Wrist Septic Arthritis: An 11 Year Review

Abstract

Staphylococcus aureus, the most common microbial pathogen in our findings, point to the need to adopt a lower threshold for escalation of antibiotics for immunocompromised patients with slow reversal of infection in order to reduce morbidity, mortality, number of surgeries and length of post-operative stay.

Predictors of Septic Wrist: A Dual-Center 10-Year Review of Risk Factors

“…9,11 ►Table 8 is a review table of the available literature describing the presentation, diagnosis, and treatment of patients with septic wrist. 1,3,10,[12][13][14] Interestingly, our current study found that a higher synovial WBC was associated with septic wrist arthritis (average 123,691) when compared with nonseptic wrists (p < 0.001; average 56,982) and crystalline arthropathy (p = 0.002; average 64,733). Although the optimal synovial WBC threshold was found to be 87,750 cells/µL, and while this value should be interpreted with caution, this may provide preliminary data supporting the development of a threshold cutoff for synovial WBC in predicting septic wrist arthritis.…”

“…Additionally, waiting for microbial growth in cultures can cause a delay in timely diagnosis and intervention that has been shown to affect total number of surgeries required and functional outcome. 6,10 Currently, physicians rely on clinical acumen and a high level of suspicion to diagnose septic wrist arthritis. 2,9 It should be noted that in our current study, 3.3% (1/30) of septic wrist cases were diagnosed from positive operative cultures.…”

Total wrist arthrodesis for septic wrist arthritis and loss of the bony carpus following percutaneous pinning of the fifth carpometacarpal joint: a case report

“…Additional antibiotic treatments should be initiated according to the generated antibiogram using the collected tissue samples of the index surgical procedure. Studies showed that the most common bacteria detected were Staphylococcus aureus [9, 15]. The average duration of antibiotic treatment has been explained diversely in literature.…”

“…The average duration of antibiotic treatment has been explained diversely in literature. The authors describe treatment periods between 5 and 180 days [7, 15]. There is hardly any evidence about the sequence, combination, or the superiority of primary closed needle aspiration and surgical aspiration with or without arthroscopy.…”

“…In up to 73% of the cases, SWA results in a partially destroyed joint or may even result in amputation [4, 13, 15]. …”