Materiały źródłowe

• #1 Septic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538176/

  Septic arthritis is inflammation of the joints secondary to an infectious etiology such as bacterial, fungal, mycobacterial, viral, or other pathogens. […] This activity outlines the evaluation and treatment of septic arthritis and explains the role of the interprofessional team in improving care for patients with this condition. […] Early diagnosis and treatment are crucial for preserving joint function. […] The procedure used to drain joint fluid depends on multiple factors and is determined by the orthopedic surgeon. […] Aggressive physical therapy is necessary to restore joint function and prevent muscle atrophy. […] Consultation with an orthopedic surgeon should be requested early in the disease’s course for synovial fluid drainage. […] Patients and caregivers need to be educated about the severity of this condition and the potential for increased morbidity even after successful antibiotic treatment.

• #2 Septic arthritis in adults – UpToDate

  https://www.uptodate.com/contents/septic-arthritis-in-adults

  Septic arthritis is synonymous with an infection in a joint. Septic arthritis is usually caused by bacteria but can also be caused by other microorganisms. Septic arthritis due to bacterial infection is often a destructive form of acute arthritis and has a 5 to 15 percent mortality. […] The epidemiology, microbiology, clinical manifestations, diagnosis, differential diagnosis, and treatment of septic arthritis of native joints due to typical bacteria are reviewed here. […] Issues related to prosthetic joint infection are discussed separately. […] Issues related to septic arthritis in children are discussed separately. […] Issues related to gonococcal arthritis, lyme arthritis, and viral causes of arthritis are discussed separately.

• #3 Septic Arthritis: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.septic-arthritis-care-instructions.ut3248

  Septic arthritis is an infection in a joint. The infection can come from bacteria, fungus, or a virus. This occurs when an infection from another part of the body, such as pneumonia or a skin or urinary tract infection, travels through the bloodstream to the joint. It may also spread to the joint from an infection in nearby soft tissue, or it can follow a surgery or injury. The joint is often warm, swollen, and tender. […] Early treatment can prevent permanent damage to the joint. Treatment includes antibiotics and draining the joint to remove the infection. Depending on which part of your body is infected, your doctor may drain the joint with a needle or you may need surgery to drain the joint. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #4 Septic arthritis Information | Mount Sinai – New York

  https://www.mountsinai.org/health-library/diseases-conditions/septic-arthritis

  Septic arthritis is inflammation of a joint due to a bacterial or fungal infection. […] Most cases of acute septic arthritis are caused by staphylococcus or streptococcus bacteria. […] Septic arthritis may be seen at any age. In children, it occurs most often in those younger than 3 years. […] Symptoms usually come on quickly. There is a fever and joint swelling that is usually in just one joint. […] Your health care provider will examine the joint and ask about the symptoms. […] Antibiotics are used to treat the infection. […] Resting, raising the joint above heart level, and using cool compresses may help relieve pain. […] Recovery is good with prompt antibiotic treatment. […] Contact for an appointment with your provider if you develop symptoms of septic arthritis. […] Preventive (prophylactic) antibiotics may be helpful for people at high risk.

• #5 Infectious (Septic) Arthritis – Rheumatology – Diseases – McMaster Textbook of Internal Medicine

  https://empendium.com/mcmtextbook/chapter/B31.II.16.14.

  Infectious arthritis is acute or chronic arthritis caused by microorganisms invading the synovium. […] Risk factors for bacterial arthritis include rheumatic diseases (rheumatoid arthritis [RA], systemic lupus erythematosus [SLE]), joint replacement surgery (particularly of the knee or hip), treatment with tumor necrosis factor (TNF)-alpha inhibitors, joint aspiration, advanced age, diabetes mellitus, immunosuppression (alcohol dependence, immunosuppressive treatment, HIV infection), IV drug use, renal or liver failure, and hemophilia. […] Local manifestations: Pain, swelling, erythema, warming of the joint, and a decreased range of motion. […] In patients with suspected bacterial arthritis start empiric antimicrobial therapy after obtaining appropriate specimens. […] For the first few days of treatment the joint should be immobilized in a splint (usually in extension). Beginning from day 3, passive mobilization should be started, followed by active mobilization after the resolution of pain; this promotes healing and regeneration of the cartilage and periarticular tissues as well as prevents contractures and adhesions within the joint.

• #6 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/ea5c832a188309fb082878b8e62ce6cd

  A Patient’s Guide to Septic Arthritis […] Introduction […] Septic arthritis is an infection inside a joint that is caused by bacteria. It comes on suddenly and causes very noticeable pain and swelling in the affected joint. It can affect anyone, including infants and children. But it is most likely to affect people over 60 and people with certain health or joint problems. […] This guide will help you understand how septic arthritis develops, how doctors diagnose the condition, and what can be done for septic arthritis. […] Symptoms […] Septic arthritis causes moderate to severe joint pain that comes on from a few hours to a few days. The pain is much worse when you move or touch the joint. The joint is usually warm and red, and it can’t move easily. You may have other evidence of infection, including a fever, chills, flu-like symptoms, and high white blood cell counts. However, 20 percent of patients with septic arthritis run no fever.

• #7 Septic Arthritis – Clinical Features – Management – TeachMeSurgery

  https://teachmesurgery.com/orthopaedic/principles/septic-arthritis/

  Septic arthritis refers to the infection of a joint. It requires a high index of suspicion and can affect both native and prosthetic joints. […] Patients will most commonly present with a single swollen joint causing severe pain. Pyrexia will be in around 60% of affected individuals (although its absence should not rule out septic arthritis). […] Often the joint is rigid and the patient will not tolerate any passive movement at all, and will be unable to weight bear. Symptoms are more florid and obvious in native joint injection; in prosthetic joint infections, the features can be more subtle. […] Any septic patient should be managed appropriately, with early resuscitation and investigation as a priority. […] Empirical antibiotic treatment should be started as soon as possible, after any planned cultures and aspirates have been performed.

• #8 Septic Arthritis | Nurse Key

  https://nursekey.com/septic-arthritis/

  Septic Arthritis Also known as infectious arthritis, pyogenic septic arthritis is a medical emergency. It arises when bacteria invade a joint and cause the synovial lining to become inflamed. […] However, prompt antibiotic therapy and aspiration or drainage of the joint cure most patients. […] The patient may have a history of a known infection outside the involved joint, an immunosuppressive condition, or I.V. drug abuse. He may complain of an abrupt onset of intense pain in the affected joint. […] Inspection may show that the patient prefers to keep the affected joint flexed. This position eases pain by minimizing intra-articular pressure. […] On palpation, you’ll usually note warmth and extreme tenderness over the involved joint. […] Arthrocentesis allows the collection of a synovial fluid specimen.

