Septic arthritis Flashcards
Presentation septic arthriti s
Rapid onset pain, swelling, redness in single joint, restricted ROM
Treatment of neissieria gonorhea causing septic arthritis
IV 2mg ceftriazone for 2 weeks
Follow with 4 weeks oral cipraflozacin 500mg BD
Formal knee washout
What does neisseria gonorrhea do on agar plates and biocheical reactions
Poor growth on blood agar
Smooth round grey colonies on chocolate agar
Small raised translucent on modified NYC agar
Oxidase and catalase positive
Presentation of disseminated gonorrhea infection
Purulent monoarthritis +/-
Triad - tenosynovitis, dermatitis (papules, pusutles, necrotic lesions), asymmetric migratory polyarthralgia
Risk factors for disseminated gonorrheal infection
Female sex
HIV infection
Menses
Low SE/educational status
Pregnancy
Multiple sexual partners
SLE
Complement deficiency
Diagnosis of disseinated gonorrhea infection
Blood cultures - may be negative
Synovial fluid analysis - joint aspirate
Gram stain - infalm effusion, neutrophil predominance =/- gram - diplococci
Culture and sensitivity testing
NAAT PCR
What does parvovirus B19 cause joint wise
Symmetrical polyarthralgia
Diagnosis of septic arthritis
Clinical
Joint aspiration - urgent gram stain, culture and antimicrobial sensitivity testing (start empirical immediately)
Investigations for prosthetic infection
FBC, WCC, CRP, U+Es, clotting
Blood cultres
Plain X ray o joint
Ortho referral for assessment
Possible oragnisms causing Gram + cocci in clusters on gram stain
Staph aureus OR coagulase negative staph
What antibiotics use in case of possible MRSA
Teicoplanin, vancomycin, linezolid
Broad spectrum antibiotics if confirmed infection - eg gram negative = tazocin
Staph aueus on agar and biochemt tests
Round, convex colonies 1-4mm sharp border w clear zone haemolysis
Catalase positive (staphylococcus)
Coagulase + = staph aureus
