The outcome of bacterial arthritis. A prospective community‐based study

Kaandorp, C. J. E.; Krijnen, Pieta; Moens, Hein J. Bernelot; Habbema, J. Dik F.; Schaardenburg, Dirkjan van

doi:10.1002/art.1780400516

Cited by 231 publications

(112 citation statements)

References 44 publications

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“…According to one report septic arthritis has an annual incidence of two to 10 per 100,000 individuals, although that study did not report data on the incidence of ankle septic arthritis [6]. Untreated joint infection can lead to irreversible destruction of articular cartilage, disability, systemic sepsis and death [3,4,7]. A retrospective study of septic arthritis in the United Kingdom reported 23.8% of patients had considerable loss of function in the affected joint and 11.5% of patients died as a result of their illness [18].…”

Section: Introductionmentioning

confidence: 99%

Hematogenous Septic Ankle Arthritis

Holtom

Borges

Zalavras

2008

Clinical Orthopaedics &Amp; Related Research

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Ankle infection is a serious problem with limited published information on microbiology and associated morbidities. We describe the laboratory findings, microbiology, and occurrence of adjacent osteomyelitis in patients with hematogenous septic ankle arthritis. We retrospectively reviewed 30 patients with hematogenous septic arthritis of the ankle admitted over a 10-year period. Twenty-two patients were male and eight female. The mean age was 46 years (range, 23-67 years). C-reactive protein and erythrocyte sedimentation rate were elevated in all patients, but the peripheral white blood cell count was elevated in only 47% of patients. Staphylococcus aureus (S. aureus) was the most common pathogen, isolated in 13 (54%) of the 24 patients with positive cultures; four of these isolates (four of 24; 17% of positive cultures) were oxacillin-resistant. Four (17%) of the 24 patients with positive cultures had a mycobacterial infection. We identified adjacent osteomyelitis in 30% of patients, which was considerably associated with the presence of patient comorbidities. S. aureus is the most common pathogen in septic ankle arthritis and empiric antibiotic therapy is recommended. Adjacent osteomyelitis may be present and a high index of suspicion is necessary in patients with comorbidities.

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Section: Introductionmentioning

confidence: 99%

Hematogenous Septic Ankle Arthritis

Holtom

Borges

Zalavras

2008

Clinical Orthopaedics &Amp; Related Research

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“…If treatment is delayed, septic arthritis has a mortality rate between 5% and 15 % often as a result of septic shock [4]. Septicemia is a known complication resulting from the transient or chronic bacteremia associated with most cases of septic arthritis.…”

Section: Discussionmentioning

confidence: 99%

“…Septicemia is a known complication resulting from the transient or chronic bacteremia associated with most cases of septic arthritis. [4] However, such deaths usually have a more progressively deteriorating course rather than a sudden deterioration of seemingly improving condition. Sudden deterioration of her condition points towards pulmonary thrombo embolism; another well known complication of septic arthritis [5].…”

Section: Discussionmentioning

confidence: 99%

A case of sudden death due to septic pulmonary embolism

Kitulwatte¹,

Wijerathna²

2014

Medico-Legal J SL

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Introduction: Sudden deaths in hospital following a short duration of seemingly improving illness arouse suspicion of medical maltreatment. It is mandatory to have a medico-legal investigation in to such deaths. Facts, explanations, and opinions made by the forensic pathologists at the end of an autopsy examination are of crucial importance to eliminate or confirm such doubts. We report how a thorough autopsy examination including ancillary testing can lead to effective administration of justice in such cases.Case History: A 42 year woman with diabetes mellitus was admitted to hospital with fever and right knee joint swelling and tenderness of one week's duration. There was cellulitis over the right knee joint and underlying septic arthritis. Surgical drainage of the joint was done and intra venous antibiotics were given and the condition seemed to be improving. On the 4 th day of admission, she developed sudden onset of shortness of breath and central chest pain resulting in death 12 hours later. At autopsy she was pale and icteric. There was evidence of septic arthritis with surrounding necrotizing fasciitis and deep venous thrombosis of the right calf. There was consolidation of the right lung with patchy focal pale yellow areas with surrounding erythema, and evidence of multi-organ sepsis. Microscopy confirmed multi organ involvement and revealed pneumonia of the right lung with early abscess formation and multiple bilateral peripheral septic thrombo emboli. There was septic thrombosis of the calf veins with associated thrombo phlebitis. Conclusion:Facts revealed at autopsy explained the sudden death and the possibility of such death was scientifically clarified. The cause of death was concluded as septic pulmonary thrombo embolism due to deep venous septic thrombosis and thrombophlebitis due to septic arthritis and necrotizing fasciitis.

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“…Postoperative risk factors include woundhealing complications (e.g., superficial infection, hematoma, delayed healing, wound necrosis, and dehiscence), atrial fibrillation, myocardial infarction, urinary tract infection, prolonged hospital stay, and S. aureus bacteremia [12][13][14][15], [18][19][20][21]. An increased rate of infection occurs in the pre-damaged joint and is also associated with particular predispositions of the patients (Table 1) [22][23][24]. In articular, a joint prosthesis is a high risk predisposition for an infection.…”

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confidence: 99%