Infectious Arthrirtis Flashcards
Bacterial Arthritis - Etiology
H. influenza - less than 2yo S. aureus - older children/adult Gonococcus - sexually active, young adult Streptococcus Gram neg bacilli - E. coli - Salmonella (SCD) - Pseudomonas
Bacterial Arthritis - Pathology
MC - Hematogenous Spread during an episode of bacteremia
Neonates - Contiguous Spread from Epiphyseal Osteomylitis
Salmonella and SCD
- Lose ability to phagocytize in spleen
- IgM levels depressed in serum
- Suppression of lymphocyte responsiveness
- Changes in Opsonin-Alternative Complement System
Bacterial Arthritis - Clinical
Any Bone Adjacent to Abcess Swollen Infected Joint w/ Restricted ROM Fever Leukocytosis Elevated ESR
Tuberculous Arthritis - Epidemiology
All age groups, especially adults
Tuberculous Arthritis - Pathology
MONOarticular disease
Tuberculous Arthritis - Morphology
Seeding of the joint with Mycobacterium causes confluent GRANULOMAS with central caseous necrosis
Synovium grow as a PANNUS over articular cartilage and erode bone along joint margins
Tuberculous Arthritis - Clinical
Weight Bearing Joints
Hips>Knees>Ankles
Associated with Pott’s Disease
Lyme Arthritis - Epidemiology
Patients who get Lyme Disease and untreated
Lyme Arthritis - Pathology
Caused by BORRELIA BURGDORFERI (a spirochete) via IXODES RICINUS (ticks)
Caused by immune response against BORRELIA ANTIGENS (OspA) that cross react with proteins in joints
Lyme Arthritis - Morphology
Synovium: Chronic Papillary Synovitis Synoviocyte Hyperplasia Fibrin Deposition Mononuclear Cell Infiltrates Onionskin Thickening of Arterial Walls
Silver Stain:
Small Number of Organisms in vicinity of Blood Vessels
Lyme Arthritis - Clinical
LARGE JOINTS (Knee, shoulder, elbow)
Migratory Pain
Can lead to chronic with PANNUS
Resembles RA
Viral Arthritis - Epidemiology
Parvovirus B19
Rubella
Hepatitis B and C
Viral Arthritis - Pathology
Direct Infection
Autoimmune Reaction to Infection
Viral Arthritis - Clinical
Therapy for HIV may ameliorate their severity
