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Infectious arthritis

Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness and headache. Occasionally, more than one joint may be involved. Septic arthritis, also known as joint infection or infectious arthritis, is the invasion of a joint by an infectious agent resulting in joint inflammation. Symptoms typically include redness, heat and pain in a single joint associated with a decreased ability to move the joint. Onset is usually rapid. Other symptoms may include fever, weakness and headache. Occasionally, more than one joint may be involved. Causes include bacteria, viruses, fungi and parasites. Risk factors include an artificial joint, prior arthritis, diabetes and poor immune function. Most commonly, joints become infected via the blood but may also become infected via trauma or an infection around the joint. Diagnosis is generally based on aspirating joint fluid and culturing it. White blood cells of greater than 50,000 mm3 or lactate greater than 10 mmol/l in the joint fluid also makes the diagnosis likely. Initial treatment typically includes antibiotics such as vancomycin, ceftriaxone or ceftazidime. Surgery may also be done to clean out the joint. Without early treatment, long-term joint problems may occur. Septic arthritis occurs in about 5 people per 100,000 each year. It occurs more commonly in older people. With treatment, about 15% of people die, while without treatment 66% die. Septic arthritis most commonly causes pain, swelling and warmth at the affected joint. Therefore, those affected by septic arthritis will often refuse to use the extremity and prefer to hold the joint rigidly. Fever is also a symptom; however, it is less likely in older patients. On physical examination, the septic joint should be ruled out of intra-articular (from inside the joint) or periarticular (around the joint such as bursa and skin) cause. Intra-articular arthritis usually results in severe limitation of the range of movement of the joint with the joint held in extended position; the joint space will be maximal in this position. In peri-articular arthritis, pain only occurs when the joint is moved, and the lesion usually lies in one specific area around the joint. The most common joint affected is the knee. Hip, shoulder, wrist and elbow joints are less commonly affected. Spine, sternoclavicular and sacroiliac joints can also be involved. The most common cause of arthritis in these joints is intravenous drug use. Usually, only one joint is affected. More than one joint can be involved if bacteria are spread through the bloodstream. For those with artificial joint implants, there is a chance of 0.86 to 1.1% of getting infected in a knee joint and 0.3 to 1.7% of getting infected in a hip joint. There are three phases of artificial joint infection: early, delayed and late. Septic arthritis is most commonly caused by a bacterial infection. Bacteria can enter the joint by: Microorganisms in the blood may come from infections elsewhere in the body such as wound infections, urinary tract infections, meningitis or endocarditis. Sometimes, the infection comes from an unknown location. Joints with preexisting arthritis, such as rheumatoid arthritis, are especially prone to bacterial arthritis spread through the blood. In addition, some treatments for rheumatoid arthritis can also increase a patient's risk by causing an immunocompromised state. Intravenous drug use can cause endocarditis that spreads bacteria in the bloodstream and subsequently causes septic arthritis. Bacteria can enter the joint directly from prior surgery, intraarticular injection, trauma or joint prosthesis.

[ "Arthritis" ]
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