Septic arthritis

Also known as: Bacterial arthritis and Non-gonococcal bacterial arthritis

Definition

Septic arthritis is inflammation of a joint due to a bacterial infection other than gonorrhea (joint infection due to gonorrhea has different symptoms).

Causes, incidence, and risk factors

Septic arthritis develops when bacteria spread through the bloodstream to a joint. It may also occur when the joint is directly infected with bacteria by 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 organisms such as staphylococcus or streptococcus.

Chronic septic arthritis (which is less common) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans.

The following increase your risk for septic arthritis:

• Artificial joint implants
• Bacterial infection elsewhere in your body
• Chronic illness or disease (such as diabetes, rheumatoid arthritis, and sickle cell disease)
• Intravenous (IV) or injection drug use
• Medications that suppress your immune system
• Recent joint trauma
• 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 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 or Haemophilus influenza., if not immunized.

Symptoms

Symptoms usually come on quickly, with joint swelling, intense joint pain, and low-grade fever.

Symptoms in newborns or infants:

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

Symptoms in children and adults:

• Inability to move the limb with the infected joint (pseudoparalysis)
• Intense joint pain
• Joint swelling
• Joint redness
• Low-grade fever

Chills may occur, but are uncommon.

Signs and tests

• Blood culture
• Joint fluid analysis and culture
• X-ray of affected joint

Treatment

Antibiotics are used to treat the infection.

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

If joint (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 may be needed. Severe cases may need surgery to drain the infected joint fluid.

Expectations (prognosis)

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

Complications

• Joint degeneration (arthritis)

Calling your health care provider

Call for an appointment with your health care provider if you develop symptoms of septic arthritis.

Prevention

Preventive (prophylactic) antibiotics may be helpful for people at high risk.

References

Espinoza LR. Infections of bursae, joints, and bones. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier. 2007: chap 290.

See also:

• Symptoms

  Joint swelling

  

  Joint swelling is the buildup of fluid in the soft tissue surrounding the joint.

• Disease

  Rheumatoid arthritis

  

  Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues. It can also affect other organs.

• Disease

  Flu

  

  The flu is an infection of the nose, throat, and lungs caused by the influenza virus. See also: (H1N1)

• Special Topic

  Chronic

  

  Chronic refers to something that continues or persists over an extended period of time. A chronic condition is usually long-lasting and does not easily or quickly go away. Chronic is the opposite of .

• Disease

  Gonococcal arthritis

  

  Gonococcal arthritis is inflammation of a joint (usually just one) due to a gonorrhea infection. See also:

• Special Topic

  Acute

  

  Acute means sudden or severe. Acute symptoms appear, change, or worsen rapidly. It is the opposite of .

• Symptoms

  Joint pain

  

  Joint pain can affect one or more joints. See also: (inflammation of joints)

• Disease

  Pulmonary tuberculosis

  

  Pulmonary tuberculosis (TB) is a contagious bacterial infection that involves the lungs, but may spread to other organs.

• Test

  Arthroscopy

  

  Arthroscopy is a method of viewing a joint, and, if needed, to perform surgery on a joint. An arthroscope consists of a tiny tube, a lens, and a light source. See also:

• Disease

  Group B streptococcal septicemia of the newborn

  Group B streptococcal septicemia is a severe bacterial infection that affects . See also:

Review date:

May 30, 2009

Reviewed by:

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School, Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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