In our study, septic arthritis due to Staphylococcus aureus and Streptococcal species was more common in the elderly. This contrasts with Lyme arthritis which has a higher incidence in younger patients. The majority of joint infections were in the elderly, with a median age of 65 (range 14-95) for Staphylococcus aureus and 70 for Streptococcal species. The age range of Methicillin-resistant Staphylococcus aureus (MRSA) septic arthritis was 27-95 (median 72) with 39/53 (73.6%) above age 60. The age range of Streptococcal arthritis patients was 36-86 (median 70). There were more males with septic arthritis for both Staphylococcus aureus (86/134) 64% and streptococci (12/22) 55%. The most frequently involved joint was the knee, 49.3% for S. aureus followed by hip (23.9%), elbow (14.3%), shoulder (14%), wrist (1.5%), ankle (0.75%) and sternoclavicular (0.75%). The knee was affected in 81% of Streptococcal infections, with the rest equally divided between the hip, elbow, acromioclavicular and ankle joints. The history of prior joint replacement in patients with septic arthritis was 21/28 (80%) for MRSA, 36/102 (35.3%) for methicillin-susceptible Staphylococcus aureus (MSSA) and 9/21 (43%) for streptococcal arthritis suggestive of healthcare-associated infections. Our results suggest a need for improvements to prevent the entry of pathogens into the surgical site during and after surgery.

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Background Many viruses infect salivary glands. These include mumps, Epstein-Barr, herpes virus 6, parainfluenza, influenza, adeno virus, boca virus and others. Almost all coronavirus disease 2019 (COVID -19) infected patients carry the virus in saliva. Salivary duct epithelium were the early target cells in macaque monkeys infected with severe acute respiratory syndrome corona virus (SARS-COV). Here we present 2 COVID-19 cases with the involvement of salivary glands. Salivary gland involvement has not been reported in COVID-19. Methods We followed the COVID 19 clinical findings in a Pennsylvania long term care facility with 190 residents. Thirty tested polymerase chain reaction (PCR) positive. However, 48 were presumed infected. Eighteen likely cases were not tested due to shortage of swabs. Thirty four employees also tested positive. Two out of 48 patients aged 78 and 88 developed unilateral sialadenitis during the course of the illness. Both were Hispanic females. We studied the Clinical presentations, co-morbidities, lab and imaging results and the outcome. Results Case 1: Two days after the first confirmed case, a 88 year old Hispanic female developed fever and fatigue and tested COVID-19 positive. Fever lasted 5 days. Twenty days later the patient developed a 5x3 cm tender left parotid mass and hypoxia treated with oxygen via nasal cannula. (Table 1) Case 2: A 78 year old Hispanic female developed high fever and cough 7 days after the index case. Six days later she had persistent fever and presented with a tender 8.5x3.5 cm right submandibular mass. The patient was intubated for 3 days to protect the airway due to the size of the mass. Both made an uneventful recovery. (Table 1 and Figure 1) Conclusion New clinical findings of COVID -19 have been gradually added during the course of the pandemic. The virus is almost universally present in the saliva. In experimental Chinese macaques with SARS-COV early target cells were the salivary duct epithelium. Salivary gland inflammation and swelling should be included amongst the clinical features of COVID-19. Disclosures All Authors: No reported disclosures

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