Infectious arthritis (pyogenic septic arthritis) - a complex infectious disease of the joints accompanied by fever, pain, chills, loss of mobility of the affected joints, their swelling and damage.
susceptible people of all ages, including infectious arthritis occurs in children. In adults, the disease usually affects the knees or hands. In some patients, symptoms of disease are observed, not one but several joints. Infectious arthritis in children often causes arthritis and defeat the knee, shoulder and hip joints.
The high-risk group includes the following categories of people:
- chronic rheumatoid arthritis;
- recently received intra-articular injections;
- recently undergone surgery or trauma on the joints;
- with some types of cancer;
- homosexual (increased risk of gonococcal arthritis);
- systemic infections (HIV, gonorrhea);
- diabetics and patients with sickle cell disease, or systemic lupus erythematosus;
- alcohol or drug addiction.
Causes of infectious arthritis
Mostly cause of infectious arthritis are fungal, viral or bacterial infections that enter into the joint with blood flow. It is also the causative agent can enter into the joint during surgery or other means. The emergence of the pathogenic factor depends on the age of the patient. Infectious arthritis in children just born, usually caused by gonococcal infection transmitted from mother to child, gonorrhea. Children also can develop as a result of a variety of hospital manipulation, including by inserting a catheter.
As pathogens in children up to 2 years in favor staphylococcus aureus or haemophilius influencae. In older children and adults can also become agents of streptococcus viridans and streptococcus pyogenes. As a rule, sexually active people infectious arthritis is a consequence of the infection of Neisseria gonorrhoeae. Older people get exposed to Gram-negative bacteria, such as Pseudomonas and Salmonella.
The symptoms of infectious arthritis
Mostly pyogenic arthritis begins suddenly. Sometimes the symptoms of infectious arthritis is increasing for several weeks. It is accompanied by swelling of the affected joint and increased his pain.
Symptoms of infectious arthritis of the hip joint is a pain in the groin, which becomes very noticeable when walking. In most cases, the patient's body temperature rises, there is a fever. In children, infectious arthritis often causes nausea and vomiting.
Local symptoms of infectious arthritis is a sharp pain on movement, pain in the joint, changing its contours, increasing swelling, impaired motor function of limbs, fever.
Complications of infectious arthritis
The disease poses a direct threat not only to health, but also the life of the patient, as threatens the destruction of cartilage, bone or septic shock, which mostly leads to death. For example, Staphylococcus aureus can lead to very rapid destruction of cartilage, just a couple of days. Destruction of cartilage leads to displacement of bone joints.
bacterial infection, it can spread to the surrounding tissues and blood, causing blood poisoning or abscesses. The most common complication of the disease is osteoarthritis.
Diagnosis of infectious arthritis
Correct diagnosis doctor may put only after the date of the relevant laboratory tests, a careful study of medical records and a careful examination of the patient. When the diagnosis should be aware that the symptoms of septic arthritis may also occur in other diseases (rheumatic fever, gout, Lyme disease, etc.).
Sometimes the doctor refers the patient to additional consultation to the orthopedist and rheumatologist in order to avoid misdiagnosis.
To confirm the diagnosis, the doctor prescribes the following types of research:
- arthrocentesis for a detailed study of synovial fluid;
- Biopsy and culture of synovial tissue around the joint;
- crops of urine and blood, and mucus from the cervix, etc.
In the early stages of septic arthritis hardware diagnostics is not effective (the first 10-14 days after infection).
Treatment of infectious arthritis
As a rule, infectious arthritis patients being treated for some time stationary, assigning him the medication and physiotherapy for several weeks or months.
If the disease is detected at a later stage and can cause serious disorders, doctors urgently start intravenous antibiotics. And after the detection of the pathogen the doctor assigns adequate treatment of infectious arthritis.
In viral infections prescribe nonsteroidal anti-inflammatory agents. The course of therapy with intravenous antibiotics up to two weeks, after which the patient prescribed a long course of oral antibiotics.
The whole period of hospital treatment the patient is under constant medical supervision. The patient takes a daily synovial fluid for analysis. This allows you to determine the effectiveness of treatment. Since infectious arthritis is often accompanied by severe pain, the patient is prescribed painkillers. To protect joints from accidental and sudden movements, the patient may impose the tire.
In some cases, for the treatment of infectious arthritis applied surgery. It is used for those patients for whom antibiotic therapy is not effective or in case of serious injuries of the hip or other joints of which is problematic to take a puncture. Surgical treatment is preferred in cases where infectious arthritis caused by penetrating or gunshot wound.
If the patient has already taken place heavy defeat cartilage and bone reconstructive surgery may be used. However, the operation can be carried out only when the infection is completely gone from the body.
After discharge from the hospital, patients are encouraged to perform a special set of physical exercises that promote a speedy recovery.
Forecast infectious arthritis
The favorable outcome of the disease depends on how quickly started appropriate treatment of infectious arthritis. It should be noted that about 70% of the patients are avoided irreversible joint destruction, but many patients develop complications such as partial deformation of joints and osteoarthritis. Children with septic arthritis of the hip joint is often the case violation of the zone of bone growth. The most frequent causes of death are respiratory failure and septic shock.