Septic arthritis risk factors
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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]Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [3]
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 |
| |
| Impaired host defense mechanisms |
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| Direct penetration |
| |
| Joint damage |
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| Other risk factors | ||
Micrbiological Clue Based on Risk factors
| Type of risk factor | Examples |
|---|---|
| Rheumatoid arthritis | Staphylococcus aureus[12][13][8][14][4] |
| 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 |
| Elderly adults | Staphylococcus aureus, streptococci, Gram-negative bacilli |
| Post-aspiration or injection | Staphylococcus aureus |
| Trauma | Gram-negative bacilli, anaerobes, Staphylococcus aureus |
| 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 |
| Systemic lupus
erythematosus |
Salmonella |
| Sickle cell anemia | Salmonella |
| Hemophilia | Staphylococcus aureus, streptococci, Gram-negative bacilli |
| Ingestion of unpasteurized dairy products | Brucella spp |
The following conditions increase the risk for septic arthritis:
- Artificial joint implants
- Bacterial infection somewhere else in the body
- Chronic illness or disease (such as diabetes, rheumatoid arthritis, and sickle cell disease)
- Intravenous (IV) or injection drug use
- Medications that suppress the immune system
- Recent joint injury
- Recent joint arthroscopy or other surgery
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
- ↑ Esterhai JL, Gelb I (1991) Adult septic arthritis. Orthop Clin North Am 22 (3):503-14. PMID: 1852426
- ↑ 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
- ↑ 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
- ↑ 4.0 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
- ↑ Dickie AS (1986) Current concepts in the management of infections in bones and joints. Drugs 32 (5):458-75. PMID: 3792229
- ↑ 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
- ↑ 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
- ↑ 8.0 8.1 Goldenberg DL, Reed JI (1985) Bacterial arthritis. N Engl J Med 312 (12):764-71. DOI:10.1056/NEJM198503213121206 PMID: 3883171
- ↑ 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
- ↑ 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
- ↑ Rubinow A, Spark EC, Canoso JJ (1980) Septic arthritis in a Charcot joint. Clin Orthop Relat Res (147):203-6. PMID: 6989540
- ↑ Goldenberg DL (1998) Septic arthritis. Lancet 351 (9097):197-202. DOI:10.1016/S0140-6736(97)09522-6 PMID: 9449882
- ↑ 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
- ↑ 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