![]() Sigmund IK, Holinka J, Sevelda F, et al.Concomitant septic arthritis in crystal monoarthritis. Serum procalcitonin levels as a diagnostic marker for septic arthritis. Risk of septic arthritis in patients with rheumatoid arthritis and the effect of anti-TNF therapy: results from the British Society for Rheumatology Biologics Register. Galloway JB, Hyrich KL, Mercer LK, et al.Clinical characteristics and outcomes in polyarticular septic arthritis. Acute monoarthritis: diagnosis in adults. Can C-reactive protein be used to predict acute septic arthritis in the adult population? South Med J. Thornton L, Ormsby N, Allgar V, et al.Sensitivity of erythrocyte sedimentation rate and C-reactive protein for the exclusion of septic arthritis in emergency department patients. Clinical practice guidelines by the Infectious Diseases Society of America for the treatment of methicillin-resistant Staphylococcus aureus infections in adults and children: executive summary. Clinical manifestations and bacteriological features of culture-proven Gram-negative bacterial arthritis. Pneumococcal septic arthritis: review of 190 cases. Ross JJ, Saltzman CL, Carling P, et al.A guide to utilization of the microbiology laboratory for diagnosis of infectious diseases. Miller JM, Binnicker MJ, Campbell S, et al.Clinical features and outcome of septic arthritis in a single UK Health District 1982–1991. Weston VC, Jones AC, Bradbury N, et al.Epidemiology, management, and outcomes of large and small native joint septic arthritis in adults. McBride S, Mowbray J, Caughey W, et al. ![]() Horowitz DL, Katzap E, Horowitz S, et al.Consideration for microorganisms such as Neisseria gonorrhoeae, Borrelia burgdorferi, and fungal infections should be based on history findings and laboratory results. Total duration of therapy ranges from two to six weeks however, certain infections require longer courses. Oral antibiotics can be given in most cases because they are not inferior to intravenous therapy. After synovial fluid has been obtained, empiric antibiotic therapy should be initiated if there is clinical concern for septic arthritis. ![]() Staphylococcus aureus is the most common pathogen isolated in septic arthritis however, other bacteria, viruses, fungi, and mycobacterium can cause the disease. History and Gram stain aid in determining initial antibiotic selection. Synovial fluid studies are required to confirm the diagnosis. Physical examination findings and serum markers, including erythrocyte sedimentation rate and C-reactive protein, are helpful in the diagnosis but are nonspecific. A delay in diagnosis and treatment can result in permanent morbidity and mortality. Risk factors for septic arthritis include age older than 80 years, diabetes mellitus, rheumatoid arthritis, recent joint surgery, hip or knee prosthesis, skin infection, and immunosuppressive medication use. There's more to see - the rest of this topic is available only to subscribers.Septic arthritis must be considered and promptly diagnosed in any patient presenting with acute atraumatic joint pain, swelling, and fever. A listing of these findings varies among facilities. Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse.
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