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Mos common causative agent
S. aureus
Incidence of H. influenzae has decreased due to
the vaccine
Infection Sources
Trauma
Hematogenous
Osteomylitis
Soft tissue infections
Clinical Presentation:
“red, hot, painful joint”
IV drug users might contract
Pseudomonas
4 independent variables
Transient synovitits VS septic arthritis
Fever
non-weight bearing
ESR >40
WBC > 12,000
Kocher Criteria
DIFFERENTIAL DIAGNOSIS
Osteomyelitis
An acute haemarthrosis
Transient synovitis(irritable joint)
Gout and pseudogout
Rheumatic fever
If gram –positive organisms are identified ,
Flucloxacillin
If in doubt about causative bacteria, give
third generation cephalosporin
Children less than 4 yr( if suspicion of H.Infl) treated with
Ampicillin.
Indication of Surgical Drainage:
1-Joints that do not respond to antimicrobial therapy
2-. Any joint with limited accessibility, including the sternoclavicular or the hip joint
3-Patients with underlying disease, including diabetes, rheumatoid arthritis, immunosuppression, or other systemic symptoms, should be treated more aggressively with earlier surgical intervention