Infecto 4 Flashcards
Septic arthritis
Infection of synovial fluid and joint tissues in 1 joint
Infection of synovial fluid and joint tissue
Septic arthritis
Septic arthritis agent
30 % Gram + staph aureus
Divisions of septic arthritis
Nongonococcal vs gonococcal
Gonococcal septic arthritis
Sexually active, migratory pain spreads thru joints polyarthritis, tenosynovitis (tendon sheath inflamed), blood culture < 10%
Nongonococcal arthritis
In young or elderly, mono arthritis, blood culture = 50%
Septic arthritis diagnosis
Test synovial fluid by wbc and isolate bacteria to culture
Blood test, CSF or urine test
Rule out gout/pseudogout with uric crystal analysis
Prosthetic septic arthritis
In knee or hip joint within 1 year of surgery
History of fall or surgical revisions (25-20%)
Prosthetic septic arthritis agent
Staph epidermidis
Diagnose prosthetic septic arthritis
symptoms
Communication between sinus tract and prosthesis may be diagnostic. Synovial fluid for cell count/culture.
X-rays imaging show loosening of prosthesis or periosteal reaction but NOT diagnostic
Treat prosthetic septic arthritis
arthrotomy - surgical exploration of joints to clean up with debridement of all cement, abscesses and devitalized tissues. Put in a spacer treated with antibiotics.
Debridement is followed by immediate prosthesis revision or placement of an antibiotic impregnated spacer and then delayed (2-4 months) implantation of a new prosthesis using antibiotic impregnated cement.
Septic arthritis of prosthetic VS native joints
coagulase - staphylococcus like S. epidermidis account for a greater percentage of prosthetic joint infections than they do native joint infections.
Vertebral osteomyelitis and spondylodiscitis
Spinal cord infection from surgical spine injury or spread thru bloodstream
More common in men
Risks for spinal vertebral osteomyelitis
Dialysis, sickle cell anemia, older, injection drug abuser
