Polyarticular Septic Arthritis: Analysis of 19 Cases
Artritis séptica politópica: análisis de 19 casos
Lourdes Mateo Soria
, Alejandro Olivé Marqués, Elisabet García Casares, Emma García Melchor, Susana Holgado Pérez, Xavier Tena Marsà
Corresponding author
Sección de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
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"tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "13" "paginaFinal" => "17" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Osteopenia en atención primaria: ¿debemos ser más rigurosos?" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Antoni Serra Torres, Salvador Sitjar Martínez de Sas, Josep Miquel Sotoca Momblona, Laia Alemany Vilches, Bibiana Contreras Raris, Jordi Hoyo Sánchez" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Antoni" "apellidos" => "Serra Torres" ] 1 => array:2 [ "nombre" => "Salvador Sitjar" "apellidos" => "Martínez de Sas" ] 2 => array:2 [ "nombre" => "Josep Miquel" "apellidos" => "Sotoca Momblona" ] 3 => array:2 [ "nombre" => "Laia" "apellidos" => "Alemany Vilches" ] 4 => array:2 [ "nombre" => "Bibiana" "apellidos" => "Contreras Raris" ] 5 => array:2 [ "nombre" => "Jordi" "apellidos" => "Hoyo Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574309700814?idApp=UINPBA00004M" "url" => "/21735743/0000000500000001/v1_201305061551/S2173574309700814/v1_201305061551/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "titulo" => "Polyarticular Septic Arthritis: Analysis of 19 Cases" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "18" "paginaFinal" => "22" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Lourdes Mateo Soria, Alejandro Olivé Marqués, Elisabet García Casares, Emma García Melchor, Susana Holgado Pérez, Xavier Tena Marsà" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Lourdes" "apellidos" => "Mateo Soria" "email" => array:1 [ 0 => "lmateo.germanstrias@gencat.net" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Olivé Marqués" ] 2 => array:2 [ "nombre" => "Elisabet" "apellidos" => "García Casares" ] 3 => array:2 [ "nombre" => "Emma" "apellidos" => "García Melchor" ] 4 => array:2 [ "nombre" => "Susana" "apellidos" => "Holgado Pérez" ] 5 => array:2 [ "nombre" => "Xavier" "apellidos" => "Tena Marsà" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Sección de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Artritis séptica politópica: análisis de 19 casos" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-03-30" "fechaAceptado" => "2008-06-26" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec111974" "palabras" => array:3 [ 0 => "Polyarticular septic arthritis" 1 => "Infectious arthritis" 2 => "Septic embolism" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec111975" "palabras" => array:3 [ 0 => "Poliartritis séptica" 1 => "Infección poliarticular" 2 => "Embolia séptica" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Polyarticular septic arthritis accounts for 15% of all septic arthritis, but there are few references in the literature. We describe characteristics of patients with polyarticular septic arthritis in a rheumatology service.</p> <span class="elsevierStyleSectionTitle">Patients and method</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Retrospective analysis of patients with septic arthritis involving more than one joint. Only patients with positive culture of synovial fluid were included. Clinical, analytical, and radiological variables are reviewed.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Nineteen patients (14 male) had a polyarticular infection. Mean age was 55 years. Mean time from onset to diagnosis was 6 days. The knee was the most commonly involved joint, followed by ankle. The mean number of joints involved per patient was 3. Risk factors included diabetes, chronic renal, or hepatic disease, gout, and rheumatoid arthritis. Most commonly isolated agents were <span class="elsevierStyleItalic">S aureus</span> (47%) and <span class="elsevierStyleItalic">S agalactiae</span> (21%). Blood cultures were positive in 52.6% and 15.8% had septic shock. Scintygraphic bone scan showed a polyarticular uptake. Mean duration of antibiotic therapy was 46 (27) days. Clinical outcome was good in 52.6%, complicated in 26%, and mortality rate was 15.8% (3 cases). Joint debridement was performed in 21%.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Multiple joint involvement does not exclude the diagnosis of septic arthritis. Inflammatory arthritis is an important risk factor. <span class="elsevierStyleItalic">S aureus</span> in the main infectious agent. The morbidity and mortality of this condition are important, so we need to maintain a high index of suspicion for the condition.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El 15% de las artritis sépticas corresponde a formas poliarticulares, si bien son escasas las series publicadas. Evaluamos las características de los enfermos con artritis séptica poliarticular recogidos en un servicio de reumatología.