A painful, red,
warm, swollen, and stiff joint. (In some cases, multiple joints
(possibly as high as 104°F) and chills.
rash (with Lyme arthritis, as well as gonorrheal,
syphilitic, and some varieties of viral
When To Call Your Doctor
a doctor immediately if you develop symptoms of infectious arthritis.
Prompt treatment may help prevent permanent damage to the joint.
your doctor immediately if you have rheumatoid arthritis or
gout and you develop arthritic symptoms that do not respond to
medication prescribed for flare-ups.
What Is It?
Infectious arthritis is joint inflammation due
to infection by one of a number of microorganisms. The infectious
organism may enter the joint directly from a wound, or the infection
may spread from a nearby site (such as a boil), but most often
it travels to the joint via the bloodstream from an infection
elsewhere in the body. The knee and other weight-bearing joints
are the ones most commonly affected.
Infectious arthritis is not a permanent condition
and does not lead to other forms of joint inflammation, such
as osteoarthritis or rheumatoid arthritis. However, if left untreated,
it may cause lasting stiffness and limitation of movement in
the affected joint or joints.
What Causes It?
infection in another part of the body may invade a joint (usually
only one) and result in infectious arthritis, typically accompanied
by severe joint pain and swelling, fever, and a general feeling
of illness. Staphylococcus, the strain of bacteria that causes
skin infections (boils), is the most common underlying cause,
but various other strains may produce infectious arthritis too,
including those that cause strep throat, gonorrhea, and tuberculosis.
Most cases of bacterial arthritis tend to be acute but relatively
short-lived, except for those associated with tuberculosis, which
tend to be more mild and progress gradually over a period of
bacterial arthritis affects people who do not have a previously
damaged joint or bloodstream infection. The gonococcal organism
is the most common cause of infectious arthritis among sexually
active young women and men. It is rare after age 45. Unlike the
other types of bacterial arthritis, it may affect several joints
at once, especially those in the hands and wrists.
bacterial arthritis affects patients with specific risk factorsincluding
abnormal joint anatomy (such as in rheumatoid arthritis), previous
joint trauma or surgery, advanced age, diabetes, corticosteroid
or other immunosuppressive use, and endocarditis (infection of
the inner lining of the heart).
including the viruses that cause hepatitis B, rubella, mumps,
infectious mononucleosis, and herpes, may cause infectious arthritis.
In some cases, the rubella vaccine may be a cause as well. Viral
arthritis often affects multiple joints but generally leaves
no permanent damage.
may cause infectious arthritis; it typically progresses more
slowly and is milder than bacterial arthritis.
transmitted by a tick bite, may cause recurrent bouts of infectious
arthritis (Lyme arthritis) despite initial treatment.
cause infectious arthritis, although this is now quite rare.
treatment for infections elsewhere in the body.
and physical examination.
from the swollen joint. Fluid may be withdrawn with a needle
and syringe (arthrocentesis). Surgery (arthrotomy) may be required
to obtain fluid from some joints (such as the hip) and to treat
prosthetic joint infections.
(computed tomography) scans, or MRI (magnetic resonance imaging).
How To Treat It
are prescribed to treat bacterial infections and Lyme arthritis.
These drugs should be taken for the full term prescribedwhich
may be as long as six weeks or more in severe caseseven
if symptoms subside before that time. Failure to do so can permit
the strongest, most virulent strains of the underlying organism
to survive and multiply, which may result in an even more severe
rebound infection that is harder to treat. For acute bacterial
infections, antibiotics are often initially delivered in very
high doses by intravenous injection.
other nonsteroidal anti-inflammatory drugs (NSAIDs) may be administered
to reduce pain and inflammation in viral infections.
painkillers, such as narcotics, may be prescribed in severe cases.
B, an antifungal drug, may be used for fungal infections.
to work, the infected joint must be drainedas often as
necessary to control swelling (sometimes as often as several
times a day).
may be required for fluid drainage of some joints, such as the
hip or shoulder.
a prosthetic joint usually requires removal of the prosthesis.
A new joint can be implanted after intensive treatment cures
of the joint is necessary during the healing process. This may
require bed rest in addition to a cast or splint.
may be necessary after the infection has subsided, to regain
mobility and strength in the affected joint.
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