A Case of Bilateral Knee Septic Artiritis Complicating Rheumatoid Arthritis.
- Author:
Sung Soo KIM
1
;
Won PARK
;
Sung Kwon BAE
;
Jeong Soo SONG
;
Kyung Ho MOON
;
Joung Yoon LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Inha University, Inchon, Korea.
- Publication Type:Case Report
- Keywords:
Septic arthritis;
Bilateral knees;
Rheumatoid arthritis
- MeSH:
Anti-Bacterial Agents;
Arthritis, Infectious;
Arthritis, Rheumatoid*;
Bacteria;
Diagnosis;
Drainage;
Early Diagnosis;
Female;
Gram-Positive Cocci;
Humans;
Immunocompromised Host;
Joints;
Knee Joint;
Knee*;
Middle Aged;
Mortality;
Risk Factors;
Sepsis;
Staphylococcus aureus;
Steroids;
Suppuration;
Synovial Fluid
- From:The Journal of the Korean Rheumatism Association
1999;6(2):167-171
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Septic artiritis is a disease that causes a rapid joint destruction by various kinds of bacteria such as Staphylococcus aureus. It affects more frequently the patients with rheumatoid arthritis, diabetes, immunocompromised patients, and chronic steroid users. In patients with rheumatoid arthritis, 1 to 12% of patients are affected by septic arthritis. In these patients, it is very difficult to distinguish between an acute exacerbation of rheumatoid arthritis and a development of septic arthritis if the latter affects more than one joint. Septic arthritis usually affects single joint, especially the knee joint. If the diagnosis and treatment are delayed, it would cause sepsis resulting in high mortality and morbidity. Thus early diagnosis by arthrocentesis, prompt drainage, and antibiotics therapy are essential. We experienced a 46 years-old woman with rheumatoid arthritis who abused the steroids for 10 years and complaining recent aggravation of bilateral knee joint swelling, warmth, and tenderness. Large amount of pus from both knees showed Gram positive cocci. The immediate open surgical drainage of both knees was done. The patient recovered from septic arthritis after 6 weeks of antibiotics therapy. The synovial fluid microbiology study should be done in all joints of the patients with the risk factors of joint infection.