• #9 Septic arthritis

  https://www.rch.org.au/kidsinfo/fact_sheets/Septic_arthritis/

  Septic arthritis is an infection in a joint. It is most commonly a bacterial infection. Joints affected are usually leg joints such as hips, knees and ankles. […] Septic arthritis is usually caused by bacteria entering the joint through the bloodstream, or following infection of a surrounding bone. […] The infection causes the build-up of pus within the joint, which makes the joint swollen and painful. […] If you think your child has septic arthritis, you should take your child to the nearest emergency department. […] Your child may need to be admitted to hospital for treatment, including antibiotics given directly into a vein through a drip (intravenous or IV therapy). […] Pain relief medicine will be given. […] Your child will usually need to have a surgical procedure where the joint is washed out, to clean the infection out of the joint.

• #10 Septic Arthritis

  https://pedemmorsels.com/septic-arthritis/

  Septic arthritis is an infection in the joint space and synovial fluid. […] High Risk populations = children less than 2 years of age, immunocompromised, and patients without functional spleens. […] Complications: Capsule damage, Chronic arthritis, Osteonecrosis, Growth Arrest, Sepsis. […] Fever. […] Joint pain, swelling, and erythema. […] Pain with passive range of motion! […] Limps or refuses to bear weight on limb. […] 80% of cases in children involve the lower limbs. […] The treatment strategies and potential outcomes are quite different for the two conditions, so differentiating between them is critical although challenging. […] NO SINGLE TEST WILL DIAGNOSE OR RULE-OUT SEPTIC ARTHRITIS. […] Anticipate what tool (ex, Kocher Criteria) your consultants will likely use, but know their limitations.

• #11 Septic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538176/

  Septic arthritis is inflammation of the joints secondary to an infectious etiology such as bacterial, fungal, mycobacterial, viral, or other pathogens. […] This activity outlines the evaluation and treatment of septic arthritis and explains the role of the interprofessional team in improving care for patients with this condition. […] Early diagnosis and treatment are crucial for preserving joint function. […] The procedure used to drain joint fluid depends on multiple factors and is determined by the orthopedic surgeon. […] Aggressive physical therapy is necessary to restore joint function and prevent muscle atrophy. […] Consultation with an orthopedic surgeon should be requested early in the disease’s course for synovial fluid drainage. […] Patients and caregivers need to be educated about the severity of this condition and the potential for increased morbidity even after successful antibiotic treatment.

• #12 Septic arthritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000116

  Septic arthritis presents with a hot, swollen, acutely painful joint with restriction of movement. This presentation should be regarded as septic arthritis until proven otherwise, even in the absence of fever and irrespective of microbiology and blood test results. […] Take a synovial fluid sample, bloods, and any other relevant culture samples before starting empirical intravenous antibiotics, unless this would cause undue delay. […] Refer patients with suspected septic arthritis of the hip immediately to orthopaedics for ultrasound-guided joint aspiration and possible surgical debridement. […] Do not aspirate a prosthetic joint. Refer the patient to an orthopaedic surgeon. […] Base antibiotic choice on individual patient demographic and clinical factors; then narrow your treatment when you get the microscopy and Gram stain results and aspirate the joint to dryness as often as necessary. […] Continue intravenous therapy for 2 weeks and then switch to oral antibiotic therapy for a further 4 weeks.

• #13 Septic Arthritis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538176/

  Septic arthritis usually presents as an acute monoarticular joint inflammation which has a broad differential diagnosis. […] Arthrocentesis is a crucial component in the diagnostic algorithm. […] Patients with septic arthritis are usually managed initially in the inpatient hospital setting and require an interprofessional team of caregivers including the primary care provider, nurses, wound care team, physical and occupational therapist. […] It is essential that patients complete the required antibiotic therapy and follow up.

• #14 Septic Arthritis | Nurse Key

  https://nursekey.com/septic-arthritis/

  Synovial fluid analysis shows gross pus or watery, cloudy fluid of decreased viscosity, typically with 50,000/l or more white blood cells (WBCs) containing primarily neutrophils. […] Gram stain or fluid culture or a biopsy of the synovial membrane confirms the diagnosis and identifies the causative organism. […] Blood cultures may be positive and confirm the diagnosis even when the synovial culture is negative.

• #15 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Before initiating antibiotic therapy in patients with suspected septic arthritis, analysis of synovial fluid obtained through arthrocentesis should be performed, including Gram stain, cultures, white blood cell count with differential, and crystal analysis. […] Initial empiric antibiotic therapy for adults with septic arthritis should cover Staphylococcus aureus and Streptococcus species. […] Oral antibiotics are not inferior to intravenous antibiotics for treatment of septic arthritis. […] Septic arthritis caused by methicillin-resistant S. aureus should be treated with drainage or debridement and 14 days of intravenous antibiotics followed by oral antibiotics, totaling three to four weeks of therapy. […] In patients with joint replacements, prophylactic antibiotics are not recommended to prevent joint infection for routine outpatient dental, urologic, or gastrointestinal procedures.

• #16 Septic Arthritis | Nurse Key

  https://nursekey.com/septic-arthritis/

  Synovial fluid analysis shows gross pus or watery, cloudy fluid of decreased viscosity, typically with 50,000/l or more white blood cells (WBCs) containing primarily neutrophils. […] Gram stain or fluid culture or a biopsy of the synovial membrane confirms the diagnosis and identifies the causative organism. […] Blood cultures may be positive and confirm the diagnosis even when the synovial culture is negative.

• #17 Septic Arthritis & Osteomyelitis | Nurse – PMM

  https://www.pmmonline.org/nurse/arthritis-conditions/red-flag-conditions/septic-arthritis-osteomyelitis/

  There is likely involvement of several clinical teams (paediatrics, orthopaedics, microbiology) to determine the management plan, whether to opt for bone aspiration / biopsy as well as joint aspiration, take the appropriate cultures and choice of antibiotics (given by intravenous route). […] Blood tests, cultures and imaging (radiographs, ultrasound and sometimes CT or MRI) are needed. […] Antibiotics are usually given empirically whilst awaiting cultures. […] Antibiotics are usually continued for several weeks (IV) and then oral, pending clinical progress and blood tests (acute phase reactants – ESR, CRP – and white cell count). […] Analgesia and resting the joint / limb (splinting) are important. […] Pointers towards septic arthritis at the hip are given below and are useful in practice (Kocher’s rules) – especially in the child with hip effusion and differentiating between irritable hip and sepsis.

