Septic arthritis resident survival guide
Vertigo Resident Survival Guide |
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Overview |
Causes |
FIRE |
Diagnosis |
Treatment |
Do's |
Don'ts |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Iqra Qamar M.D.[2], Aditya Ganti M.B.B.S. [3]
Overview
Causes
FIRE
Diagnosis
Treatment
Empiric treatment should be commenced as soon as possible after culture samples have been obtained. The choice of empiric antibiotics should be determined on the basis of:[1][2][3]
If the patient fails to respond to initial treatment, consider:[1]
Intra-articular antibiotics are not useful as it may increase infection rate and also causes chemical synovitis and cartilage toxicity.[4] Methicillin-resistant Staphylococcus aureus (MRSA)Patient at high risk of methicillin-resistant Staphylococcus aureus (MRSA) include:[5][6] | |||||||||
Antimicrobial Regimen – Empiric Therapy:
Newborn (< 1 week) | Newborn (1–4 weeks) | Infants (1–3 months) | Children (3 months–14 years) | Adults |
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High Risk for MRSA
Low Risk for MRSA
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High Risk for MRSA
Low Risk for MRSA
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High Risk for MRSA
Low Risk for MRSA
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Preferred Regimen
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Monoarticular
Polyarticular
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Antimicrobial Regimen – Synovial Fluid Gram Stain-Based Therapy:
Gram stain result | First choice antibiotic | Second choice antibiotic |
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Negative Gram stain |
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and
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Gram-positive cocci |
|
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Gram-negative cocci |
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Gram-negative bacilli |
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Antimicrobial Regimen – Pathogen Based Therapy:
Duration of Antimicrobial Therapy:
Do's
Don'ts
References
- ↑ 1.0 1.1 Shirtliff ME, Mader JT (2002) Acute septic arthritis. Clin Microbiol Rev 15 (4):527-44. PMID: 12364368
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 978-1455748013.
- ↑ Mathews, Catherine J.; Weston, Vivienne C.; Jones, Adrian; Field, Max; Coakley, Gerald (2010-03-06). "Bacterial septic arthritis in adults". Lancet. 375 (9717): 846–855. doi:10.1016/S0140-6736(09)61595-6. ISSN 1474-547X. PMID 20206778.
- ↑ Stutz G, Kuster MS, Kleinstück F, Gächter A (2000) Arthroscopic management of septic arthritis: stages of infection and results. Knee Surg Sports Traumatol Arthrosc 8 (5):270-4. DOI:10.1007/s001670000129 PMID: 11061294
- ↑ Liu, Catherine; Bayer, Arnold; Cosgrove, Sara E.; Daum, Robert S.; Fridkin, Scott K.; Gorwitz, Rachel J.; Kaplan, Sheldon L.; Karchmer, Adolf W.; Levine, Donald P.; Murray, Barbara E.; J Rybak, Michael; Talan, David A.; Chambers, Henry F.; Infectious Diseases Society of America (2011-02-01). "Clinical practice guidelines by the infectious diseases society of america for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children". Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America. 52 (3): –18-55. doi:10.1093/cid/ciq146. ISSN 1537-6591. PMID 21208910.
- ↑ Sharff KA, Richards EP, Townes JM (2013) Clinical management of septic arthritis. Curr Rheumatol Rep 15 (6):332. DOI:10.1007/s11926-013-0332-4 PMID: 23591823