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PubMed · 8310090

Infectious arthritis.

Abstract

Infectious arthritis should be suspected in any patient with a swollen joint but especially in children, debilitated patients, immunocompromised persons, those with infection elsewhere (even if on antibiotics), and those with other types of arthritis or a prosthetic joint. Diagnosis depends on obtaining joint fluid for culture and Gram stain. Initial appropriate broad spectrum antibiotics are best narrowed to suit the individual organism, which 2 to 6 weeks of therapy can eradicate. Repeated needle aspiration or surgical drainage is usually helpful in lessening joint damage and achieving a more rapid resolution of symptoms.

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BibTeXRIS

D B Middleton. 1993. Infectious arthritis.. https://pubmed.ncbi.nlm.nih.gov/8310090/

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A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted.

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