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Titolo:
Pyogenic arthritis in adults
Autore:
Dubost, JJ; Soubrier, M; Sauvezie, B;
Indirizzi:
Gabriel Montpied Hosp, Dept Rheumatol, Clin Immuno Unit, F-63003 Clermont Ferrand, France Gabriel Montpied Hosp Clermont Ferrand France F-63003 nt Ferrand, France
Titolo Testata:
JOINT BONE SPINE
fascicolo: 1, volume: 67, anno: 2000,
pagine: 11 - 21
SICI:
1297-319X(200001)67:1<11:PAIA>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
COMPLICATING RHEUMATOID-ARTHRITIS; STAPHYLOCOCCUS-AUREUS SEPTICEMIA; SUPPURATIVE BACTERIAL ARTHRITIS; GONOCOCCAL INFECTIOUS ARTHRITIS; NITRIC-OXIDE SYNTHASE; NECROSIS-FACTOR-ALPHA; SYNOVIAL-FLUID; NEEDLE ASPIRATION; SURGICAL DRAINAGE; JOINT INFECTIONS;
Keywords:
joint infection; septic arthritis;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
104
Recensione:
Indirizzi per estratti:
Indirizzo: Dubost, JJ Gabriel Montpied Hosp, Dept Rheumatol, Clin Immuno Unit, F-63003 Clermont Ferrand, France Gabriel Montpied Hosp Clermont Ferrand France F-63003 France
Citazione:
J.J. Dubost et al., "Pyogenic arthritis in adults", JOINT BONE, 67(1), 2000, pp. 11-21

Abstract

Septic arthritis has shown no change in incidence, and despite advances inantimicrobial therapy is often responsible for residual functional impairment and for a high mortality rate among debilitated patients. Risk factors include older age, diabetes mellitus, rheumatoid arthritis, immunodeficiency, and a preexisting joint disease (e.g., rheumatoid arthritis) to which the symptoms of septic arthritis are sometimes ascribed. Staphylococcus aureus contributes over two-thirds of identified organisms; a range of streptococci and gram-negative bacilli are next in frequency. The most common site is the knee, followed by the hip and shoulder. Over 10% of patients have polyarticular involvement reflecting bacteremia and diminished resistance to infection; (over 50% of polyarticular forms occur in rheumatoid arthritis patients). Prosthetic joint infection is becoming increasingly common; chronic forms due to intraoperative contamination and resulting in septic loosening should be distinguished from acute hematogenous infection in which emergency treatment can allow to salvage the prosthesis. Demonstration of the organism in the joint is the key to the diagnosis. Joint aspiration should beperformed on an emergency basis, if needed after identification of radiographic landmarks or under ultrasonographic guidance. Seeding the fluid on blood culture flasks immediately after aspiration increases the yield. Antibiotics should be started as soon as the microbiological specimens have been collected. When aspiration is difficult (hip) or inadequate, arthroscopic drainage usually makes arthrotomy unnecessary. Early antiinflammatory therapy (nonsteroidal antiinflammatory drugs, systemic or local glucocorticoids, anticytokines, and antiinflammatory cytokines) are being considered as tools for limiting joint damage; their efficacy and safety will first have to be established in animal studies. (C) 2000 Editions scientifiques et medicales Elsevier SAS.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 07:53:21