Artritis infecciosa

Infectious arthritis is the inflammatory process secondary to infection of a joint by a micro-organism, generally bacteria. The term septic arthritis refers to arthritis caused by a pyogenic bacteria that can cause major joint destruction. The Gram-positive cocci have a greater capacity to colonise the joints, S. aureus being the commonest micro-organism among them. Infection is principally by haematogenous spread. It is more common in patients with a previous joint lesion or immunosuppression. Most often, septic arthritis is monoarticular, and predominates in the large joints. It is generally acute, with fever and local inflammatory symptoms. Diagnostic arthrocentesis should be performed on all patients before starting treatment. The correct treatment of infectious arthritis involves a combination of appropriate antibiotic treatment, drainage and immobilisation of the joint in the functional position. Most prosthetic joint infections are acquired during surgery or immediately afterwards. Negative-coagulase staphylococci are the most common microorganisms involved. Patients present with joint pain and occasionally purulent drainage through the surgical wound. Diagnosis is by culture of the joint fluid or synovial tissue. Appropriate treatment is removal of the prosthesis and prolonged antibiotic treatment.