Early diagnosis of septic arthritis in immunocompromised patients

J Orthop Sci. 2018 May;23(3):542-545. doi: 10.1016/j.jos.2018.02.011. Epub 2018 Mar 5.

Abstract

Objectives: Septic arthritis results in rapid joint destruction if not properly diagnosed and treated. A work up for septic arthritis includes a peripheral white blood cell count, inflammatory markers, and a joint aspiration. In the general population, the interpretation of these labs has been well-defined by prior studies. To this point, no study has determined how immunosuppressive states affect this work up.

Methods: Patients with immunosuppressive conditions who received a joint aspiration for a painful joint were retrospectively identified. Laboratory results from their work up were gathered and analyzed.

Results: 216 patients were included in the study, 21 of whom were diagnosed with septic arthritis. The average aspiration WBC count was 74,190 with 88% PMNs. 81% had a positive gram stain.

Discussion: Laboratory values for immunosuppressed patients with septic arthritis were similar to those associated with septic arthritis in historical general population controls.

MeSH terms

  • Arthritis, Infectious / blood
  • Arthritis, Infectious / diagnosis*
  • Arthritis, Infectious / immunology*
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Early Diagnosis
  • Humans
  • Immunocompromised Host*
  • Leukocyte Count
  • Retrospective Studies
  • Sensitivity and Specificity
  • Synovial Fluid / metabolism
  • Synovial Fluid / microbiology

Substances

  • C-Reactive Protein