Septic arthritis or Bacterial arthritis is inflammation of a synovium along with purulent effusion inside the joint capsule due to bacterial infection. This disease may also be called as suppurative, purulent, or infectious arthritis. Septic arthritis is a rare disease of the joints. Sometimes bacteria infect might only infect the joint and it is possible that rest of the body remains unharmed.

Sometimes fungi may infect the joints but the infection is usually rare. Any age group may get infected. Diseases do not carry any sexual preponderance. Septic arthritis is a rare disease which typically affects monoarticular joints. Septic arthritis is a rather rare but important disease that typically affects monoarticular joints. Most commonly, septic arthritis affects a single joint, but occasionally more joints are involved. Bacteria may reach joints by many routes some of which are –

 

• Blood from the abscess or some wounds
• Spread from osteomyelitic lesion
• Spread from nearby soft tissues

• Entry by iatrogenic means

• Microbes may enter by some iatrogenic means

Symptoms and signs

• Fever
• Chills
• Swelling of the joint affected
• Often low-grade fever
• Hip joint is most commonly affected in infants
• Sharp Pain
• Affected joint is hot to touch
• Redness and stiffness of joints affected
• Pseudoparalysis i.e. inability to move the limb with the affected joint

• Irritability

• Intense joint pain

Causes

• Staphylococcus aureus – adults
• Streptococcus – second most common
• Haemophilus influenzae – was common cause previously but now a day due to vaccination practices incidences have decreased.
• Neisseria gonorrhoea – common in young adults and teens indulged in sexual activities
• Escherichia coli – common in intravenous drug users
• Pseudomonas aeruginosa - common in intravenous drug users
• Mycobacterium tuberculosis

• Salmonella

• Brucella

Risk Factors

• Previous joint diseases and other problems like prosthetic joints
• Depressed immune system due to medications as taken in Rheumatoid arthritis

• Persons on immunosuppressive drugs are at increased risk

• Persons with increased skin fragility due to eczema and psoriasis

Diagnosis and tests

• Monoarthritis
• Fever
• High WBC counts
• Increased CRP
• Increased ESR
• Gram staining of joint fluid
• Culture of joint fluid
• X- Ray to analyze the damage to the joints

• Alterations in the glucose and protein concentration of the synovial fluid

• PCR to detect bacterial DNA

Treatment and drugs

• Antibiotics depending on the organism infecting the joint or if some particular infection is suspected based on the clinical findings
• Arthroscopic procedure is performed for the drainage of the joints containing bacterial infected fluids. Arthrocentesis may be performed daily based on the improvement the joints are showing
• After the infection is controlled some light exercises are prescribed to improve the blood flow to the joint and to speed up the joint healing process so the early mobility of the joint can be expected