septic arthritiscon
DESCRIPTION
SEPTIC ARTHRITISTRANSCRIPT
SEPTIC ARTHRIRIS (HIP)
INTRODUCTION:
Septic arthritis, also known as infectious arthritis, may represent a
direct invasion of joint space by various microorganisms, most commonly
caused by a variety of bacteria .However, viruses, mycobacteria, and fungi have
been implicated. Reactive arthritis is a sterile inflammatory process that usually
results from an extra-articular infectious process.
Bacteria are the most significant pathogens because of their rapidly
destructive nature. For this reason, the current discussion concentrates on the
bacterial septic arthritides. Failure to recognize and to appropriately treat septic
arthritis results in significant rates of morbidity and may even lead to death.
ETIOLOGY
Staphylococcus aureus infection is the cause of the vast majority of
cases of acute bacterial arthritis in adults and in children This pathogen is the
cause in 80% of infected joints affected by rheumatoid arthritis.
Streptococcal species, such as Streptococcus viridans, S pneumoniae,
and group B streptococci, account for 20% of cases. Aerobic gram-negative rods
are involved in 20-25% of cases Infection of the sternoclavicular and sacroiliac
joints with Pseudomonas aeruginosa or Serratia
PATHOPHYSIOLOGY
Route of Transmission:
1. Hematogenous
• Most common
• Bacteremia associated with URTI, Skin or GIT infections. Or
invasive procedures.
2. Direct Inoculation
• Joint contamination by foreign object
3. Contiguous spread
• Osteomyelitis due to several factors in infants
Bacteria deposits in synovium producing inflamation
↓
Spreads to synovial fluid and multiplies
↓
Products of inflamation destroys joint components
(Swollen, painful joint)
↓
SEPTIC ARTHRITIS
CLINICAL MANIFESTATION
Infants
• More septicaemia
• Rather than joint pain
• Baby is irritable & refuses to feed
• Tachycardia with fever
• Joints are inflamed
• Pseudoparalysis
• Check umbilical cord and IV site for infection
Children
• Acute pain in single large joint(esp hip)
• Pseudoparesis
• Child is ill, rapid pulse and swinging fever
• Overlying skin looks red & superficial joint swelling may be obvious
• Local warmth and marked tenderness
• All movements are restricted by pain or spasm.
• Look for source of infection
.
DIAGNOSTIC METHOD
1 Obtain at least 2 sets of blood cultures to rule out a bacteremic origin of
the septic.
2. Plain radiography is of limited value in evaluating a joint for infection
3. soft-tissue swelling is the most common finding.
4.the x-ray
MANAGEMENT
I MEDICAL MANAGEMENT
a) SURGICAL TEATMENT
Arthrotomy-Surgical opening and depritment
b) ANTIBIOTIC PROPHYLAXIS - with an antistaphylococcal antibiotic has
been demonstrated to reduce wound infections in joint replacement
surgery.
II.NURSING MANAGEMENT