Definition

Septic arthritis is an inflammation of a joint caused by a bacteria infection other than gonorrhea.

Alternative Names

Bacterial arthritis; Non-gonococcal bacterial arthritis

Causes, incidence, and risk factors

Septic arthritis develops when bacteria spreads through the bloodstream to a joint. It may also occur when the joint is directly infected with bacteria during injury or surgery.

Acute septic arthritis tends to be caused by organisms such as staphylococcus, streptococcus pneumoniae and group B streptococcus.

Chronic septic arthritis (which occurs less frequently) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans. The knee and the hip are the most commonly infected joints.

The following increase your risk for septic arthritis:

• Artificial joint implants
• Bacterial infection
• Chronic illness or disease
• Intravenous (IV) drug abuse
• Medications that suppress the immune system
• Recent joint trauma
• Recent joint arthroscopy or other surgery
• Rheumatoid arthritis
• Sickle cell disease

Septic arthritis may be seen at any age. In children, it occurs most often in those less than 3 years old. The hip is a frequent 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 and Haemophilus influenza.

Symptoms

The onset of the symptoms is usually rapid with joint swelling, intense joint pain, and low-grade fever.

Symptoms in newborns or infants:

• Unable to move the limb with the infected joint (pseudoparalysis)
• Cries when infected joint is moved (example: diaper change causes crying if hip infected)
• Irritability
• Fever

Symptoms in children and adults:

• Intense joint pain
• Joint swelling
• Joint redness
• Unable to move the limb with the infected joint
• Low-grade fever

Chills may occur, but are uncommon.

Signs and tests

• Blood culture
• Synovial fluid analysis or culture of joint fluid
• X-ray of affected joint

Treatment

Antibiotics are used to treat the infection.

Rest, immobilization, elevation, and warm compresses may help relieve pain. Performing exercises for the affected joint aids the recovery process.

If synovial fluid builds up rapidly in the joint as a result of the infection, frequent aspiration of the fluid by inserting a needle into the joint or surgery may be needed. Severe cases may need surgery to drain the infected joint fluid.

Support Groups

Expectations (prognosis)

Recovery is good with prompt antibiotic treatment. If treatment is delayed, permanent joint damage may result.

Complications

• Joint degeneration

Calling your health care provider

Call for an appointment with your health care provider if symptoms of this disorder develop.

Prevention

Prophylactic (preventive) antibiotics may be helpful for high-risk people.

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