Infectious Arthritis and Bursitis

Infectious Arthritis and Bursitis is a topic covered in the Washington Manual of Medical Therapeutics.

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General Principles

  • Infectious arthritis is commonly bacterial, although mycobacterial and fungal arthritis can be seen, especially in immunocompromised host. Bacterial septic arthritis is generally categorized into gonococcal and nongonococcal disease.
  • Nongonococcal infectious arthritis in adults tends to occur in patients with previous joint damage or compromised host defenses. It is caused most often by Staphylococcus aureus (60%) and Streptococcus spp. Gram-negative organisms are less common and typically seen with IV drug abuse, neutropenia, concomitant urinary tract infection, or postoperative status. Septic arthritis is common when the underlying joint is affected by rheumatoid arthritis or in the setting of a joint prosthesis.
  • Gonococcal arthritis causes one-half of all septic arthritis in otherwise healthy, sexually active young adults.

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