Septic arthritis causes
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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.