Clinical and laboratory characteristics in septic arthritis patients with and without isolated germs

Background

The management of septic arthritis without bacteriological evidence is not well codified.

Aim of the work

To compare the features of septic arthritis with and without isolated germs.

Patients and Methods

This is a retrospective study including all patients with septic arthritis, discharged from the Rheumatology Department of Charles Nicolle Hospital, Tunisia over a period of 17?years 1998–2014]. The epidemiological and clinical data were evaluated. Patients were grouped according to the presence and absence of isolated germs.

Results

Fifty-nine septic arthritis patients were collected with an average of 3.5?cases/year. The mean age of the patients was 54.6?±?19?years 15–95] without sex predominance: 28 were male and 31 were female. At least one risk factor for SA was founded in 41 patients (69.5%). It was monoarticular in 50 cases (84.7%), oligoarticular in 6 (10.2%) and polyarticular in 3 (5.1%). The knee was the most often affected (49.2%). Germ was isolated in cultures and/or synovial fluids in 27 patients (45.8%). The age tended to be older in those with isolated germs and the elderly were more frequently infected compared to the non-elderly (51.8% versus 21.9%) (p?=?.01). The synovial fluid analysis, clinical and laboratory characteristics were comparable but the functional disability was significant higher in those without isolated germs (p?=?.024). Sternoclavicular joint was more common in patients with isolated germs (p?=?.016). There was no difference between the two groups regarding the course of the infection.

Conclusion

Patients with isolated and non-isolated germs have similar epidemiologic, clinical, biological and radiological characteristics.