O'Callaghan C, Axford JS (2004). Medicine (2nd ed. ed.). Oxford: Blackwell Science. ISBN 0-632-05162-0.
- ↑ 2.0 2.1 Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA (1997). "Incidence and sources of native and prosthetic joint infection: a community based prospective survey". Ann Rheum Dis. 56 (8): 470–5. PMC 1752430. PMID 9306869. Unknown parameter
|month=ignored (help)
Weston VC, Jones AC, Bradbury N, Fawthrop F, Doherty M (1999). "Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991". Ann Rheum Dis. 58 (4): 214–9. PMC 1752863. PMID 10364899. Unknown parameter|month=ignored (help) - ↑ Bowerman SG, Green NE, Mencio GA (1997). "Decline of bone and joint infections attributable to haemophilus influenzae type b". Clin Orthop Relat Res. (341): 128–33. PMID 9269165. Unknown parameter
|month=ignored (help)
Peltola H, Kallio MJ, Unkila-Kallio L (1998). "Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment". J Bone Joint Surg Br. 80 (3): 471–3. PMID 9619939. Unknown parameter|month=ignored (help) - ↑ Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.