Infectious Arthritis & Bursitis

Etiologies & Diagnosis of Infectious Arthritis

Etiologies (Curr Rheumatol Rep 2013;15:332)

  • Bacterial (nongonococcal): early diagnosis and treatment essential
  • Gonococcal (N. gonorrhea): consider in sexually active young adults
  • Viral: parvovirus, HCV, HBV, acute HIV, Chikungunya; mainly polyarticular, may mimic RA
  • Mycobacterial: monoarticular or axial (Pott’s disease)
  • Fungal: Candida (esp. prosthetic joints), coccidiomycosis (valley fever), histoplasmosis
  • Other: Lyme, Mycoplasma, Salmonella (2° to anti-TNF Rx), Brucellosis, T. whipplei

Diagnosis (JAMA 2007;297:1478)

  • H&P w/ poor sensitivity and specificity for septic arthritis
  • Arthrocentesis in acute onset inflammatory monoarthritis to r/o septic ; if possible obtain fluid sample prior to starting antibiotics