• #18 Septic Arthritis & Osteomyelitis | Nurse – PMM

  https://www.pmmonline.org/nurse/arthritis-conditions/red-flag-conditions/septic-arthritis-osteomyelitis/

  There is likely involvement of several clinical teams (paediatrics, orthopaedics, microbiology) to determine the management plan, whether to opt for bone aspiration / biopsy as well as joint aspiration, take the appropriate cultures and choice of antibiotics (given by intravenous route). […] Blood tests, cultures and imaging (radiographs, ultrasound and sometimes CT or MRI) are needed. […] Antibiotics are usually given empirically whilst awaiting cultures. […] Antibiotics are usually continued for several weeks (IV) and then oral, pending clinical progress and blood tests (acute phase reactants – ESR, CRP – and white cell count). […] Analgesia and resting the joint / limb (splinting) are important. […] Pointers towards septic arthritis at the hip are given below and are useful in practice (Kocher’s rules) – especially in the child with hip effusion and differentiating between irritable hip and sepsis.

• #19 Transient Synovitis or Septic Arthritis? Evaluating the Kocher Criteria — Taming the SRU

  https://www.tamingthesru.com/blog/intern-diagnostics/kocher-criteria

  Septic arthritis most commonly affects children less than 3 years old and occurs when an organism invades the joint space and synovial fluid. […] Diagnosis is definitively made with an arthrocentesis that has a positive gram stain/culture or a high white blood cell count. The joint is treated with drainage and washout in the operating room with IV antibiotic administration. Septic arthritis commonly causes significant joint destruction but may also result in avascular necrosis, joint laxity or restriction, limb length discrepancy, and sepsis. […] A detailed history and physical exam are critical in the assessment of pediatric hip pain. Subsequent investigations including laboratory and imaging studies should be guided by your pre-test probability of septic arthritis. The Kocher criteria, especially when used in conjunction with CRP, can help guide the need for arthrocentesis and consultation of orthopedic surgery however the positive predictive value of the criteria is variable.

• #20 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  The physical examination of patients with septic arthritis almost always reveals a severely painful joint with motion, often including an obvious effusion. […] Analysis of synovial fluid obtained via arthrocentesis is necessary to differentiate septic arthritis from other forms of arthritis and to determine the causative pathogen. […] Antibiotic treatment should be based on results of a synovial fluid Gram stain or suspicion of a pathogen from the clinical scenario. […] Treatment should be individualized according to clinical response and microbiology results. […] Cohort studies demonstrated that medical management is not inferior to surgical management of septic arthritis. […] However, 30% of cases ultimately required surgical management, including about one-half of shoulder and hip arthritis cases, because of poor response to medical therapy.

• #21 Septic Arthritis Treatment and Management Options

  https://www.healthline.com/health/arthritis/septic-arthritis-treatment

  Septic arthritic is considered a medical emergency because it can cause serious joint damage and can be fatal if not treated early. […] Treatment may include antibiotics, joint fluid drainage, physical therapy, and surgery. […] Antibiotics are the first line of treatment for septic arthritis caused by a bacterium. […] A doctor may recommend wearing a splint to support your affected joint. Splints are used to limit movement, which in turn reduces pain and tissue damage. […] You may need to have the infected fluid around your joint (synovial fluid) drained to ease pain and swelling and prevent joint damage. […] In some cases, a doctor may recommend surgery to drain your joint and remove damaged tissue (debridement). […] If you have an artificial joint and its infected, it may need to be removed and temporarily replaced with a joint spacer.

• #22 Managing Your Septic Arthritis – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/septic-arthritis

  Septic arthritis (or infectious arthritis) is a bacterial infection inside a joint. […] Untreated septic arthritis can damage and destroy the joint and lead to joint replacement surgery. […] Three stages of therapy are needed: antibiotics, joint drainage, and restoring normal motion to the joint. […] Antibiotics are usually given through a vein for the first 2 weeks and then by mouth for 2 to 4 weeks or more. […] Joint fluid should generally be drained to help resolve the infection. […] After the first few days of treatment, people with joint infections should start therapy to restore normal joint motion. Physical therapists help with restoring normal movement. Therapy should continue until after the pain leaves and the joint works normally. […] DO exercises to maintain joint motion and preserve strength. […] DO call your health care provider if you need a referral for physical or occupational therapy. […] DONT continue an exercise program that causes pain. If you have pain after exercise, the exercise program usually needs to be modified specifically for you.

• #23 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Septic arthritis must be considered and promptly diagnosed in any patient presenting with acute atraumatic joint pain, swelling, and fever. […] A delay in diagnosis and treatment can result in permanent morbidity and mortality. […] After synovial fluid has been obtained, empiric antibiotic therapy should be initiated if there is clinical concern for septic arthritis. […] Oral antibiotics can be given in most cases because they are not inferior to intravenous therapy. […] Total duration of therapy ranges from two to six weeks; however, certain infections require longer courses. […] A delay in diagnosis and treatment of septic arthritis can lead to permanent morbidity and mortality. […] Subcartilaginous bone loss, cartilage destruction, and permanent joint dysfunction can occur if appropriate antibiotic therapy is not initiated within 24 to 48 hours of onset.

• #24 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Before initiating antibiotic therapy in patients with suspected septic arthritis, analysis of synovial fluid obtained through arthrocentesis should be performed, including Gram stain, cultures, white blood cell count with differential, and crystal analysis. […] Initial empiric antibiotic therapy for adults with septic arthritis should cover Staphylococcus aureus and Streptococcus species. […] Oral antibiotics are not inferior to intravenous antibiotics for treatment of septic arthritis. […] Septic arthritis caused by methicillin-resistant S. aureus should be treated with drainage or debridement and 14 days of intravenous antibiotics followed by oral antibiotics, totaling three to four weeks of therapy. […] In patients with joint replacements, prophylactic antibiotics are not recommended to prevent joint infection for routine outpatient dental, urologic, or gastrointestinal procedures.

