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==Overview==
==Overview==
Septic arthritis develops when bacteria or other tiny disease-causing organisms (microorganisms) spread through the bloodstream to a joint. It may also occur when the joint is directly infected with a microorganism from an injury or during surgery.<ref name="pmid8412643">Dubost JJ, Fis I, Denis P, Lopitaux R, Soubrier M, Ristori JM et al. (1993) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8412643 Polyarticular septic arthritis.] ''Medicine (Baltimore)'' 72 (5):296-310. PMID: [https://pubmed.gov/8412643 8412643]</ref> The most common etiological agent of all nongonococcal causes of septic arthritis in the United States is Staphylococcus aureus.<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> The most common sites for this type of infection are the knee and hip. Most cases of acute septic arthritis are caused by bacteria such as staphylococcus or streptococcus. Chronic septic arthritis (which is less common) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans.Gram-negative bacilli account for 10 to 20% of septic arthritis causes.<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> ~10% of patients with nongonococcal septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases.
Septic arthritis develops when [[bacteria]] or tiny disease-causing [[microorganisms]] that spread through the bloodstream to a [[synovium]]. It may also occur when the joint is directly infected with a microorganism from an injury or during [[surgery]].<ref name="pmid8412643">Dubost JJ, Fis I, Denis P, Lopitaux R, Soubrier M, Ristori JM et al. (1993) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=8412643 Polyarticular septic arthritis.] ''Medicine (Baltimore)'' 72 (5):296-310. PMID: [https://pubmed.gov/8412643 8412643]</ref> The most common etiological agent of all [[Nongonococcal urethritis|nongonococcal]] causes of septic arthritis in the United States is [[Staphylococcus aureus]].<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> The most common sites for this type of infection are the knee and hip. Most cases of acute septic arthritis are caused by bacteria such as [[staphylococcus]] or [[streptococcus]]. Chronic septic arthritis (which is less common) is caused by organisms such as [[Mycobacterium tuberculosis]] and [[Candida albicans]].[[Gram-negative bacilli]] account for 10 to 20% of septic arthritis causes.<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> ~10% of patients with nongonococcal septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases.


==Causes==
==Causes==
Gram-negative bacilli account for 10 to 20% of septic arthritis causes.<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> ~10% of patients with nongonococcal septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases. Most common cause of septic arthritis in children age < 2 years are Haemophilus influenzae (in immunized children), Staph. aureus, group A Streptococcal infections and Kingella kingae.<ref name="pmid7735407">Yagupsky P, Bar-Ziv Y, Howard CB, Dagan R (1995) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7735407 Epidemiology, etiology, and clinical features of septic arthritis in children younger than 24 months.] ''Arch Pediatr Adolesc Med'' 149 (5):537-40. PMID: [https://pubmed.gov/7735407 7735407]</ref> The source of infection in most of the cases (~50%) often from the skin, lungs or bladder.
[[Gram-negative bacilli]] account for 10 to 20% of septic arthritis causes.<ref name="pmid2283490">Deesomchok U, Tumrasvin T (1990) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=2283490 Clinical study of culture-proven cases of non-gonococcal arthritis.] ''J Med Assoc Thai'' 73 (11):615-23. PMID: [https://pubmed.gov/2283490 2283490]</ref> ~10% of patients with [[Nongonococcal urethritis|nongonococcal]] septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases. Most common cause of septic arthritis in children age < 2 years are [[Haemophilus influenzae]] (in immunized children), [[Staphylococcus aureus|Staph. aureus]], [[Group A streptococcal infection|group A Streptococcal infections]] and [[Kingella|Kingella kingae]].<ref name="pmid7735407">Yagupsky P, Bar-Ziv Y, Howard CB, Dagan R (1995) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=7735407 Epidemiology, etiology, and clinical features of septic arthritis in children younger than 24 months.] ''Arch Pediatr Adolesc Med'' 149 (5):537-40. PMID: [https://pubmed.gov/7735407 7735407]</ref> The source of infection in most of the cases (~50%) often from the [[skin]], [[lungs]] or [[Urinary bladder|bladder]].
===Common Causes===
===Common Causes===
Common microorganisms causing septic arthritis includes:<ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref name="pmid9269165">Bowerman SG, Green NE, Mencio GA (1997) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9269165 Decline of bone and joint infections attributable to haemophilus influenzae type b.] ''Clin Orthop Relat Res''  (341):128-33. PMID: [https://pubmed.gov/9269165 9269165]</ref><ref name="pmid9619939">Peltola H, Kallio MJ, Unkila-Kallio L (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9619939 Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment.] ''J Bone Joint Surg Br'' 80 (3):471-3. PMID: [https://pubmed.gov/9619939 9619939]</ref><ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref>[http://wordnet.com.au/Products/topics_in_infectious_diseases_Aug01.htm Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.]</ref><ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref name="pmid9306869">Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA (1997) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9306869 Incidence and sources of native and prosthetic joint infection: a community based prospective survey.] ''Ann Rheum Dis'' 56 (8):470-5. PMID: [https://pubmed.gov/9306869 9306869]</ref>
Common microorganisms causing septic arthritis includes:<ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref name="pmid9269165">Bowerman SG, Green NE, Mencio GA (1997) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9269165 Decline of bone and joint infections attributable to haemophilus influenzae type b.] ''Clin Orthop Relat Res''  (341):128-33. PMID: [https://pubmed.gov/9269165 9269165]</ref><ref name="pmid9619939">Peltola H, Kallio MJ, Unkila-Kallio L (1998) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9619939 Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment.] ''J Bone Joint Surg Br'' 80 (3):471-3. PMID: [https://pubmed.gov/9619939 9619939]</ref><ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref>[http://wordnet.com.au/Products/topics_in_infectious_diseases_Aug01.htm Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.]</ref><ref name=Axford>{{cite book |author=O'Callaghan C, Axford JS |title=Medicine |publisher=Blackwell Science |location=Oxford |year=2004 |pages= |isbn=0-632-05162-0 |edition=2nd ed.}}</ref><ref name="pmid9306869">Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA (1997) [https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=9306869 Incidence and sources of native and prosthetic joint infection: a community based prospective survey.] ''Ann Rheum Dis'' 56 (8):470-5. PMID: [https://pubmed.gov/9306869 9306869]</ref>
* Staphylococcus aureus
* [[Staphylococcus aureus]]
* Streptococcal pyogenous
* [[Streptococcal Infection|Streptococcal pyogenous]]
* Streptococcal agalectae
* [[Streptococcal Infection|Streptococcal agalectae]]
* Streptococcal pneumonia
* [[Streptococcal Infection|Streptococcal pneumonia]]
* [[Neisseria gonorrhoeae]]
* [[Neisseria gonorrhoeae]]
* Escherichia coli
* [[Escherichia coli]]
* Staphylococcus epidermidis
* [[Staphylococcus epidermidis]]
* [[Haemophilus influenzae]]
* [[Haemophilus influenzae]]
* [[Pseudomonas aeruginosa]]
* [[Pseudomonas aeruginosa]]
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=== Less Common Causes ===
=== Less Common Causes ===
* Peptostreptococcus
* [[Peptostreptococcus]]
* Bacteroides fragilis
* [[Bacteroides fragilis]]
* Fusobacterium species 
* [[Fusobacterium species]] 
* Borrelia burgdorferi
* [[Borrelia burgdorferi]]
* [[Brucella]]
* [[Brucella]]
* [[Mycobacterium tuberculosis]]
* [[Mycobacterium tuberculosis]]
* '''Mycoplasma hominis'''
* '''[[Mycoplasma hominis]]'''
* '''Fungal infection''' such as
* '''Fungal infection''' such as
** Blastomycosis
** [[Blastomycosis]]
** Cryptococcus
** [[Cryptococcus]]
** Coccidioidomycosis
** [[Coccidioidomycosis]]
** Sporotrichosis
** [[Sporotrichosis]]
** [[Candida]]


