Skip to main content

Infectious Arthritis

  • Chapter
  • First Online:
Book cover Absolute Rheumatology Review
  • 1333 Accesses

Abstract

Infectious arthritis, due to viral, bacterial, or fungal etiologies, is a common cause of joint inflammation and can vary in clinical presentation based on the particular infectious etiology and the host characteristics. Though bacterial organisms are the most common and usually present with a monoarticular or oligoarticular arthritis, viral arthritis predominantly presents with polyarticular involvement and can mimic inflammatory arthritis such as rheumatoid arthritis. The most important aspect of evaluation is to perform an arthrocentesis in order to identify the organism, or in cases of viruses, sending the appropriate serologic workup. Following this, antibiotic treatment should be tailored to the correct organism, and additional measures such as drainage should be considered. Prompt evaluation is important to prevent long-term sequelae of infection and inflammation leading to permanent joint damage.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cooper C, Cawley MI. Bacterial arthritis in an English health district: a 10 year review. Ann Rheum Dis. 1986;45:458–63.

    Article  CAS  Google Scholar 

  2. Haug JB, Harthug S, Kalager T, et al. Bloodstream infections at a Norwegian university hospital, 1974–1979 and 1988–89: changing etiology, clinical features, and outcome. Clin Infect Dis. 1994;19:246–56.

    Article  CAS  Google Scholar 

  3. Ross JJ, Saltzman CL, Carling P, et al. Pneumococcal septic arthritis: review of 190 cases. Clin Infect Dis. 2003;36:319–27.

    Article  Google Scholar 

  4. Kaandorp CJ, Dinant HJ, van de Laar MA, et al. Incidence and sources of native and prosthetic joint infection: a community based prospective survey. Ann Rheum Dis. 1997;56:470–5.

    Article  CAS  Google Scholar 

  5. Muñoz-Egea MC, Blanco A, Fernández-Roblas R, et al. Clinical and microbiological characteristics of patients with septic arthritis: a hospital-based study. J Orthop. 2014;11(2):87–90.

    Article  Google Scholar 

  6. Horowitz DL, Horowitz S, Barilla-LaBarca ML. Approach to septic arthritis. Am Fam Physician. 2011;84(6):653–60.

    PubMed  Google Scholar 

  7. Ross JJ. Septic arthritis of native joints. Infect Dis Clin N Am. 2017;31(2):203–18.

    Article  Google Scholar 

  8. Goldenberg DL. Septic arthritis and other infections of rheumatologic significance. Rheum Dis Clin N Am. 1991;17:149.

    CAS  Google Scholar 

  9. Dubost JJ, Fis I, Denis P, et al. Polyarticular septic arthritis. Medicine (Baltimore). 1993;72:296.

    Article  CAS  Google Scholar 

  10. Ross JJ, Shamsuddin H. Sternoclavicular septic arthritis: review of 180 cases. Medicine (Baltimore). 2004;83:139.

    Article  Google Scholar 

  11. Li SF, Henderson J, Dickman E, et al. Laboratory tests in adults with monoarticular arthritis: can they rule out a septic joint? Acad Emerg Med. 2004;11:276–80.

    Article  Google Scholar 

  12. Goldenberg DL, Cohen AS. Acute infectious arthritis. Am J Med. 1976;60:369–77.

    Article  CAS  Google Scholar 

  13. Shen CJ, Wu MS, Lin KH, et al. The use of procalcitonin in the diagnosis of bone and joint infections: a systematic review and meta-analysis. Eur J Clin Microbiol Infect Dis. 2013;32:807–14.

    Article  CAS  Google Scholar 

  14. Ross JJ, Davidson L. Methicillin-resistant. Rheumatology (Oxford). 2005;44:1197–8.

    Article  CAS  Google Scholar 

  15. Sharff KA, Richards EP, Townes JM. Clinical management of septic arthritis. Curr Rheumatol Rep. 2013;15(6):1–9.

    Article  CAS  Google Scholar 

  16. Weston VC, Jones AC, Bradbury N, et al. Clinical features and outcome of septic arthritis in a single UK Health District 1982–1991. Ann Rheum Dis. 1999;58:214–9.

    Article  CAS  Google Scholar 

  17. Gupta MN, Sturrock RD, Field M. Prospective comparative study of patients with culture proven and high suspicion of adult onset septic arthritis. Ann Rheum Dis. 2003;62:327–31.

    Article  CAS  Google Scholar 

  18. Ross JJ, Saltzman CL, Carling P, Shapiro DS. Pneumococcal septic arthritis: review of 190 cases. Clin Infect Dis. 2003;36:319.

    Article  Google Scholar 

  19. Goldenberg DL, Cohen AS. Acute infectious arthritis. A review of patients with nongonococcal joint infections (with emphasis on therapy and prognosis). Am J Med. 1976;60:369–77.

    Article  CAS  Google Scholar 

  20. Howard AW, Viskontas D, Sabbagh C. Reduction in osteomyelitis and septic arthritis. J Pediatr Orthop. 1999;19:705–9.

    CAS  PubMed  Google Scholar 

  21. Workowski KA, Berman SM, Centers for Disease Control and Prevention. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recomm Rep. 2006;55(RR- 11):1–94.