• #25 Septic Arthritis Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/septic_arthritis/article.htm

  Septic arthritis is infection of one or more joints by microorganisms. Normally, the joint is lubricated with a small amount of fluid that is referred to as synovial fluid or joint fluid. The normal joint fluid is sterile and, if removed and cultured in the laboratory, no microbes will be detected. With this form of arthritis, microbes are identifiable in an affected joint’s fluid. […] Treatment of septic arthritis includes antibiotic therapy and drainage of the infected joint (synovial) fluid from the joint (arthrocentesis). […] Optimally, antibiotics are given immediately. Often, health care professionals administer intravenous antibiotics in a hospital setting. The choice of antibiotics can be guided by the results of the culture of joint fluid. Until those results are known, empiric antibiotics are chosen to cover a wider range of possible infectious agents.

• #26 Managing Your Septic Arthritis – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/septic-arthritis

  Septic arthritis (or infectious arthritis) is a bacterial infection inside a joint. […] Untreated septic arthritis can damage and destroy the joint and lead to joint replacement surgery. […] Three stages of therapy are needed: antibiotics, joint drainage, and restoring normal motion to the joint. […] Antibiotics are usually given through a vein for the first 2 weeks and then by mouth for 2 to 4 weeks or more. […] Joint fluid should generally be drained to help resolve the infection. […] After the first few days of treatment, people with joint infections should start therapy to restore normal joint motion. Physical therapists help with restoring normal movement. Therapy should continue until after the pain leaves and the joint works normally. […] DO exercises to maintain joint motion and preserve strength. […] DO call your health care provider if you need a referral for physical or occupational therapy. […] DONT continue an exercise program that causes pain. If you have pain after exercise, the exercise program usually needs to be modified specifically for you.

• #27 Septic arthritis – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000116

  Septic arthritis presents with a hot, swollen, acutely painful joint with restriction of movement. This presentation should be regarded as septic arthritis until proven otherwise, even in the absence of fever and irrespective of microbiology and blood test results. […] Take a synovial fluid sample, bloods, and any other relevant culture samples before starting empirical intravenous antibiotics, unless this would cause undue delay. […] Refer patients with suspected septic arthritis of the hip immediately to orthopaedics for ultrasound-guided joint aspiration and possible surgical debridement. […] Do not aspirate a prosthetic joint. Refer the patient to an orthopaedic surgeon. […] Base antibiotic choice on individual patient demographic and clinical factors; then narrow your treatment when you get the microscopy and Gram stain results and aspirate the joint to dryness as often as necessary. […] Continue intravenous therapy for 2 weeks and then switch to oral antibiotic therapy for a further 4 weeks.

• #28 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Before initiating antibiotic therapy in patients with suspected septic arthritis, analysis of synovial fluid obtained through arthrocentesis should be performed, including Gram stain, cultures, white blood cell count with differential, and crystal analysis. […] Initial empiric antibiotic therapy for adults with septic arthritis should cover Staphylococcus aureus and Streptococcus species. […] Oral antibiotics are not inferior to intravenous antibiotics for treatment of septic arthritis. […] Septic arthritis caused by methicillin-resistant S. aureus should be treated with drainage or debridement and 14 days of intravenous antibiotics followed by oral antibiotics, totaling three to four weeks of therapy. […] In patients with joint replacements, prophylactic antibiotics are not recommended to prevent joint infection for routine outpatient dental, urologic, or gastrointestinal procedures.

• #29 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Septic arthritis must be considered and promptly diagnosed in any patient presenting with acute atraumatic joint pain, swelling, and fever. […] A delay in diagnosis and treatment can result in permanent morbidity and mortality. […] After synovial fluid has been obtained, empiric antibiotic therapy should be initiated if there is clinical concern for septic arthritis. […] Oral antibiotics can be given in most cases because they are not inferior to intravenous therapy. […] Total duration of therapy ranges from two to six weeks; however, certain infections require longer courses. […] A delay in diagnosis and treatment of septic arthritis can lead to permanent morbidity and mortality. […] Subcartilaginous bone loss, cartilage destruction, and permanent joint dysfunction can occur if appropriate antibiotic therapy is not initiated within 24 to 48 hours of onset.

• #30 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Before initiating antibiotic therapy in patients with suspected septic arthritis, analysis of synovial fluid obtained through arthrocentesis should be performed, including Gram stain, cultures, white blood cell count with differential, and crystal analysis. […] Initial empiric antibiotic therapy for adults with septic arthritis should cover Staphylococcus aureus and Streptococcus species. […] Oral antibiotics are not inferior to intravenous antibiotics for treatment of septic arthritis. […] Septic arthritis caused by methicillin-resistant S. aureus should be treated with drainage or debridement and 14 days of intravenous antibiotics followed by oral antibiotics, totaling three to four weeks of therapy. […] In patients with joint replacements, prophylactic antibiotics are not recommended to prevent joint infection for routine outpatient dental, urologic, or gastrointestinal procedures.

• #31 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Optimal duration of treatment for nongonococcal septic arthritis is uncertain but is at least two weeks for small joints; at least six weeks is more commonly prescribed for all joints. […] Septic arthritis caused by methicillin-resistant S. aureus requires drainage or debridement and three to four weeks of antibiotics. […] A large cohort study showed that the 90-day mortality rate for septic arthritis is 7% and increases to 22% to 69% in patients 80 years and older. […] Other comorbidities such as diabetes mellitus, rheumatoid arthritis, bacteremia, and low creatinine clearance are also associated with increased mortality. […] Poor functional outcomes such as amputation, arthrodesis, prosthetic surgery, and severe functional deterioration occur in about 24% to 33% of patients with septic arthritis and are more likely with older age, preexisting joint disease, and synthetic intraarticular material.

• #32 Septic Arthritis Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/septic_arthritis/article.htm

  Drainage is essential for rapid clearing of the infection. Drainage of a joint effusion can be done by regular aspirations with a needle and syringe, often daily early on, or via surgical procedures. […] Septic arthritis is a medical emergency and requires acute treatment by an appropriate medical team. […] The outlook for septic arthritis depends on the precise microbe causing the infection, the duration of the infection, and the underlying overall health of the individual infected. […] Rapid clearing of the infection is critical to preserve the joint. If appropriate antibiotics are begun immediately, joint integrity can be maintained, and return to function is expected. […] It is possible to prevent septic arthritis by avoiding infections, puncture wounds, and damage to the skin.

