Septic arthritis causes: Difference between revisions
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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). | 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). | ||
Microorganisms 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: | Bacteria that are commonly found to cause septic arthritis are: | ||
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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
Septic arthritis develops when bacteria or other tiny disease-causing organisms (microorganisms) spread through the bloodstream to a joint. It may also occur when the joint is directly infected with a microorganism from an injury or during surgery. The most common sites for this type of infection are the knee and hip. Most cases of acute septic arthritis are caused by bacteria such as staphylococcus or streptococcus. Chronic septic arthritis (which is less common) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans.
Causes
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).
Microorganisms 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.