CD-ROM Today 1996 January/CD-ROM Today 1996 January.iso/dp/0349/03492.txt

Text File | 1994-01-17 | 8.0 KB | 185 lines

$Unique_ID{BRK03492}
$Pretitle{}
$Title{Arthritis, Infectious}
$Subject{Arthritis, Infectious Bacterial Arthritis Purulent Arthritis Pyogenic
Arthritis Suppurative Arthritis Septic Arthritis Pyarthrosis}
$Volume{}
$Log{}

Copyright (C) 1986, 1989, 1990 National Organization for Rare Disorders, Inc.

263:
Arthritis, Infectious

** IMPORTANT **
It is possible the main title of the article (Infectious Arthritis) is
not the name you expected.  Please check the SYNONYMS listing to find the
alternate names and disorder subdivisions covered by this article.

Synonyms

     Bacterial Arthritis
     Purulent Arthritis
     Pyogenic Arthritis
     Suppurative Arthritis
     Septic Arthritis
     Pyarthrosis

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.


Infectious Arthritis occurs as a result of infection of tissues of a
joint by bacteria, viruses or fungi.

Symptoms

The symptoms of Infectious Arthritis depend upon which agent has caused the
infection.  The symptoms may include fever (which may be quite high), chills,
general weakness and headaches, followed by inflammation of one or more
joints.  The affected joint or joints often become very painful, swollen,
slightly red and stiff within a few hours or days.  Rapid onset of symptoms
may indicate that a bacterium is the cause.  In a few people, however, the
infection develops slowly, over a period of months or even years.  This
slower type of infection is more often the result of a virus or fungus than a
bacteria.

Infectious Arthritis usually affects just one joint, but occasionally may
involve multiple joints.  The joints most often involved are the large ones:
the knees, ankles, shoulders, hips, elbows or wrists.  The disorder may occur
in other joints.  For people who already have some form of arthritis,
especially rheumatoid arthritis, the infection may seem like a flare-up of
their existing condition.

In Lyme disease (one form of infectious arthritis), joint inflammation
usually occurs several weeks after onset of other symptoms.  (For more
information on Lyme Disease, choose "Lyme" as your search term in the Rare
Disease Database.)

In general, the symptoms of Infectious Arthritis also include severe pain
near the end of an involved bone, after which the joint swells.  Pain is
accentuated with movement of the joint.

Causes

Any disease-causing microbe may infect a joint.  Bacteria are most often
responsible, typically producing an acute arthritis.  In young children the
most common bacteria are staphylococci, Hemophilus influenzae, and gram-
negative bacilli.  Older children and adults are most commonly infected with
gonococci, staphylococci, streptococci or pneumococci.  Acute Infectious
Arthritis at any age may be associated with rubella, mumps or hepatitis B
infections.  Chronic Infectious Arthritis may be caused by Mycobacterium
tuberculosis and other mycobacteria or fungi such as Sporothrix schenckii,
Coccidioides immitis and Histoplasma capsulatum.  The infection can be spread
through the blood (circulatory system).  Bacteria or fungi may infect a
person during surgery or through drug injections, or the infection may be
secondary to injury of a joint.  Patients with rheumatoid arthritis and
chronically inflamed joints are particularly susceptible to Infectious
Arthritis.

Affected Population

Infectious Arthritis can affect people of all ages and both sexes.

Related Disorders

Rheumatoid Arthritis is a chronic disease characterized by usually symmetric
inflammation of the peripheral joints, which can eventually result in
progressive destruction of joints.  Generalized symptoms may also be present.
(For more information on Rheumatoid Arthritis, see article in the Prevalent
Health Conditions/Concerns area of NORD Services.)

Reiter's syndrome is arthritis associated with nonbacterial urethritis
and conjunctivitis, usually seen in genetically susceptible males following
recent sexual exposure.  (For more information, choose "Reiter" as your
search term in the Rare Disease Database.)

Psoriatic Arthritis is a rheumatoid-like arthritis associated with
psoriasis of the skin or nails and a negative RA serology; HLA-B27 antigen is
present in most patients.  (For more information, choose "Psoriatic
Arthritis" as your search term in the Rare Disease Database.)

Ankylosing Spondylitis (Marie-Struempell disease) is a chronic progressive
form of arthritis distinguished by inflammation and eventual immobility
(ankylosis) of a number of joints, primarily involving the spine and
paraspinal structures.  (For more information, choose "Spondylitis" as your
search term in the Rare Disease Database.)

Osteoarthritis (OA; Degenerative Joint Disease; DJD) is the most common
form of arthritis, characterized by degenerative loss of joint cartilage,
bony sclerosis beneath the cartilage, and bone proliferation at the joint
margins.  Secondary synovial tissue inflammation is common.

Therapies:  Standard

It is important to treat Infectious Arthritis in a timely manner in order to
avoid spread of the infection and destruction of the joint.  Successful
treatment depends on early and appropriate use of antibiotics.  These may
have to be started before identification of the infecting bacteria has been
made.  However, examination and culture of the joint fluid should be started
before therapy.

Antibiotic therapy should be determined by the type of bacteria isolated
and its sensitivity studies.  When no organism is present and a gonococcal
infection is suspected, penicillin-G is commonly used for treatment.  Some
antibiotics are usually injected into the veins or the muscles, when
absorption of oral antibiotics may be inadequate.  Antibiotics injected into
the joint may cause synovitis and are should be avoided.  Treatment should be
continued for at least two weeks after all symptoms and signs of inflammation
have disappeared.

Fluid from the joint may be withdrawn to remove accumulated pus, and
cultured to confirm that the infection is gone.  If a decrease of symptoms
and sterilization of the joint fluid are not apparent after 48 hours of
treatment, the choice and dose of the antibiotic may need to be adjusted.
Surgical drainage may be indicated when needle aspiration of the joint is
difficult, as in hip infections, or if the infection is not controlled after
48 hours.  Splinting may be useful for pain relief during the acute stage.
Physical therapy is often useful in building up muscle strength preventing
stiffness or restoring mobility.

Antibiotic treatment for mycobacterial or fungal arthritis is usually the
same as for other serious infections by these agents.  Infectious Arthritis
caused by a virus is usually self-limited and commonly responds to
symptomatic therapy.

Therapies:  Investigational

This disease entry is based upon medical information available through July
1990.  Since NORD's resources are limited, it is not possible to keep every
entry in the Rare Disease Database completely current and accurate.  Please
check with the agencies listed in the Resources section for the most current
information about this disorder.

Resources

For more information on Infectious Arthritis, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     [phone]

     Arthritis Foundation
     1314 Spring Street, N.W.
     Atlanta, GA 30309
     [phone]

     The National Arthritis and Musculoskeletal and
     Skin Diseases Information Clearinghouse
     Box AMS
     Bethesda, MD  20892
     [phone]

References

Infectious Arthritis.  Schmid:  Arthritis Medical Information Series,
Arthritis Foundation (1983).