A prospective 2-year study of 75 patients with adult-onset septic arthritis.
OBJECTIVE
To assess the clinical features of septic arthritis and characterize therapeutic strategies and outcome in a prospective study of 75 patients selected by positive synovial fluid culture.


RESULTS
Underlying joint disease was present in 46 patients, 25 of whom had rheumatoid arthritis and 15 osteoarthritis. Eleven patients were i.v. drug abusers. Fifty-six per cent of cases involved the knee, 15% involved two or more joints, and staphylococci and streptococci were cultured in >90%. Seventy-eight per cent of patients lived in areas of high social deprivation. Fever was present in 64% and the white cell count (WCC) was normal in 38%. The C-reactive protein was elevated in 98%. Leg ulcers were present in 11% of all patients but in 38% of patients who died (P<0.006). Median duration of antibiotic therapy was 15 days i.v. with subsequent oral treatment for 21 days. Thirty-seven per cent of cases required surgical intervention. Mortality was 11%. A raised WCC at presentation (P<0.02) and the development of abnormal renal function (P<0.015) were predictors of poor prognosis.
Gupta
M N
MN
Centre for Rheumatic Diseases, University Department of Medicine, Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK.
Sturrock
R D
RD
Field
M
M
D017668:Age of Onset; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001170:Arthritis, Infectious / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery; D001424:Bacterial Infections / Q000188:drug therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012923:Social Class; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents