Author(s): Gupta MN, Sturrock RD, Field M
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Abstract AIMS AND METHODS: To assess the clinical features of septic arthritis and characterize therapeutic strategies and outcome in a prospective study of 75 patients selected by positive synovial fluid culture. RESULTS: Underlying joint disease was present in 46 patients, 25 of whom had rheumatoid arthritis and 15 osteoarthritis. Eleven patients were i.v. drug abusers. Fifty-six per cent of cases involved the knee, 15\% involved two or more joints, and staphylococci and streptococci were cultured in >90\%. Seventy-eight per cent of patients lived in areas of high social deprivation. Fever was present in 64\% and the white cell count (WCC) was normal in 38\%. The C-reactive protein was elevated in 98\%. Leg ulcers were present in 11\% of all patients but in 38\% of patients who died (P<0.006). Median duration of antibiotic therapy was 15 days i.v. with subsequent oral treatment for 21 days. Thirty-seven per cent of cases required surgical intervention. Mortality was 11\%. A raised WCC at presentation (P<0.02) and the development of abnormal renal function (P<0.015) were predictors of poor prognosis.
This article was published in Rheumatology (Oxford)
and referenced in Journal of Arthritis