• #33 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Usually, immobilization of the infected joint to control pain is not necessary after the first few days. If the patient’s condition responds adequately after 5 days of treatment, begin gentle mobilization of the infected joint. Most patients require aggressive physical therapy to allow maximum post-infection functioning of the joint. […] The choice of the type of drainage, whether percutaneous or surgical, has not been resolved completely. In general, use a needle aspirate initially, repeating joint taps frequently enough to prevent significant reaccumulation of fluid. […] Surgical drainage is indicated when one or more of the following occur: The appropriate choice of antibiotic and vigorous percutaneous drainage fails to clear the infection after 5 to 7 days; The infected joints are difficult to aspirate (eg, hip); Adjacent soft tissue is infected.

• #34 Septic Arthritis: Symptoms, Diagnosis, and Treatment

  https://www.webmd.com/arthritis/septic-arthritis-symptoms-diagnosis-and-treatment

  Septic arthritis treatments include using a combination of powerful antibiotics as well as draining the infected synovial fluid from the joint. […] The treatment, however, may be continued on an outpatient basis at home with the assistance of a home health nursing service. […] Drainage of the infected area is critical for rapid clearing of the infection. […] Drainage is performed by removing the fluid with a needle and syringe. […] If drainage cannot be accomplished with joint aspirations or arthroscopy, open joint surgery is often necessary to drain the joint.

• #35 Frontiers | An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review

  https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1193645/full

  Acute septic arthritis is on the rise among all patients. Acute septic arthritis must be extensively assessed, identified, and treated to prevent fatal consequences. Antimicrobial therapy administered intravenously has long been considered the gold standard for treating acute osteoarticular infections. […] This article aims to furnish radiologists, orthopaedic surgeons, and other medical practitioners with contemporary insights on the subject matter and foster collaborative efforts to improve patient outcomes. […] To provide the best possible care for these patients, doctors must have a comprehensive awareness of the patient’s medical history, the results of the physical exam, the diagnostic testing, and the available treatment options. […] Standard treatment consists of irrigation and debridement of the affected joint, followed by intravenous antibiotics. This can be accomplished using either an open surgery technique (arthrotomy) or a minimally invasive technique (arthroscopy).

• #36 Frontiers | An update on recent progress of the epidemiology, etiology, diagnosis, and treatment of acute septic arthritis: a review

  https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1193645/full

  In order to limit the risk of lifelong disability, making a fast diagnosis and treatment plan for ASA patients is crucial. […] Early and appropriate administration of antibiotics (without waiting for bacteriological results) and immobilization of the afflicted limb are required. […] Antibiotic courses of 3 to 4 weeks are usually adequate for uncomplicated bacterial arthritis. Treatment duration should be extended to 6 weeks if there is imaging evidence of accompanying osteomyelitis. […] Once a patient is diagnosed with septic arthritis characterized by joint discomfort, reduced mobility, and inability to bear weight, he or she should have surgery or arthroscopy for irrigation and debridement to drain purulent fluid. […] Arthroscopic surgery can treat joint cavity infections with debridement under the microscope, continuous closed lavage and drainage, harmful bacteria disappear rapidly, infection control is dependable, antibiotics are employed for a short period, and the efficacy is satisfactory.

• #37 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Usually, immobilization of the infected joint to control pain is not necessary after the first few days. If the patient’s condition responds adequately after 5 days of treatment, begin gentle mobilization of the infected joint. Most patients require aggressive physical therapy to allow maximum post-infection functioning of the joint. […] The choice of the type of drainage, whether percutaneous or surgical, has not been resolved completely. In general, use a needle aspirate initially, repeating joint taps frequently enough to prevent significant reaccumulation of fluid. […] Surgical drainage is indicated when one or more of the following occur: The appropriate choice of antibiotic and vigorous percutaneous drainage fails to clear the infection after 5 to 7 days; The infected joints are difficult to aspirate (eg, hip); Adjacent soft tissue is infected.

• #38 JBJI – Guideline for management of septic arthritis in native joints (SANJO)

  https://jbji.copernicus.org/articles/8/29/2023/

  Arthroscopic lavage (with synovectomy, depending on the clinical stage) is recommended for SANJO particularly in larger joints, although open revision could be considered in cases with synovial membrane adhesions or in the presence of cartilage or bone damage. […] Joint mobilization to avoid contracture should be started as soon as possible when infection is under control and after drains have been removed. […] Careful postoperative evaluation should reveal early signs of treatment failure, which indicates repeated surgical revision. […] This guideline also includes specific considerations for SANJO: (1) after reconstruction of the anterior cruciate ligament, (2) in tuberculous arthritis, and (3) in pediatric population. […] Guidelines cannot always account for individual variation among patients. They are not intended to replace physician judgment with respect to particular patients or special clinical situations.

• #39 Management of septic arthritis: a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1856038/

  Management of septic arthritis: Prompt treatment with antibiotics together with removal of any purulent material is the mainstay of treatment for septic arthritis. […] There is little evidence on which to base the choice and duration of antibiotic treatment, and we found no randomised, controlled trials. […] Successful treatment of a septic native joint includes removal of purulent material from the joint space. This can be achieved either surgically or through closed needle aspiration. […] The other five papers retrieved were also retrospective observational studies of case series of joint sepsis treated by arthroscopy and washout with or without synovectomy, arthrotomy or debridement.

• #40 Management of septic arthritis: a systematic review

  https://pmc.ncbi.nlm.nih.gov/articles/PMC1856038/

  Management of septic arthritis: Prompt treatment with antibiotics together with removal of any purulent material is the mainstay of treatment for septic arthritis. […] There is little evidence on which to base the choice and duration of antibiotic treatment, and we found no randomised, controlled trials. […] Successful treatment of a septic native joint includes removal of purulent material from the joint space. This can be achieved either surgically or through closed needle aspiration. […] The other five papers retrieved were also retrospective observational studies of case series of joint sepsis treated by arthroscopy and washout with or without synovectomy, arthrotomy or debridement.

