Arthritis, Infectious

Infectious arthritis (in-FEK-shus ar-THRY-tis) is a bacterial, fungal, or viral infection of the tissue and fluid within a joint * . The infection causes inflammation and can result in pain, swelling, and limited motion of the joint.

What Is Infectious Arthritis?

Most of the time, bacteria cause infectious arthritis. Infectious arthritis is also called septic arthritis, and the infected joint is referred to as a septic joint. Staphylococcus (stah-fih-lo-KAH-kus) or Streptococcus (strep-tuh-KAH-kus) bacteria are the culprits in most cases of septic arthritis. Infectious arthritis can also occur in other diseases, for example, in Lyme disease and tuberculosis. Bacteria can be introduced directly into the joint by injury or surgery, but more often the bacteria are carried to the joint through the bloodstream from an infection somewhere else in the body. The most common cause of septic arthritis in young adults is Neisseria gonorrhoeae (nye-SEER-e-uh gah-no-REE-eye), the bacterium that causes gonorrhea. These bacteria may spread from infected areas, such as the cervix * , rectum *

People whose immune systems are weak because they have a disease such as diabetes * , sickle cell anemia * , certain cancers, lupus * , or AIDS * are more likely to get infectious arthritis. Alcoholism and intravenous drug use also put people at higher risk. Because a joint that is damaged is more vulnerable to germs, people with existing disease involving the joints (such as rheumatoid arthritis * ) are more likely to develop infectious arthritis. Anyone who has had joint-replacement surgery is at increased risk of infection of that joint in the future.

How Common Is Infectious Arthritis?

Cases of infectious arthritis are more common in some places than in others. Rates are highest in Africa, Latin America, and Asia. In the United States, about 20,000 cases of infectious arthritis occur each year. Men, women, and children of all ages can get infectious arthritis, but almost half of patients in whom the illness is diagnosed are 65 years or older.

Is Infectious Arthritis Contagious?

Infectious arthritis is not contagious, but certain viruses and the bacterium that causes gonorrhea can be transmitted from one person to another. However, contracting a particular infection caused by these organisms does not necessarily mean individuals will also get infectious arthritis.

What Are the Signs and Symptoms of Infectious Arthritis?

The symptoms of infectious arthritis vary by type of infection and the particular joint that is affected. With infectious arthritis, symptoms usually appear within a few hours or days, and include redness, warmth, swelling, pain, and sometimes fever and chills. It is difficult to move the affected joint because of the pain and swelling. Arthritis from a viral infection tends to come on more slowly, often with absence of fever and with less swelling, limitation of movement, and pain in the affected joint. Viruses may infect the joint directly, or sometimes the response of the body's immune system to a virus may cause joint inflammation (called postinfectious arthritis). Inflammation stemming from a fungal infection or tuberculosis usually develops very slowly, sometimes over weeks or months. The bacteria that cause Lyme disease can settle in a joint and may lead to recurrent bouts of infectious arthritis. Usually, swelling and limitation of movement of the joint are the main symptoms of this form of arthritis.

How Do Doctors Make the Diagnosis?

* of some of the synovial fluid * within the affected joint. The doctor inserts a thin sterile needle through the skin directly into the joint and removes a sample of fluid. The fluid is then examined under a microscope to look for evidence of microorganisms (such as bacteria) and infection-fighting white blood cells. Some of the sample is put in a jellylike medium containing nutrients that support the growth of bacteria, and this is placed in an incubator for a few days. If bacteria grow, bacterial infectious arthritis is diagnosed. This synovial fluid can also be tested for evidence of viral or fungal infections. In addition, blood tests can help diagnose arthritis caused by a virus or bacterium. If the suspected cause of inflammation is a fungus or tuberculosis, a tissue sample from the infected joint may need to be removed and analyzed. X-rays, computed tomography * , or magnetic resonance imaging * studies can detect excess fluid and sometimes destruction of the tissues within or surrounding an affected joint.

What Is the Treatment for Infectious Arthritis?

The type of organism causing infectious arthritis determines which medicines are needed to treat the infection. Antibiotics are prescribed to treat joint infections caused by bacteria, and antifungal medications are given for infection due to a fungus. Doctors also may recommend that individuals with infectious arthritis keep the affected joint elevated (raised) and avoid moving it. Over-the-counter anti-inflammatory medications, such as ibuprofen * , can relieve swelling and pain. Sometimes, to help healing and decrease discomfort, some of the excess synovial fluid is removed from a joint. This procedure may have to be repeated several times. In certain cases, a septic joint might be drained by a surgical procedure to help cure the infection.

