Septic Arthritis
Septic Arthritis is a topic covered in the 5-Minute Pediatric Consult.
To view the entire topic, please sign in or purchase a subscription.
Pediatrics Central™ is an all-in-one application that puts valuable medical information, via your mobile device or the web, in the hands of clinicians treating infants, children, and adolescents. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
Microbiologic infection and inflammation of the usually sterile joint space
Epidemiology
- Most common age: toddler and school age (2 to 6 years)
- Predominant sex: male (2:1 female)
- Most common location: lower extremities (hip, knee, and ankle) and large joints (hip, shoulder, elbow)
Pathophysiology
- Entry of bacteria into joint space
- Hematogenous spread (seeding during transient bacteremia) most common
- Direct inoculation (penetrating trauma or during surgery)
- Extension from bone infection (mainly in children <1 year old when vessels cross from metaphysis to epiphysis)
- In response to cytokines, influx of inflammatory cells and release of proteolytic enzymes
- Leads to destruction of synovium and cartilaginous structures
Etiology
- Most common causes by age:
- Neonates: group B Streptococcus, Staphylococcus aureus, Escherichia coli, and Candida albicans
- Older children: S. aureus, group A Streptococcus, Kingella kingae in toddlers, Haemophilus influenzae
- Also consider
- Salmonella: in patients with sickle cell
- Neisseria gonorrhoeae: in sexually active adolescents and in neonates
- Neisseria meningitidis
- Mycobacterium tuberculosis
- Anaerobes (rare)
- Rubella
- Parvovirus
- Hepatitis B or C
- Mumps
- Herpesviruses (Epstein-Barr virus, cytomegalovirus, herpes simplex virus, varicella-zoster virus)
- Fungal etiologies (e.g., coccidioidomycosis, rarely candida)
Commonly Associated Conditions
- Sickle cell disease: Salmonella
- Immunocompromised patients: Mycoplasma, Ureaplasma, Klebsiella, or Aspergillus infection
-- To view the remaining sections of this topic, please sign in or purchase a subscription --
Citation
Cabana, Michael D., editor. "Septic Arthritis." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617393/all/Septic_Arthritis.
Septic Arthritis. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617393/all/Septic_Arthritis. Accessed October 14, 2019.
Septic Arthritis. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617393/all/Septic_Arthritis
Septic Arthritis [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 October 14]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617393/all/Septic_Arthritis.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Septic Arthritis
ID - 617393
ED - Cabana,Michael D,
BT - 5-Minute Pediatric Consult
UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617393/all/Septic_Arthritis
PB - Wolters Kluwer
ET - 8
DB - Pediatrics Central
DP - Unbound Medicine
ER -