Bone and Joint Infections

Abstract: This chapter reviews the commonly encountered infectious diseases pertaining to bone and joints, beginning with native septic arthritis, which can be further divided into gonococcal and nongonococcal arthritis. Staphylococcus aureus or streptococci are responsible for most cases of native arthritis. Other etiologies, such as fungal and viral arthritides, are also described. We also describe vertebral osteomyelitis, as well as osteomyelitis of the appendicular skeleton. S. aureus is the commonly implicated pathogen here too. Treatment involves several weeks of pathogen-directed antibiotics, with surgical debridement varying from case to case. In addition, we describe osteomyelitis in the diabetic population and patients with vascular disease. Periprosthetic joint infections (PJIs) are among the most dreadful complications of joint arthroplasty. We review risk factors, clinical presentation, and treatment approach, which varies from case to case. However, several weeks of antibiotics—up to 6 weeks—are typically administered, followed by suppressive courses in select patients. We also describe suppurative tenosynovitis. This can involve flexor or extensor tendons of the extremities. Diagnosis is typically based on clinical presentation, and therapy consists of appropriate antibiotics and incision and drainage to prevent tendon necrosis. Mycobacterial tenosynovitis warrants special attention, as treatment is typically prolonged.