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Infection and arthritis 

Infection and arthritis
Infection and arthritis

Graham Raftery

, and Muddassir Shaikh

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date: 05 March 2021

Septic arthritis (or infective arthritis) is the most serious cause of one or more hot swollen joints. A causative organism can be identified in about 80% of cases, with Staphylococcus aureus the most common, followed by Streptococcus and gram-negative organisms. The key diagnostic investigation is microscopy and culture of aspirated joint fluid. Management is with drainage of bacteria, pus, and debris from the joint, along with antibiotics. Consensus is that these should be given intravenously for up to two weeks, or until clinical signs improve, followed by oral antibiotics for four weeks. Prosthetic joint infection is a particular challenge requiring specialist care. Arthralgia and/or arthritis are common occurrences with many viral infections, particularly parvovirus, hepatitis B and C, rubella, HIV, alpha (including chikungunya) and dengue viruses. Joint manifestations are usually sudden in onset, correlate with the onset of clinical illness, and generally self-limiting, but can persist following infection.

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