- Direct injury
- Blood-borne infection
- Susceptibility in
- Chronically inflamed joints
- Immunosuppressed patients
- Artificial joints
Organisms
- Staphylococcus aureus
- Streptococcus and other staphylococci
- Neisseria gonorrhoeae
- Haemophilus influenzae
- Gram-negative organisms
Clinical features
- Joint pain (may be severe)
- Muscle spasm
- Joint hot, red and swollen
- Signs of the source of infection
Investigations
- Urgent joint aspiration
- Microscopy and culture/gram stain
- Elevated white cell count
- Blood cultures
Management
- Two i.v. antibiotics for 2 weeks (start antibiotics immediately diagnosis suspected)
- Followed by 6 weeks of oral antibiotics
- Initial mobilisation of the joint
- Early physiotherapy
- Consider surgical drainage and washout
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