Non-Tuberculous Septic Arthritis: A Study Of 51 Cases

Background Septic arthritis may cause damage and inflammation in short period of time and may also be a serious cause of mortality. Only early diagnosis and treatment can allow good prognosis. Objectives Our objective is to describe the cases of non tuberculosis septic arthritis, which were reported and confirmed in our hospital. Methods This a retrospective study which included medical records of patients treated for non tuberculosis septic arthritis during the ten past years [2002-2012]. Epidemiologic, clinical, biologic and therapeutic data were recorded and analysed. Results Fifty one cases of non tuberculosis septic arthritis were treated during the ten past years. The mean age was 52,8 years (range 22 to 90 years) with a female to male ration 1.1. The predisposing conditions were present in 50% of cases: diabetes mellitus (8 cases), renal failure (8 cases), rheumatoid arthritis (2 cases), psoriatic arthritis (1 case), osteoarthritis (3 cases) and hepatic cirrhosis (2 cases), high-dose corticosteroid intake (1 case) and arthroscopy (1 case). The median duration from the onset of symptoms to the diagnosis of septic arthritis was 20 days (1 range to 75days). Fever was observed in 97% of cases an average value of 38,3(37,9-40,5). Anorexia and weight loss were present in 7 cases. Mono-arthritis were noted in 43 cases (84%), localized in knees (24 cases), hips (6 cases), elbow (5 cases), Shoulders (3 cases), ankles (2 cases), sternocostal joint (1 case), manubriosternal joint (1 case) and sternoclavicular joint (1 case). Oligo-arthritis were noted in 4 cases and polyarthritis in 6 cases. Biological inflammatory tests were rised in all cases. Hyperleucocytosis was noted in 43% of cases and leucopenia in 3 cases. Radiographies schowed soft tissueabnormalities (8 cases), joint narrowing (17 cases) and joint destructions (7 cases). The germ has been identified in 52% (26 cases) of the cases and recovered in the joint in 17.6% of cases. Staphylococcus was the most common (10 cases) . The other germs were: Streptococcus (4 cases), Pseudomonas (2 cases), Gonococcus (1 case), E.Coli (6 cases), Proteus mirabilis (2 cases) and a combination of two microorganisms in one case. The treatment associated parental use of two antibiotics for 6 weeks except for for gonococcal arthritis. Joint washing was indicated in all cases. Surgical treatment was performed in 5 cases. We noted a good outcome in most cases with only a flessum in 4 cases. Nevertheless, 3 patients with diabetes died. Conclusions Septic arthritis should be evocated in front of any arthritis, especially if it is acute, with fever and in presence of predisposing factors. The predominant germ is the staphylococcus and the treatment must be urgent to avoid complications. Disclosure of Interest None Declared