Septic Arthritis - Etiology

Etiology

Bacteria are carried by the bloodstream from an infectious focus elsewhere, introduced by a skin lesion that penetrates the joint, or by extension from adjacent tissue (e.g. bone or bursae bovine tb).

Micro-organisms must reach the synovial membrane of a joint. This can happen in any of the following ways:

  • dissemination of pathogens via the blood, from abscesses or wound infections, or from an unknown focus
  • dissemination from an acute osteomyelitic focus,
  • dissemination from adjacent soft tissue infection,
  • entry via penetrating trauma
  • entry via iatrogenic means.

Bacteria that are commonly found to cause septic arthritis are:

  • Staphylococcus aureus - the most common cause in adults
  • Streptococci - the second most common cause
  • Haemophilus influenzae - was the most common cause in children but is now uncommon in areas where Haemophilus vaccination is practiced
  • Neisseria gonorrhoea - in young adults (now thought rare in Western Europe)
  • Escherichia coli - in the elderly, IV drug users and the seriously ill
  • M. tuberculosis, Salmonella spp. and Brucella spp. - cause septic spinal arthritis

In bacterial infection, Pseudomonas aeruginosa has been found to infect joints, especially in children who have sustained a puncture wound. This bacterium also causes endocarditis.

Read more about this topic:  Septic Arthritis

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