Bacterial Culture And Sensitivity Testing
Bacterial culture and sensitivity testing are the key aspects of the septic arthritis diagnosis and treatment.
As diagnostic examination procedures, the bacterial culture and sensitivity testing will help the veterinarian confirm the presence of infectious bacteria and determine the exact bacteria type. Knowing the exact bacteria type responsible for the joint infection is vital for determining the right antibiotics.
Bacterial culture and sensitivity testing should be performed in every dog whose clinical signs and symptoms include lameness, joint pain, and fever.
Key Points About Septic Arthritis In A Child
- Different types of bacteria, viruses, and fungi can infect a joint.
- Symptoms include fever, joint pain, swelling, redness, and warmth.
- Quick treatment with antibiotics is needed to stop the risk of joint damage.
- Other treatments include medicines for pain and fever, draining the joint, physical therapy, and splints.
When Should I See My Healthcare Provider
If youre experiencing symptoms of septic arthritis, such as pain, fever, extreme warmth, redness or tenderness in your joint and having limited mobility in your joint, contact your healthcare provider or go to the nearest hospital immediately. Septic arthritis is a serious condition that needs to be treated with antibiotics. If left untreated, it can be life-threatening.
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What’s The Treatment For Septic Arthritis
Septic arthritis treatments include using a combination of powerful antibiotics as well as draining the infected synovial fluid from the joint. It’s likely that antibiotics will be administered immediately to avoid the spread of the infection. Intravenous antibiotics are given, usually requiring admission to the hospital for initial treatment. The treatment, however, may be continued on an outpatient basis at home with the assistance of a home health nursing service.
Initially, empiric antibiotics are chosen to cover a wide range of infections. If the bacteria can be identified, antibiotics specific to that organism are used. It may take four to six weeks of treatment with antibiotics to ensure complete eradication of the infectious agents.
Draining The Infected Joint With A Needle
Fluid can be drained using a needle during an arthrocentesis, which is less invasive than surgical options. The synovial fluid is usually clear but may be yellowish or cloudy due to the bacterial infection present. A sample of fluid is examined to determine what type or types of bacteria are causing the infection.
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What Are The Symptoms Of Septic Arthritis In A Child
The most common joints affected by septic arthritis are the knee, hip, shoulder, elbow, and wrist. Most often, only one joint is affected. Symptoms may vary in each child. Common symptoms include:
- Redness in the affected area
- Warmth around the infected area
- Limited use of the affected limb, such as not wanting to walk
- Guarding or protecting the affected area to keep it from being touched or seen
- Other symptoms of illness, such as vomiting, sore throat, or headache
- Loss of appetite
These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
Who Is At Risk Of Septic Arthritis
Anyone can get septic arthritis but some people are more at risk. This includes people:
- with rheumatoid arthritis
- with a weakened immune system
- who have recently had joint surgery
- who have an artificial joint, such as a knee or hip replacement
- who inject drugs like heroin
- with gonorrhoea, which is a sexually transmitted infection
Page last reviewed: 07 January 2020 Next review due: 07 January 2023
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Everything You Need To Know About Septic Arthritis In Dogs
By Katelyn Son | Updated November 10, 2022
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The presence of infective agent makes the importance of early diagnosis and prompt treatment of imperative importance.
However, because of the non-specific clinical signs of septic arthritis, it can be hard for dog owners to react in a timely manner.
To stay on the safe side, dog owners should seek veterinary attention as soon as they notice lameness, joint swelling, and decreased playfulness as these are the red flags for joint infections.
Treatment Of Septic Arthritis In Dogs
Treatment of septic arthritis often involves aggressive therapy with antibiotics. If your dog is systemically ill and very sick when diagnosed, they may need to be hospitalized until they are stable. Sometimes these patients require lavage, or flushing with sterile saline, of the affected joints.
Often, patients with septic arthritis will be placed on oral antibiotics for a lengthy time. Follow-up visits to recheck the joints are recommended. Your veterinarian may need to repeat some of the previous diagnostics to ensure that the infection is resolving and that your dog is on the right track to recovery.
Monitor your pet closely while theyre undergoing treatment at home for septic arthritis. Note any changes in their comfort, gait, and appetite. Sometimes antibiotics can lead to gastrointestinal upset, so closely monitor your dogs appetite and stools while on medication.
Follow the instructions on the label and do not discontinue an antibiotic prematurely unless instructed to do so by your veterinarian. Be sure to inform your veterinarian about any changes you notice in your dogs response to treatment. Consider talking to your veterinarian about adding a probiotic while on antibiotics to keep a healthy gastrointestinal biome.
