[Septic arthritis of the shoulder following intra-articular injection therapy. Lethal course due to delayed initiation of therapy].
Detection of a bacterial arthritis of the shoulder represents an absolute indication for intervention. Irrespective of the cause of the infection, the most decisive prognostic factors are early diagnosis and therapy. We report on two patients who suffered from generalized sepsis and resulting death after delayed treatment of iatrogenic joint infections of the shoulder caused by intra-articular injection therapy. Both patients suffering from septic shock syndrome had been transferred to our hospital for surgical and intensive care treatment. They died in spite of maximal intensive care and aggressive surgical treatment. On the basis of the cases presented, it can be concluded that an acute infection of the shoulder joint must be excluded early when painfully limited range of motion in combination with clinical and laboratory signs of inflammation become apparent. Successful therapy of joint infection also requires early surgical treatment, including resection of infected tissue. If surgical joint revision is not performed or is performed too late, there is the risk of irreversible damage to the afflicted joint, even septic spread endangering the patient's life.
Esenwein
S A
SA
Berufsgenossenschaftliche Kliniken Bergmannsheil - Universitätsklinik, Chirurgische Klinik mit Poliklinik, Germany. stefan.a.esenwein@ruhr-uni-bochum.de
Ambacher
T
T
Kollig
E
E
Kutscha-Lissberg
F
F
Hopf
F
F
Muhr
G
G
D000368:Aged; D000465:Algorithms; D001170:Arthritis, Infectious / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007270:Injections, Intra-Articular / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D012772:Shock, Septic / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D012785:Shoulder Joint; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D013290:Streptococcal Infections / Q000175:diagnosis / Q000209:etiology / Q000401:mortality; D013297:Streptococcus pyogenes