Infectious Arthritis Tóm tắt về bệnh

Tổng quan

Infectious arthritis is a destructive form of joint disease caused by hematogenous spread of organisms from a distant site of infection or a direct penetration of the joint as a result of trauma, surgery, or spread from adjacent osteomyelitis, as stated in the Introduction section.

The prevalence of infectious arthritis varies with age, ethnicity, and socioeconomic status. A detailed discussion about the prevalence of infectious arthritis is in the Epidemiology section.

Pathogens causing infectious arthritis are Staphylococcus aureus, Staphylococcus epidermidis, streptococci, Gram-negative Bacilli, Neisseria gonorrhoeae, anaerobes, Mycobacterial sp and fungi. Discussion on these pathogens is in the Etiology section.

The Pathophysiology section states that hematogenous spread is the most common route for infections to reach the joint space, with penetrating trauma or inoculation as potential triggers. The development process of infectious arthritis is in this section.

The Risk Factors section discusses risk factors in the development of infectious arthritis, such as age, surgery, systemic diseases, and the use of glucocorticoids.

Infectious Arthritis_Disease Summary

History and Physical Examination

The Clinical Presentation section describes the clinical features seen in patients with infectious arthritis. The History section emphasizes the importance of a complete history and the Physical Examination section discusses the signs to look for during a thorough examination of patients with infectious arthritis.

Chẩn đoán

Discussion on synovial fluid exam, blood culture, metagenomic next-generation sequencing, and other tests in the evaluation of infectious arthritis is in the Laboratory Tests and Ancillaries section. While in the Imaging section, radiographic tests that can be done are discussed.

Other diseases that should be ruled out in the diagnosis of infectious arthritis are listed in the Differential Diagnosis section.

Xử trí

In treating patients with infectious arthritis, the appropriate antibiotic treatment should be started once specimens for microbiology studies are obtained. This is further discussed in the Principles of Therapy section.

The Pharmacological Therapy section discusses in detail the use and duration of antibiotic therapy in the empiric treatment of infectious arthritis based on the patient’s clinical profile, age, and results of the synovial fluid examination. 

Discussions on joint drainage to decompress the joint and remove pus, and allow debridement as well as specimens to be obtained for biopsy and repeat culture in the management of infectious arthritis, are in the Surgery section.

The Monitoring section discusses patient follow-up in the management of infectious arthritis.