==References==
==References==

Revision as of 20:47, 25 January 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

Septic arthritis develops when bacteria or tiny disease-causing microorganisms that spread through the bloodstream to a synovium. It may also occur when the joint is directly infected with a microorganism from an injury or during surgery.[1] The most common etiological agent of all nongonococcal causes of septic arthritis in the United States is Staphylococcus aureus.[2] The most common sites for this type of infection are the knee and hip. Most cases of acute septic arthritis are caused by bacteria such as staphylococcus or streptococcus. Chronic septic arthritis (which is less common) is caused by organisms such as Mycobacterium tuberculosis and Candida albicans.Gram-negative bacilli account for 10 to 20% of septic arthritis causes.[2] ~10% of patients with nongonococcal septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases.

Causes

Gram-negative bacilli account for 10 to 20% of septic arthritis causes.[2] ~10% of patients with nongonococcal septic arthritis are due to polymicrobial cause of infections. Anaerobes are also can cause septic arthritis in few cases. Most common cause of septic arthritis in children age < 2 years are Haemophilus influenzae (in immunized children), Staph. aureus, group A Streptococcal infections and Kingella kingae.[3] The source of infection in most of the cases (~50%) often from the skin, lungs or bladder.

Common Causes

Common microorganisms causing septic arthritis includes:[4][5][6][4][7][4][8]

Less Common Causes

References

  1. Dubost JJ, Fis I, Denis P, Lopitaux R, Soubrier M, Ristori JM et al. (1993) Polyarticular septic arthritis. Medicine (Baltimore) 72 (5):296-310. PMID: 8412643
  2. 2.0 2.1 2.2 Deesomchok U, Tumrasvin T (1990) Clinical study of culture-proven cases of non-gonococcal arthritis. J Med Assoc Thai 73 (11):615-23. PMID: 2283490
  3. Yagupsky P, Bar-Ziv Y, Howard CB, Dagan R (1995) Epidemiology, etiology, and clinical features of septic arthritis in children younger than 24 months. Arch Pediatr Adolesc Med 149 (5):537-40. PMID: 7735407
  4. 4.0 4.1 4.2 O'Callaghan C, Axford JS (2004). Medicine (2nd ed. ed.). Oxford: Blackwell Science. ISBN 0-632-05162-0.
  5. Bowerman SG, Green NE, Mencio GA (1997) Decline of bone and joint infections attributable to haemophilus influenzae type b. Clin Orthop Relat Res (341):128-33. PMID: 9269165
  6. Peltola H, Kallio MJ, Unkila-Kallio L (1998) Reduced incidence of septic arthritis in children by Haemophilus influenzae type-b vaccination. Implications for treatment. J Bone Joint Surg Br 80 (3):471-3. PMID: 9619939
  7. Topics in Infectious Diseases Newsletter, August 2001, Pseudomonas aeruginosa.
  8. Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA (1997) Incidence and sources of native and prosthetic joint infection: a community based prospective survey. Ann Rheum Dis 56 (8):470-5. PMID: 9306869


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