    PubMed  Google Scholar 

  22. O’Brien JP, Goldenberg DL, Rice PA. Disseminated gonococcal infection: a prospective analysis of 49 patients and a review of pathophysiology and immune mechanisms. Medicine (Baltimore). 1983;62(6):395.

    Article  Google Scholar 

  23. García-De La Torre I, Nava-Zavala A. Gonococcal and nongonococcal arthritis. Rheum Dis Clin N Am. 2009;35:63.

    Article  Google Scholar 

  24. Kumar K, Saxena MB. Multifocal osteoarticular tuberculosis. Int Orthop. 1988;12:135.

    Article  CAS  Google Scholar 

  25. Hodgson SP, Ormerod LP. Ten-year experience of bone and joint tuberculosis in Blackburn 1978-1987. J R Coll Surg Edinb. 1990;35:259.

    CAS  PubMed  Google Scholar 

  26. Yombi JC, Seyler L, Cornu O, et al. Difficult to treat osteoarticular infections. Acta Orthop Belg. 2017;83(1):110–23.

    CAS  PubMed  Google Scholar 

  27. Rogo LD, Mokhtari-Azad T, Kabir MH, et al. Human parvovirus B19: a review. Acta Virol. 2014;58(3):199–213.

    Article  CAS  Google Scholar 

  28. Kennedy Amaral Pereira J, Schoen RT. Management of chikungunya arthritis. Clin Rheumatol. 2017;36(10):2179–86.

    Article  CAS  Google Scholar 

  29. Arvikar SL, Steere AC. Diagnosis and treatment of lyme arthritis. Infect Dis Clin N Am. 2015;29(2):269–80.

    Article  Google Scholar 

  30. Asmar BI, Andresen J, Brown WJ. Ureaplasma urealyticum arthritis and bacteremia in agammaglobulinemia. Pediatr Infect Dis J. 1998;17(1):73–6.

    Article  CAS  Google Scholar 

  31. Mian AN, Farney AC, Mendley SR. Mycoplasma hominis septic arthritis in a pediatric renal transplant recipient: case report and review of the literature. Am J Transplant. 2005;5:183–8.

    Article  Google Scholar 

  32. Mahnel R, Marth T. Progress, problems, and perspectives in diagnosis and treatment of Whipple’s disease. Clin Exp Med. 2004;4:39–43.

    Article  CAS  Google Scholar 

  33. Eder L, Zisman D, Rozenbaum M, et al. Clinical features and aetiology of septic arthritis in northern Israel. Rheumatology (Oxford). 2005;44:1559–63.

    Article  CAS  Google Scholar 

  34. Gotuzzo E, Alarcon GS, Bocanegra TS, et al. Articular involvement in human brucellosis: a retrospective analysis of 304 cases. Semin Arthritis Rheum. 1982;12:245–55.

    Article  CAS  Google Scholar 

  35. Phillips JE, Crane TP, Noy M, Elliott TS, Grimer RJ. The incidence of deep prosthetic infections in a specialist orthopaedic hospital: a 15-year prospective survey. J Bone Joint Surg Br. 2006;88:943–8.

    Article  CAS  Google Scholar 

  36. Berbari EF, Hanssen AD, Duffy MC, et al. Risk factors for prosthetic joint infection: case-control study. Clin Infect Dis. 1998;27:1247–54.

    Article  CAS  Google Scholar 

  37. Ghanem E, Parvizi J, Burnett RS, et al. Cell count and differential of aspirated fluid in the diagnosis of infection at the site of total knee arthroplasty. J Bone Joint Surg Am. 2008;90:1637–43.

    Article  Google Scholar 

  38. Pääkkönen M, Peltola H. Treatment of acute septic arthritis. Pediatr Infect Dis J. 2013;32:684–68.

    Article  Google Scholar 

  39. Pioro MH, Mandell BF. Septic arthritis. Rheum Dis Clin N Am. 1997;23:239–25.

    Article  CAS  Google Scholar 

  40. Li R, Hatcher JD. Gonococcal arthritis. Bookshelf NCBI.

    Google Scholar 

  41. Speyer I, Breedveld FC, Dijkmans BA. Human parvovirus B19 infection is not followed by inflammatory joint disease during long term follow up. A retrospective study of 54 patients. Clin Exp Rheum. 1889;16(5):576–8.

    Google Scholar 

  42. Dattwyler RJ, Wormser GP, Rush TJ, et al. A comparison of two treatment regimens of ceftriaxone in late Lyme disease. Wien Klin Wochenschr. 2005;117(11–12):393–7.

    Article  CAS  Google Scholar 

  43. Chakraborty PP, Ray S, Selvan C, et al. Poncet’s disease: AN unusual presentation of tuberculosis in a diabetic lady. World J Clin Cases. 2015;3(4):385–8.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nicola Berman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Berman, N., Golden, B.D. (2020). Infectious Arthritis. In: Efthimiou, P. (eds) Absolute Rheumatology Review. Springer, Cham. https://doi.org/10.1007/978-3-030-23022-7_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-23022-7_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-23021-0

  • Online ISBN: 978-3-030-23022-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics