Septic arthritis in the elderly: about 21 cases

BACKGROUND: Septic arthritis (SA) is a serious disease especially if occurring in elderly debilitated by frequent comorbidities and diminished immunity. AIM: The authors discuss diagnosis difficulties, prognosis and, therapeutic consequences of the occurrence of septic arthritis in elders. METHODS: It is a retrospective study about 21 cases of septic arthritis (SA) occurring in the elderly aged 65-year-old or more, hospitalized over a ten year period [1994-2005] at the department of Rheumatology of Charles Nicolle's Hospital of Tunis. RESULTS: Mean age was 70.8 years [65y-83y] with a sex-ratio of 1.1. A history of rheumatologic and/or systemic diseases was present in 62% of cases. Clinic presentation was atypical explaining the long mean diagnosis delay; 23 days for pyogenic SA, 9.3 months for tuberculous arthritis. The germ involved, isolated in 11 cases, was a Staphylococcus Aureus in most ones. Tuberculous arthritis represented 28.6% of cases. The outcome was favourable in 19 cases (90%) after antibiotherapy. CONCLUSION: Because of its seriousness, SA should be evocated in front of any articular inflammation occurring in elderly. Adequate management must be started as soon as possible.