Info
bacterial arthritis
- Epidemiology and risk factors (Infect Dis Clin North Am 2017;31:203)
- Clinical manifestations (JAMA 2007;297:1478; Lancet 2010;375:846)
- Additional diagnostic studies (JAMA 2007;297:1478)
- Treatment for native joints (IDCNA 2017;31:203)
- Prompt empiric antibiotics guided by Gram stain after surgical drainage.
- If Gram stain ⊖, empiric Rx w/ vancomycin;
- add anti-pseudomonal agent if IVDU or immunocompromised.
- Treatment for native joints (IDCNA 2017;31:203)
- IV antibiotics × ≥2 wk followed by oral antibiotics; varies by clinical course & microbiology
- Joint must be drained, often serially w/ arthroscopy (larger joints, initial Rx) or arthrocentesis. Serial synovial fluid analyses should demonstrate ↓ in WBC and sterility.
- 10-15% mortality (up to 50% w/ polyarticular); depends on virulence, time to Rx, host
- Prosthetic joint infections