Introduction:
Septic arthritis is an infection of the joint, synovial fluid, and joint tissues. Children are more commonly affected than adults, where the infection usually reaches the joints through the bloodstream. The joints may also become infected due to an injection, surgery, or injury. The condition is excruciating and can develop and aggravate quickly. A severe illness that can affect people of any age needs to be treated in hospital as soon as possible as an emergency.
Is Septic Arthritis Contagious?
Infectious arthritis is not contagious, although the name may be misleading. It can, however, be quite severe. According to studies, at least one-third of those with the condition get sick from septic arthritis, and 7 to 15 % of those who are hospitalized pass away from it. It affects patients who have compromised immune systems, including diabetics, the elderly, and small children; in addition, people who have artificial joints, or people with underlying medical issues that can weaken their immune systems, are more susceptible to the condition. This includes people with diabetes and people taking immunosuppressant medications for autoimmune conditions, cancer or organ transplants.
What Are the Principal Causes Behind Septic Arthritis?
Several strains of bacteria, viruses, and fungi can cause infection in a joint. The causative species behind septic arthritis are as follows;
- Staphylococci: These are common bacteria causing skin infections.
- Haemophilus Influenzae: These bacteria cause laryngeal, tracheal, and bronchial infections.
- Gram-negative Bacilli: This bacterial group includes E. coli.
- Streptococci: This group of bacteria is responsible for many diseases.
- Gonococci: This is the bacterium responsible for the sexually transmitted disease known as gonorrhea.
- Viruses: Human Immunodeficiency virus can result in the infection of the joints.
The strain Staphylococcus aureus principally causes septic arthritis. It is also known as S. aureus. The entry point of the bacteria into the bloodstream may be in several ways, such as:
- A broken bone is piercing the skin, known as an open fracture.
- Spread of infection from another place on the body, such as the skin or genitals.
- An infected wound.
- Foreign objects that go through the skin.
- An injury that breaks the skin.
Who Is at Risk for Septic Arthritis?
Risk factors for septic arthritis include:
- A systemic blood-borne infection.
- IV drug use.
- Osteoarthritis.
- History of septic arthritis.
- Rheumatoid arthritis.
- Alcohol consumption.
- Diabetes mellitus.
- HIV.
- Lung or liver disorders.
- Senescence and aging.
- Immunosuppression.
What Are the Symptoms of Septic Arthritis?
Septic arthritis commonly affects the knee, hip, shoulder, elbow, wrist, and finger joints, often affecting only one joint. Symptoms vary across affected persons, but common symptoms include:
- Fever or pyrexia.
- Joint pain or arthralgia.
- Swelling of the joints.
The symptoms mentioned earlier of septic arthritis may mimic other health conditions, and a healthcare provider should be consulted for a confirmed diagnosis.
How Is Septic Arthritis Diagnosed?
Early diagnosis is essential to prevent permanent damage to the joint. Therefore, a good medical history and a physical examination along with tests need to be performed, such as:
- Aspiration of the joint fluid to check for white blood cells, inflammation, and bacterial infections.
- Blood tests are done to look for the various strains of bacteria responsible for the disease.
- Other body fluids and secretions such as phlegm, cerebrospinal fluid, urine examinations, and culture sensitivity tests identify bacterial strains and locate the infection source.
What Is the Treatment Modality for Septic Arthritis?
Treatment modalities depend upon the symptoms, age, and general health of a patient and the severity of the disease.
Often a prompt treatment with antibiotics is instrumental, which can improve symptoms within the next 48 hours. Fungal infections need treatment with antifungal medicine. Viral infections are not treated with medication. Pus drainage may be required from the joint as a build-up of purulent material, which can irreversibly cause damage to the joint. Drainage is usually done with a needle, tube, or surgery, and a single site may be drained multiple times from the joint throughout treatment. Other treatment modalities include palliative therapies to provide symptomatic relief;
- Antipyretics for fever.
- Analgesics for pain and tenderness.
- Physiotherapy to maintain or regain muscular strength and functionality.
- A splint may be placed.
What Are the Complications of Septic Arthritis?
Septic arthritis can cause irreversible damage to the joint cartilage, which permanently damages the joint.
What Are the Steps to Improve Recovery Post Treatment?
When the symptoms start to ease after treatment, getting the affected joints moving again is essential. A gentle movement helps faster recovery and prevents long-term stiffness or restricted activities.
A physiotherapist can advise specific exercises to help get the joint moving. With gentle exercise and completing the entire antibiotic regimen as prescribed, most people fully recover without long-term damage. However, certain cases may show aggravated symptoms or delayed recovery.
If the pain persists following the treatment mentioned above, the following may be done;
- Resting from time to time prevents overuse or abuse of the affected joint.
- Raising the joint above the heart level if possible for reduction of swelling and pain.
- Application of ice packs to the joint for around 20 minutes to reduce swelling and pain.
- Daily strengthening and stretching exercises as prescribed by a physical therapist to increase the joint’s flexibility, restore functionality and reduce any pain.
Conclusion:
Septic arthritis is an infection of the joint, synovial fluid, and joint tissues. Children are more commonly affected than adults, where the condition usually reaches the joints through the bloodstream. In some cases, joints become infected due to an injection, surgery, or injury. Infectious arthritis is not contagious, although the name may be misleading. It can, however, be quite severe. Studies show that illness from septic arthritis occurs in at least one-third of people affected by the condition, with approximately 7 to 15 % of people hospitalized succumbing to it. The disease primarily impacts the elderly and young children, and people with impaired immune systems, such as those with diabetes.
