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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