title: [Fatal soft tissue infections after arthroscopy of the knee joint. A diagnostic or therapeutic problem?].
abstract: After detection of a bacterial infection of the joint, an absolute indication for intervention is given. Systemic antibiotic drug therapy is indicated and drainage of the joint has to be performed immediately. The following therapeutic algorithm regimen is a proven remedy in treating pyoarthrosis of the knee joint: During the initial period, the infection can be controlled by arthroscopic irrigation and systemic antibiotic therapy. Depending on the progredient findings or if the symptoms persist, curing the joint by open synovectomy is the next step of treatment. If open joint revision including synovectomy is not performed or is performed too late, there will be a threat of irreversible damage of the afflicted joint up to septic spread endangering the patient's life. We report on two patients suffering from generalized sepsis resulting in death after delayed therapy for knee joint infection. Regarding the presented cases, it can be concluded that indication to early surgical joint debridement including open synovectomy of the knee is still rarely seen after development of pyoarthritis.
authors.affiliation: Chirurgische Klinik und Poliklinik, Berufsgenossenschaftliche Kliniken Bergmannsheil, Universitätsklinik der Ruhr-Universität Bochum. Stefan.A.Esenwein@ruhr-uni-bochum.de
authors.forename: S A
authors.initials: SA
authors.lastname: Esenwein
authors.forename: E
authors.initials: E
authors.lastname: Kollig
authors.forename: F
authors.initials: F
authors.lastname: Kutscha-Lissberg
authors.forename: T
authors.initials: T
authors.lastname: Klapperich
authors.forename: G
authors.initials: G
authors.lastname: Muhr
mesh_terms: D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D001182:Arthroscopy; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000175:diagnosis / Q000401:mortality; D012772:Shock, Septic / Q000175:diagnosis / Q000401:mortality; D018461:Soft Tissue Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000628:therapy; D000074402:Synovectomy
chemical_list: D000900:Anti-Bacterial Agents