How Long Does the Infection Last?

Eliminating the infection can take time. Antibiotics may need to be given intravenously for three weeks or more. It may take even longer for someone to be able to use an affected joint without feeling pain. In cases of severe infectious arthritis, physical therapy may be recommended after other treatment has been completed to help patients recover full movement and function of the joint. Infectious arthritis can be cured with prompt and proper treatment. In cases that are severe, or when treatment is delayed, the infection may cause permanent damage to the joint and the bone, sometimes resulting in persistent pain and disability.

Can Infectious Arthritis Be Prevented?

See also Arthritis • Immune Deficiencies • Lyme Disease • Sexually Transmitted Infections (STIs): Overview • Staphylococcal Infections • Streptococcal Infections

Resources

Books and Articles

McFadzean, Nicola. The Beginner's Guide to Lyme Disease: Diagnosis and Treatment Made Simple. South Lake Tahoe, CA: BioMed, 2012.

Websites

American College of Physicians. “Septic Arthritis.” http://smartmedicine.acponline.org/content.aspx?gbosId=369 (accessed June 16, 2015).

Medline Plus. “Infectious Arthritis.” U.S. National Library of Medicine, National Institutes of Health. http://www.nlm.nih.gov/medlineplus/infectiousarthritis.html (accessed June 16, 2015).

Organizations

American Academy of Orthopaedic Surgeons. 9400 W. Higgins Rd., Rosemont, IL 60018-4262. Telephone: 847-823-7186. Website: http://www.aaos.org (accessed June 16, 2015).

Arthritis Foundation. PO Box 7669, Atlanta, GA 30357-0669. Tollfree: 800-283-7800. Website: http://www.arthritis.org (accessed June 16, 2015).

Arthritis Society. 393 University Ave., Suite 1700, Toronto, ON, M5G 1E6, Canada. Telephone: 800-321-1433. Website: http://www.arthritis.ca (accessed June 16, 2015).

* joint is the structure where two or more bones come together, allowing flexibility and motion of the skeleton.

* cervix (SIR-viks) is the lower, narrow end of the uterus that opens into the vagina.

* rectum is the final portion of the large intestine, connecting the colon to the outside opening of the anus.

* diabetes (dye-uh-BEE-teez) is a condition in which the body's pancreas does not produce enough insulin or the body cannot use the insulin it makes effectively, resulting in increased levels of sugar in the blood. This disorder can lead to increased urination, dehydration, weight loss, weakness, and a number of other symptoms and complications related to chemical imbalances within the body.

* sickle cell anemia also called sickle cell disease, is a hereditary condition in which the red blood cells, which are usually round, take on an abnormal crescent shape and have a decreased ability to carry oxygen throughout the body.

* lupus (LOO-pus) is a chronic, or long-lasting, disease that causes inflammation of connective tissue, the material that holds together the various structures of the body.

* AIDS or acquired immunodeficiency (ih-myoo-no-dih-FIH-shen-see) syndrome is an infection that severely weakens the immune system; it is caused by the human immunodeficiency virus (HIV).

* rheumatoid arthritis (ROO-mahtoyd -ar-THRY-tis) is a chronic disease characterized by painful swelling, stiffness, and deformity of the joints.

* aspiration (as-puh-RAY-shun) is the sucking of fluid or other material out of the body, such as the removal of a sample of joint fluid through a needle inserted into the joint.

* synovial fluid (sih-NO-vee-ul) is the fluid produced in the synovium, the inner lining of the flexible capsule that encloses the joint space between two bones. This fluid lubricates and nourishes the joint.

* computed tomography (kom-PYOO-ted toe-MAH-gruhfee) or CT, also called computerized axial tomography (CAT), is a technique in which a machine takes many x-rays of the body to create a three-dimensional picture.

* magnetic resonance imaging or MRI uses magnetic waves, instead of x-rays, to scan the body and produces detailed pictures of the body's structures.

* ibuprofen (eye-bew-PRO-fin) is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce fever and relieve pain or inflammation.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)