Bacterial septic arthritis in adults

Summary Symptoms and signs of septic arthritis are an important medical emergency, with high morbidity and mortality. We review the changing epidemiology of septic arthritis of native joints in adults, encompassing the increasing frequency of the disorder and its evolving antibiotic resistance. We d...

Full description

Saved in:
Bibliographic Details
Published in:The Lancet (British edition) 2010-03, Vol.375 (9717), p.846-855
Main Authors: Mathews, Catherine J, MRCP, Weston, Vivienne C, FRCP, Jones, Adrian, DM, Field, Max, FRCP, Coakley, Gerald, Dr
Format: Article
Language:English
Subjects:
Adult
Animal models
Animals
Antibiotic resistance
Antibiotics
Arthritis, Infectious - diagnosis
Arthritis, Infectious - etiology
Arthritis, Infectious - physiopathology
Arthritis, Infectious - therapy
Bacteria
Biological and medical sciences
Bisphosphonates
Corticoids
Diseases of the osteoarticular system
Drug abuse
Epidemiology
Fungal infections
General aspects
Gram-positive bacteria
Hemodialysis
Humans
Immune system
Immunotherapy
Internal Medicine
Joint surgery
Medical prognosis
Medical sciences
Microorganisms
Miscellaneous. Osteoarticular involvement in other diseases
Mortality
Organisms
Patients
Rheumatic diseases
Risk factors
Sepsis
Staphylococcus infections
Studies
Substance abuse treatment
Toxins
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Summary Symptoms and signs of septic arthritis are an important medical emergency, with high morbidity and mortality. We review the changing epidemiology of septic arthritis of native joints in adults, encompassing the increasing frequency of the disorder and its evolving antibiotic resistance. We discuss various risk factors for development of septic arthritis and examine host factors (tumour necrosis factor α, interleukins 1 and 10) and bacterial proteins, toxins, and enzymes reported to be important determinants of pathogenesis in mouse models. Diagnosis of disease is largely clinical, guided by investigations and the opinion of skilled clinicians. We emphasise the need for timely medical and surgical intervention—most importantly, through diagnostic aspiration of relevant joints, choice of suitable antibiotic, and appropriate supportive measures. Management is growing in complexity with the advent of novel and antibiotic-resistant causative microorganisms and within the current climate of increased immunosuppression. Findings from animal models and patients are shedding light on disease pathogenesis and the possibility of novel adjunctive treatments, including systemic corticosteroids, cytokines and anticytokines, and bisphosphonates.
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(09)61595-6