• #41 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Usually, immobilization of the infected joint to control pain is not necessary after the first few days. If the patient’s condition responds adequately after 5 days of treatment, begin gentle mobilization of the infected joint. Most patients require aggressive physical therapy to allow maximum post-infection functioning of the joint. […] The choice of the type of drainage, whether percutaneous or surgical, has not been resolved completely. In general, use a needle aspirate initially, repeating joint taps frequently enough to prevent significant reaccumulation of fluid. […] Surgical drainage is indicated when one or more of the following occur: The appropriate choice of antibiotic and vigorous percutaneous drainage fails to clear the infection after 5 to 7 days; The infected joints are difficult to aspirate (eg, hip); Adjacent soft tissue is infected.

• #42 Septic Arthritis (Causes, Treatment, and Management)

  https://patient.info/doctor/septic-arthritis-pro

  Septic arthritis treatment and management involves surgical drainage and lavage of the joint and high-dose intravenous antibiotics. Management involves surgical drainage and lavage of the joint and high-dose intravenous antibiotics. Treatment should be started empirically before the results of cultures are known, as evidence suggests that a better functional result is obtained the sooner an antibiotic is commenced. Antibiotics are given intravenously initially (usually for 2-3 weeks) before being switched to oral (often for at least a further 2-4 weeks). Repeated percutaneous aspiration may be required if the infection does not respond to antibiotic treatment. The limb should be splinted in the position of function (knees in extension, elbows at 90, wrists in neutral to slight extension, hips in balanced suspension in neutral rotation). Once the septic arthritis is under control, immediate joint mobilisation will promote healing of the articular cartilage and prevent contractures. Surgical drainage may be required in any infected joint which does not respond to medical treatment. […] If the septic arthritis fails to respond to five days of treatment with an appropriate antibiotic (as evidenced by persistent fever, positive cultures or synovial purulence), the therapeutic approach should be reassessed.

• #43 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Usually, immobilization of the infected joint to control pain is not necessary after the first few days. If the patient’s condition responds adequately after 5 days of treatment, begin gentle mobilization of the infected joint. Most patients require aggressive physical therapy to allow maximum post-infection functioning of the joint. […] The choice of the type of drainage, whether percutaneous or surgical, has not been resolved completely. In general, use a needle aspirate initially, repeating joint taps frequently enough to prevent significant reaccumulation of fluid. […] Surgical drainage is indicated when one or more of the following occur: The appropriate choice of antibiotic and vigorous percutaneous drainage fails to clear the infection after 5 to 7 days; The infected joints are difficult to aspirate (eg, hip); Adjacent soft tissue is infected.

• #44 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Usually, immobilization of the infected joint to control pain is not necessary after the first few days. If the patient’s condition responds adequately after 5 days of treatment, begin gentle mobilization of the infected joint. Most patients require aggressive physical therapy to allow maximum post-infection functioning of the joint. […] The choice of the type of drainage, whether percutaneous or surgical, has not been resolved completely. In general, use a needle aspirate initially, repeating joint taps frequently enough to prevent significant reaccumulation of fluid. […] Surgical drainage is indicated when one or more of the following occur: The appropriate choice of antibiotic and vigorous percutaneous drainage fails to clear the infection after 5 to 7 days; The infected joints are difficult to aspirate (eg, hip); Adjacent soft tissue is infected.

• #45 Managing Your Septic Arthritis – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/septic-arthritis

  Septic arthritis (or infectious arthritis) is a bacterial infection inside a joint. […] Untreated septic arthritis can damage and destroy the joint and lead to joint replacement surgery. […] Three stages of therapy are needed: antibiotics, joint drainage, and restoring normal motion to the joint. […] Antibiotics are usually given through a vein for the first 2 weeks and then by mouth for 2 to 4 weeks or more. […] Joint fluid should generally be drained to help resolve the infection. […] After the first few days of treatment, people with joint infections should start therapy to restore normal joint motion. Physical therapists help with restoring normal movement. Therapy should continue until after the pain leaves and the joint works normally. […] DO exercises to maintain joint motion and preserve strength. […] DO call your health care provider if you need a referral for physical or occupational therapy. […] DONT continue an exercise program that causes pain. If you have pain after exercise, the exercise program usually needs to be modified specifically for you.

• #46 Physiotherapy in Septic Arthritis Rehabilitation

  https://www.physiotattva.com/blog/physiotherapy-in-septic-arthritis-rehabilitation-a-path-to-recovery

  Septic arthritis, an acute and potentially severe joint infection, demands comprehensive rehabilitation for optimal recovery. Physiotherapy plays a crucial role in managing this condition, focusing on restoring joint function, reducing pain, and preventing complications. […] Physiotherapy in septic arthritis rehabilitation not only aids in physical recovery but also supports patients in regaining confidence and functionality, facilitating a smoother return to daily life post-infection. […] Physiotherapy in septic arthritis focuses on restoring joint function post-treatment. Once infection control measures are underway, physiotherapists design exercises to improve joint mobility gradually. […] Physiotherapy aids in regaining optimal joint function, promoting recovery, and reducing the risk of long-term joint complications.

• #47 Physiotherapy in Septic Arthritis Rehabilitation

  https://www.physiotattva.com/blog/physiotherapy-in-septic-arthritis-rehabilitation-a-path-to-recovery

  Physiotherapy in septic arthritis aids in restoring joint function, preventing stiffness, and strengthening muscles, pivotal for recovery, optimizing mobility, and reducing long-term joint issues post-infection. […] Customized home exercise programs post-septic arthritis are tailored to individual needs, providing specific exercises to improve joint mobility, strength, and flexibility. These programs, designed by physiotherapists, enable consistent rehabilitation at home, aiding recovery, preventing joint stiffness, and supporting optimal joint function in daily activities.

• #48 Septic | PPT

  https://www.slideshare.net/slideshow/septic-45214890/45214890

  Septic arthritis is a painful infection of the joint that occurs when bacteria or viruses spread from another part of the body through the bloodstream and infect the joint tissue. […] Nursing care focuses on pain management, infection control, promoting mobility and proper joint positioning, and educating patients and families. […] Nursing management ASSESSMENT: Assess the pain Assess the patient physical status History should be taken regarding the joint pain and swellings Vitals signs are taken in which elevated temperature can be found. […] The nurse should prepare the patient and gives support during the painful procedures Analgesics must be given to alleviate pain If the joints are inflammed, let the patients rest and avoid activities that stress the joints Apply local heat or cold to affected joints for approximately 20-30 min three to four times a day. Change positions frequently. Use splints to maintain proper body alignment Avoid pillow under knee to prevent knee and hip flexion deformities.