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How To Diagnose Septic Arthritis
This article was co-authored by Siddharth Tambar, MD. Dr. Siddharth Tambar, MD is a board certified rheumatologist at Chicago Arthritis and Regenerative Medicine in Chicago, Illinois. With over 19 years of experience, Dr. Tambar specializes in Regenerative Medicine and Rheumatology, with a focus on platelet rich plasma and bone marrow derived stem cell treatments for arthritis, tendinitis, injuries, and back pain. Dr. Tambar holds a BA in Economics from State University of New York at Buffalo. He earned his MD from State University of New York at Syracuse. He completed his Internship, Residency in Internal Medicine, and his Rheumatology Fellowship at Northwestern Memorial Hospital. Dr Tambar is board certified in both rheumatology and internal medicine. He also holds Musculoskeletal Ultrasound Diagnostic and Interventional certifications from the American College of Rheumatology and the American Institute of Ultrasound in Medicine.There are 10 references cited in this article, which can be found at the bottom of the page. This article has been viewed 28,205 times.
Symptoms Of Septic Arthritis
- Joint swelling due to joint effusion and inflammation
- Severe lethargy
- Lack of appetite
Not all signs of septic arthritis need to be present. Some dogs may show only lameness and decreased range of motion, while others can show more severe clinical signs of septic arthritis like fever and depression.
In all septic arthritis cases, the clinical signs and symptoms are non-specific thus making the diagnosis challenging.
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Challenges In Diagnosing Septic Arthritis
Because septic arthritis can quickly lead to permanent cartilage damage and even death, rapid and appropriate therapy is essential. However, diagnosing septic arthritis isnt necessarily straightforward because the symptoms are similar to those of other joint diseases like rheumatoid arthritis, osteoarthritis, and gout.3
In order to test for the presence of pathogens, a sample of joint fluid is extracted with a needle in a procedure called arthrocentesis. This fluid, called synovial fluid, acts as a lubricant within a joint. A lab will try to culture pathogens from the sample to help pinpoint what is causing the infection. This usually takes 4872 hours, but sometimes even longer depending on the pathogen.
Because it can take so long to get culture resultsand joint damage can occur rapidlyclinicians generally prescribe broad-spectrum antibiotics while awaiting lab results. Unfortunately, overuse of antibiotics exacerbates the problem of antimicrobial resistance and may cause unpleasant side effects for patients.
How Is Septic Arthritis Treated In A Child
Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is.
Pus may be drained from the joint. Pus buildup can damage the joint. The pus is drained with a needle, tube, or surgery. Other treatment may include:
- Medicines for pain and fever
- Physical therapy to keep muscle strength
- A splint on the joint to ease pain
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How Is Septic Arthritis Diagnosed In A Child
Early diagnosis of septic arthritis is important. This is to prevent long-term damage to the joint. Your childs healthcare provider will take your childs health history and give him or her a physical exam. Tests may also be done, such as:
- Removal of joint fluid. This is done to check for white blood cells and bacteria.
- Blood tests. These are done to look for bacteria.
- Phlegm, spinal fluid, and urine tests. These are done to look for bacteria and find the source of infection.
- X-ray. This test uses a small amount of radiation to make images of internal tissues, bones, and organs.
- Bone scan. This imaging test uses a tiny amount of a radioactive substance to look for arthritis changes in the joints.
- MRI. This test uses large magnets and a computer to make detailed images of organs and other tissues.
- Radionuclide scans. These scans use a tiny amount of a radioactive substance to look at organs and the blood flow to them.
Infectious Arthritis Vs Reactive Arthritis
A person may mistake infectious arthritis for reactive arthritis. The two can cause similar symptoms. However, infectious arthritis results from an active infection in the joint, while reactive arthritis usually results from a recent infection elsewhere in the body.
Some people may develop reactive arthritis following a sexually transmitted infection or an infection of the gastrointestinal tract from food poisoning.
Reactive arthritis does not typically result from an infection spreading into a joint. Instead, it occurs when the immune system overreacts to the initial infection, triggering joint inflammation.
cause, although viral and fungal infections can also be responsible.
A person with infectious arthritis may experience sudden swelling, severe pain, dizziness, and fatigue.
Early and aggressive treatment, including IV antibiotics, can significantly improve a persons septic arthritis outlook. If treatment begins in time, a person may make a full recovery without any lasting damage.
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Changing The Game With The Syndromic Approach
Newly granted an FDA De Novo authorization, the BIOFIRE® Joint Infection Panel takes a syndromic testing approach to joint infection diagnostics. Instead of lengthy and laboriousand often inconclusivesend-out serial testing, the BioFire JI Panel identifies 39 clinically relevant targets, including 31 causative pathogens and 8 antimicrobial resistance markers. The test requires only 0.2 mL of synovial fluid and returns results in about an hour.
The BioFire JI Panel uses multiplex PCR technology to identify pathogens and antimicrobial resistance genes at the molecular level. The BioFire JI Panel can detect difficult-to-grow anaerobes and fastidious pathogens. Compared to traditional testing, it may help facilitate increased diagnostic yield and improved polymicrobial detection.7
Fast, accurate, and comprehensive testing with the BioFire JI Panel may offer several benefits. For example, it may help determine whether the joint is infected and may help reduce time to effective therapy by identifying pathogens faster.
