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Clinical presentation and outcome of septic arthritis diagnosed in a community hospital

Abstract number: P1529

Leach A., Amador C., Rosas J., Lopez M., Martinez C., Gil M., Pasquau F.

Objective: To describe the aetiology, clinical presentation, treatment and prognostic factors of septic arthritis (SA) in adult patients diagnosed in our hospital.

Methods: Retrospective analysis of the records of patients diagnosed of SA according the database of Admission Service and review of the cultures of synovial fluid in the Microbiology department from January 2002 to november 2008.

Results: 53 episodes of SA were included on the period of study According to the modified criteria of Newman and Cooper Cawley (1). 68% of these patients were male, the mean age was 53 years (16–91 years) and 50% had underlying diseases, 20% joint disease. Clinical manifestations were pain (95%), joint swelling (90%) and fever (45%). Only 6.7% had general malaise. The knee was the most frecuent joint affected (58%) followed by the hip (10%). Only one patient had polyarticular involvement. The most common causative organisms were S. aureus (37%) followed by Streptococcus sp. (8%) and Gram-negative bacilli (7%). 8.3% of the cultures of synovial fluid were Polimicrobial. Bacteraemia was documented in 10% of patients but blood cultures were draw just in one third of cases. Empiric antibiotic therapy was considered correct in 46% of the cases. 39% of patients received NSAIDs and 6.8% were treated with steroids. Surgical drainage and continuous lavage were done in 33 (55%) patients and 17% had repeated punctures joints. 38% of patients had functional sequelae and 4 patients died during admission, two of them was related to the infection. Poor outcome was significative related with febrile presentation (p < 0.04). There were no other predictors variables of morbi-mortality.

Conclusions: 1. Half of our patients had underlaying diseases. 2 Inflammatory symptoms were more prevalent that infectious manifestations.3. There were not changes on bacterial aetiology according with the literature 4. An optimal combined treatment is desirable to improve the elevated mobility, specially in febrile patients.

1 Cooper C, Cawley MI. Bacterial arthritis in an English health district: a 10 year review. Ann Rheum Dis 1986; 45:458–63

Session Details

Date: 16/05/2009
Time: 00:00-00:00
Session name: 19th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Helsinki, Finland, 16 - 19 May 2009
Presentation type:
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