• #49 Septic | PPT

  https://www.slideshare.net/slideshow/septic-45214890/45214890

  Septic arthritis is a painful infection of the joint that occurs when bacteria or viruses spread from another part of the body through the bloodstream and infect the joint tissue. […] Nursing care focuses on pain management, infection control, promoting mobility and proper joint positioning, and educating patients and families. […] Nursing management ASSESSMENT: Assess the pain Assess the patient physical status History should be taken regarding the joint pain and swellings Vitals signs are taken in which elevated temperature can be found. […] The nurse should prepare the patient and gives support during the painful procedures Analgesics must be given to alleviate pain If the joints are inflammed, let the patients rest and avoid activities that stress the joints Apply local heat or cold to affected joints for approximately 20-30 min three to four times a day. Change positions frequently. Use splints to maintain proper body alignment Avoid pillow under knee to prevent knee and hip flexion deformities.

• #50 Septic Arthritis | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/septic-arthritis

  After beginning treatment, patients with septic arthritis will be monitored closely for clinical improvement. Further evaluation or a change in therapy may be required if a child does not improve. […] If your child is able to take oral antibiotics and they are effective, he may be discharged from the hospital after a good response to therapy is observed. […] After discharge from the hospital, your child will be followed by his regular doctor or an infectious disease specialist. He will be monitored for continued symptom improvement. Further treatment or evaluation of complications from septic arthritis may be warranted after the infection is cleared. […] Possible complications may include: Increased or decreased mobility of affected joint, Poor growth of the affected limb if the growth plate was involved, Long-term damage to the bone surrounding the affected joint, Increased risk of fracture to bones surrounding the affected joint.

• #51 Septic Arthritis: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.septic-arthritis-care-instructions.ut3248

  You will receive antibiotics through a vein (I.V.) at first. After this, you may take antibiotics by mouth. […] Take your antibiotics as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics. […] Rest the joint as much as you can. […] If possible, prop up the injured joint on pillows as much as possible for the next 3 days. Try to keep it at or above the level of your heart. This can help reduce pain and swelling. […] Follow your doctor’s instructions on exercises for the affected joint. […] Do not smoke. Smoking can make it harder for your body to fight the infection. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good. […] Call your doctor now or seek immediate medical care if: You have worse symptoms of infection, such as: Increased pain, swelling, warmth, or redness. Red streaks leading from the area. Pus draining from the area. A fever. […] You cannot use your joint. […] Watch closely for changes in your health, and be sure to contact your doctor if: You do not get better as expected.

• #52 Septic | PPT

  https://www.slideshare.net/slideshow/septic-45214890/45214890

  Septic arthritis is a painful infection of the joint that occurs when bacteria or viruses spread from another part of the body through the bloodstream and infect the joint tissue. […] Nursing care focuses on pain management, infection control, promoting mobility and proper joint positioning, and educating patients and families. […] Nursing management ASSESSMENT: Assess the pain Assess the patient physical status History should be taken regarding the joint pain and swellings Vitals signs are taken in which elevated temperature can be found. […] The nurse should prepare the patient and gives support during the painful procedures Analgesics must be given to alleviate pain If the joints are inflammed, let the patients rest and avoid activities that stress the joints Apply local heat or cold to affected joints for approximately 20-30 min three to four times a day. Change positions frequently. Use splints to maintain proper body alignment Avoid pillow under knee to prevent knee and hip flexion deformities.

• #53 Septic | PPT

  https://www.slideshare.net/slideshow/septic-45214890/45214890

  Explain about the disease condition using teaching aids appropriate to the patients and family members levels of understanding Allow significant other opportunities to share feelings and frustration including the need for adequate nutrition and regular follow up care Allow patient to get involve in the daily activities which can be done by him Communicate frequently with the patients in order to view his emotions and expressions related to his disease condition. […] Encourage performance of bed time rituals such as hygiene activity, reading or having a warm drink Initiate pain relief measures before bedtime if appropriate Encourages proper positioning of joints Encourage a balance of activity and rest Provide for uninterrupted sleep to enable completion of sleep cycle. […] Assess the patient in his self care activities Provide pain relief before the patients undertakes self care activities Provide privacy and an environment conductive to performance of each activity Schedule activities to provide for adequate rest periods.

• #54 Septic | PPT

  https://www.slideshare.net/slideshow/septic-45214890/45214890

  Explain about the disease condition using teaching aids appropriate to the patients and family members levels of understanding Allow significant other opportunities to share feelings and frustration including the need for adequate nutrition and regular follow up care Allow patient to get involve in the daily activities which can be done by him Communicate frequently with the patients in order to view his emotions and expressions related to his disease condition. […] Encourage performance of bed time rituals such as hygiene activity, reading or having a warm drink Initiate pain relief measures before bedtime if appropriate Encourages proper positioning of joints Encourage a balance of activity and rest Provide for uninterrupted sleep to enable completion of sleep cycle. […] Assess the patient in his self care activities Provide pain relief before the patients undertakes self care activities Provide privacy and an environment conductive to performance of each activity Schedule activities to provide for adequate rest periods.

• #55 Septic arthritis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bone-and-joint-infections/symptoms-causes/syc-20350755

  Septic arthritis is a painful infection in a joint that can come from germs that travel through your bloodstream from another part of your body. […] Treatment involves draining the joint with a needle or during surgery. Antibiotics also are usually needed. […] See your doctor if you have severe pain in a joint that comes on suddenly. Prompt treatment can help minimize joint damage. […] If treatment is delayed, septic arthritis can lead to joint degeneration and permanent damage. If septic arthritis affects an artificial joint, complications may include joint loosening or dislocation.

• #56 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Optimal duration of treatment for nongonococcal septic arthritis is uncertain but is at least two weeks for small joints; at least six weeks is more commonly prescribed for all joints. […] Septic arthritis caused by methicillin-resistant S. aureus requires drainage or debridement and three to four weeks of antibiotics. […] A large cohort study showed that the 90-day mortality rate for septic arthritis is 7% and increases to 22% to 69% in patients 80 years and older. […] Other comorbidities such as diabetes mellitus, rheumatoid arthritis, bacteremia, and low creatinine clearance are also associated with increased mortality. […] Poor functional outcomes such as amputation, arthrodesis, prosthetic surgery, and severe functional deterioration occur in about 24% to 33% of patients with septic arthritis and are more likely with older age, preexisting joint disease, and synthetic intraarticular material.