Tests To Find Which Germ Is Causing The Infection
The blood often contains some bacteria from the infected joint. Samples of blood are sent to the laboratory to identify which type of bacterium is causing the infection. This is important, as it will help to decide which is the best treatment. Also, if septic arthritis is suspected, a sample of fluid from the joint is taken by a fine needle. Tests on the fluid can usually confirm the diagnosis and identify the bacterium which is causing the infection.
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Holistic Ways To Help Your Dog Through Treatment
The acute signs of septic arthritis warrant immediate veterinary attention and aggressive management involving antibiotics and surgical management.
However, there are ways you can help your dog through septic arthritis treatment. When it comes to holistic management of arthritis , there are two main considerations for your dog.
Dog CBD Oil
The use of CBD oil in the veterinary medicine is new but showing promising results. CBD oil is a natural, herbal supplements that can help dogs with septic arthritis during treatment and recovery.
CBD oil promotes healthy bones, joints and supports flexibility and full range of motion while easing the joint stiffness and occasional discomfort due to daily exercise and activity.
You can give your dog CBD oil in its food or use CBD infused chewable treats. It should be noted that before adding anything new to your dogs therapy plan you need to consult with your trusted vet.
Physical therapy is a particularly helpful yet frequently neglected way of managing a dog after septic arthritis treatment.
Physical therapy is important to maintain proper joint mobility since regular physical activity will be limited for at least few weeks after treatment.
There are different physical therapy options. However, dogs with septic arthritis benefit most from passive range of motion exercises.
Causes Of Septic Arthritis
The bacteria and other infectious agents can find their way into the synovial fluid via several routes:
- Penetrating trauma associated with the joint
- Joint or bone surgery
- Intraarticular injections
- Hematogenous spread .
According to a review study from 1999, Bacterial septic arthritis in 19 dogs, published in the Aust. Veterinary J. only five of the 19 dogs developed septic arthritis due to a hematogenous spread, while the other 14 dogs aftersurgical procedures associated with the stifle joint.
Another article study from 2003, Septic Arthritis in Dogs: A Retrospective Study of 20 Cases , published in Acta Vet. Brno revealed that hematogenous spread of bacteria resulted in infected joints in 13 cases and only seven cases were due to joint surgery and joint trauma.
From the two review articles, we can assume that both infection routes are common reasons for septic arthritis.
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Is The Infected Fluid Drained
Drainage of the infected area is critical for rapid clearing of the infection. Drainage is performed by removing the fluid with a needle and syringe. Often the draining occurs daily or with multiple surgical procedures. The exact method depends on the location of the joint.
Using arthroscopy, your doctor can irrigate the joint and remove the infected tissue. If drainage cannot be accomplished with joint aspirations or arthroscopy, open joint surgery is often necessary to drain the joint. If the fluid buildup is significant, the drains are left in place to remove excess fluid that may build up after the surgery.
Urgent Advice: Ask For An Urgent Gp Appointment Or Get Help From Nhs 111 If:
- you have severe joint pain, usually in just 1 joint, that started suddenly
- you have swelling around a joint
- the skin around a joint has changed colour
- you feel generally unwell and have a high temperature or feel hot and shivery
Symptoms of septic arthritis usually develop quickly over a few days and need to be checked.
You can call 111 or get help from 111 online.
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Tests To Confirm The Diagnosis Of Septic Arthritis
If you have typical symptoms coming from a joint near to the skin surface then the diagnosis may be fairly clear. However, pain coming from deeper joints such as the hip may be due to a number of causes. Certain blood tests can help to confirm that you have severe inflammation ‘somewhere’ in the body, which may be septic arthritis.
A plain X-ray is not so useful to diagnose the early stages of septic arthritis. However, it may be a useful test to rule out other causes of joint pain. An ultrasound scan, CT scan or MRI scan of the joint may help to confirm the diagnosis.
Amps And Septic Arthritis
Although the research targeting use of AMPs against bacterial arthritis is scarce, we present few important findings. Varoga et al . reported enhanced expression of human -defensin-2 in synovial membranes that were exposed to bacteria mimicking a case of septic arthritis. The study showed that bacteria-colonized synovial membranes displayed comparatively higher levels of human -defensin-2 peptide than unexposed samples. This suggests the involvement of these cationic peptides in intra-articular defense mechanisms and their role in regulating the pathological course of septic arthritis.
Studies also highlighted the protective role of AMPs as part of innate system of the articular cartilage against infection and emphasized that purified or recombinant AMPs represent potential therapeutic agents that can be administered in septic arthritis to further boost the innate resistance system of the synovial tissue .
Table 1 New Developments related to AMP research against Bone and Joint Infections
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