• #57 Septic Arthritis Causes, Symptoms, Treatment, Medications, Prevention

  https://www.medicinenet.com/septic_arthritis/article.htm

  Drainage is essential for rapid clearing of the infection. Drainage of a joint effusion can be done by regular aspirations with a needle and syringe, often daily early on, or via surgical procedures. […] Septic arthritis is a medical emergency and requires acute treatment by an appropriate medical team. […] The outlook for septic arthritis depends on the precise microbe causing the infection, the duration of the infection, and the underlying overall health of the individual infected. […] Rapid clearing of the infection is critical to preserve the joint. If appropriate antibiotics are begun immediately, joint integrity can be maintained, and return to function is expected. […] It is possible to prevent septic arthritis by avoiding infections, puncture wounds, and damage to the skin.

• #58 Septic arthritis | Symptoms, causes, treatments

  https://versusarthritis.org/about-arthritis/conditions/septic-arthritis/

  Once the infection has been treated and your pain and inflammation have started to settle its important to begin moving your affected joint to prevent it becoming stiff. […] In most cases, early hospital treatment and antibiotics will successfully treat septic arthritis, leaving little or no lasting effects of the condition. […] When your symptoms start to ease after treatment, its important to get the affected joints moving again. Gentle movement of the joint can help your recovery and prevent long-term stiffness. […] By doing gentle exercise and completing the full course of antibiotics, most people find their joint fully recovers without any long-term damage. However, this may not always be the case.

• #59 Patient Education | Concord Orthopaedics

  https://www.concordortho.com/patient-resources/patient-education/topic/ea5c832a188309fb082878b8e62ce6cd

  As your infection begins to clear up, your doctor may suggest that you begin strengthening and range of motion exercises. They will help your joint regain its strength and flexibility. A physical or occupational therapist may oversee your exercise program. […] How well your septic arthritis responds to treatment will depend on a number of factors. Most important is how soon you got treatment. Only about 25 percent of patients who wait a week to see a doctor can hope for a complete recovery.

• #60 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Debridement and retention of the prosthesis can be considered in patients who develop periprosthetic joint infection (PJI) within 30 days of implantation or in those whose PJI presented within 3 weeks of the development of symptoms, if the prosthesis appears to be well fixed and is without a sinus tract. […] Strictly adhere to sterile procedures whenever the joint space is invaded (eg, in aspiration or arthroscopic procedures). […] Antibiotic prophylaxis with an anti-staphylococcal antibiotic has been demonstrated to reduce wound infections in joint replacement surgery. […] Treat any infection promptly to lessen the chance of bloodstream invasion. In addition, decreasing the incidence of underlying infections best prevents reactive arthritis. […] Instruct patients with a prosthetic joint in place to recognize early signs of joint infection and, more importantly, to recognize bacterial infections in other parts of their bodies to prevent associated bacteremias.

• #61 Septic Arthritis: Diagnosis and Treatment | AAFP

  https://www.aafp.org/pubs/afp/issues/2021/1200/p589.html

  Before initiating antibiotic therapy in patients with suspected septic arthritis, analysis of synovial fluid obtained through arthrocentesis should be performed, including Gram stain, cultures, white blood cell count with differential, and crystal analysis. […] Initial empiric antibiotic therapy for adults with septic arthritis should cover Staphylococcus aureus and Streptococcus species. […] Oral antibiotics are not inferior to intravenous antibiotics for treatment of septic arthritis. […] Septic arthritis caused by methicillin-resistant S. aureus should be treated with drainage or debridement and 14 days of intravenous antibiotics followed by oral antibiotics, totaling three to four weeks of therapy. […] In patients with joint replacements, prophylactic antibiotics are not recommended to prevent joint infection for routine outpatient dental, urologic, or gastrointestinal procedures.

• #62 Septic Arthritis Treatment & Management: Approach Considerations, Antibiotic Therapy, Joint Immobilization and Physical Therapy

  https://emedicine.medscape.com/article/236299-treatment

  Debridement and retention of the prosthesis can be considered in patients who develop periprosthetic joint infection (PJI) within 30 days of implantation or in those whose PJI presented within 3 weeks of the development of symptoms, if the prosthesis appears to be well fixed and is without a sinus tract. […] Strictly adhere to sterile procedures whenever the joint space is invaded (eg, in aspiration or arthroscopic procedures). […] Antibiotic prophylaxis with an anti-staphylococcal antibiotic has been demonstrated to reduce wound infections in joint replacement surgery. […] Treat any infection promptly to lessen the chance of bloodstream invasion. In addition, decreasing the incidence of underlying infections best prevents reactive arthritis. […] Instruct patients with a prosthetic joint in place to recognize early signs of joint infection and, more importantly, to recognize bacterial infections in other parts of their bodies to prevent associated bacteremias.

• #63 Septic Arthritis & Osteomyelitis | Nurse – PMM

  https://www.pmmonline.org/nurse/arthritis-conditions/red-flag-conditions/septic-arthritis-osteomyelitis/

  Septic Arthritis (infectious arthritis of a synovial joint), Osteomyelitis (infection of bone) […] These conditions are rare but can be life threatening (red flags). Early diagnosis and treatment are important. […] They are due to bacterial infection of the bone or joint and should be suspected with acute onset of: Fever, Unexplained limp, reluctance to use a limb or inability to weight bear, bone or joint pain with a hot swollen joint, bone or joint tenderness, or complete reluctance to move a joint or limb. […] Careful examination and suspicion are important. […] Septic Arthritis – most common in the young (50% 2 years), most commonly affects lower limb joints (knee, hip, ankle). […] Principles of management of septic arthritis and osteomyelitis […] Prompt diagnosis, urgent washout and drainage of joint and rapid treatment with antibiotics.

• #64 Septic arthritis | Symptoms, causes, treatments

  https://versusarthritis.org/about-arthritis/conditions/septic-arthritis/

  Once the infection has been treated and your pain and inflammation have started to settle its important to begin moving your affected joint to prevent it becoming stiff. […] In most cases, early hospital treatment and antibiotics will successfully treat septic arthritis, leaving little or no lasting effects of the condition. […] When your symptoms start to ease after treatment, its important to get the affected joints moving again. Gentle movement of the joint can help your recovery and prevent long-term stiffness. […] By doing gentle exercise and completing the full course of antibiotics, most people find their joint fully recovers without any long-term damage. However, this may not always be the case.

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