</p> <span class="elsevierStyleSectionTitle">Material y método</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Análisis retrospectivo de las artritis piógenas con afección oligoarticular o poliarticular. Se incluye únicamente a los enfermos con aislamiento del germen en el líquido articular. Se analizan las variables clínicas, analíticas y radiológicas de la serie.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se registraron 19 casos (14 varones y 5 mujeres) con una media de edad de 55 años. La media del tiempo hasta el diagnóstico fue 6 días. La articulación afectada con mayor frecuencia fue la rodilla, seguida del tobillo. La media de focos infecciosos por paciente fue 3 (intervalo, 2–6). Los factores de riesgo más frecuentes fueron la diabetes mellitus, la insuficiencia renal crónica, la hepatopatía crónica, la gota y la artritis reumatoide. Los gérmenes aislados fueron <span class="elsevierStyleItalic">Staphylococcus aureus</span> (47%), <span class="elsevierStyleItalic">S. agalactiae</span> (21%) y bacilos gramnegativos. Los hemocultivos fueron positivos en el 52,6%, y el 15,8% presentó shock séptico. La gammagrafía con 99Tc mostró la afección politópica cuando fue realizada. La duración media del tratamiento antibiótico fue 46<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>27 días. La evolución fue satisfactoria en el 52,6% y tórpida en el 26%, con mortalidad del 15,8% (3 casos). Se realizó artrotomía en el 21%.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La presencia de oligoartritis o poliartritis no excluye el diagnóstico de artritis infecciosa. Entre los factores de riesgo destacan las artropatías inflamatorias previas. <span class="elsevierStyleItalic">S. aureus</span> es el microorganismo causal más frecuente. La morbilidad y la mortalidad de esta forma de infección articular son importantes, por lo que debe mantenerse un alto índice de sospecha y realizar una exploración sistemática de todas las articulaciones.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:24 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A prospective study of 75 patients with adultonset septic arthritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.N. Gupta" 1 => "R.D. Sturrock" 2 => "M. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 6 | 16 | 22 |
| 2024 October | 32 | 37 | 69 |
| 2024 September | 34 | 28 | 62 |
| 2024 August | 43 | 45 | 88 |
| 2024 July | 40 | 44 | 84 |
| 2024 June | 46 | 34 | 80 |
| 2024 May | 32 | 32 | 64 |
| 2024 April | 34 | 23 | 57 |
| 2024 March | 26 | 35 | 61 |
| 2024 February | 23 | 24 | 47 |
| 2024 January | 16 | 19 | 35 |
| 2023 December | 18 | 27 | 45 |
| 2023 November | 15 | 18 | 33 |
| 2023 October | 23 | 31 | 54 |
| 2023 September | 26 | 42 | 68 |
| 2023 August | 33 | 13 | 46 |
| 2023 July | 29 | 29 | 58 |
| 2023 June | 24 | 23 | 47 |
| 2023 May | 24 | 14 | 38 |
| 2023 April | 30 | 18 | 48 |
| 2023 March | 32 | 32 | 64 |
| 2023 February | 28 | 31 | 59 |
| 2023 January | 31 | 37 | 68 |
| 2022 December | 30 | 33 | 63 |
| 2022 November | 28 | 23 | 51 |
| 2022 October | 31 | 31 | 62 |
| 2022 September | 31 | 41 | 72 |
| 2022 August | 22 | 39 | 61 |
| 2022 July | 24 | 53 | 77 |
| 2022 June | 30 | 34 | 64 |
| 2022 May | 20 | 39 | 59 |
| 2022 April | 32 | 52 | 84 |
| 2022 March | 25 | 40 | 65 |
| 2022 February | 24 | 38 | 62 |
| 2022 January | 21 | 38 | 59 |
| 2021 December | 23 | 37 | 60 |
| 2021 November | 20 | 48 | 68 |
| 2021 October | 24 | 42 | 66 |
| 2021 September | 29 | 42 | 71 |
| 2021 August | 20 | 55 | 75 |
| 2021 July | 20 | 29 | 49 |
| 2021 June | 27 | 48 | 75 |
| 2021 May | 23 | 39 | 62 |
| 2021 April | 81 | 97 | 178 |
| 2021 March | 37 | 33 | 70 |
| 2021 February | 39 | 33 | 72 |
| 2021 January | 35 | 16 | 51 |
| 2020 December | 42 | 23 | 65 |
| 2020 November | 35 | 18 | 53 |
| 2020 October | 30 | 13 | 43 |
| 2020 September | 25 | 25 | 50 |
| 2020 August | 31 | 17 | 48 |
| 2020 July | 34 | 28 | 62 |
| 2020 June | 30 | 16 | 46 |
| 2020 May | 42 | 18 | 60 |
| 2020 April | 43 | 20 | 63 |
| 2020 March | 19 | 11 | 30 |
| 2020 February | 5 | 0 | 5 |
| 2019 December | 4 | 0 | 4 |
| 2019 July | 2 | 2 | 4 |
| 2019 March | 2 | 0 | 2 |
| 2018 December | 1 | 0 | 1 |
| 2018 May | 7 | 2 | 9 |
| 2018 April | 38 | 24 | 62 |
| 2018 March | 29 | 20 | 49 |
| 2018 February | 26 | 13 | 39 |
| 2018 January | 17 | 12 | 29 |
| 2017 December | 20 | 11 | 31 |
| 2017 November | 17 | 17 | 34 |
| 2017 October | 17 | 16 | 33 |
| 2017 September | 17 | 16 | 33 |
| 2017 August | 16 | 23 | 39 |
| 2017 July | 12 | 22 | 34 |
| 2017 June | 38 | 11 | 49 |
| 2017 May | 27 | 18 | 45 |
| 2017 April | 33 | 24 | 57 |
| 2017 March | 19 | 48 | 67 |
| 2017 February | 12 | 12 | 24 |
| 2017 January | 28 | 7 | 35 |
| 2016 December | 67 | 17 | 84 |
| 2016 November | 37 | 19 | 56 |
| 2016 October | 58 | 18 | 76 |
| 2016 September | 60 | 20 | 80 |
| 2016 August | 47 | 23 | 70 |
| 2016 July | 25 | 21 | 46 |
| 2016 January | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 September | 1 | 0 | 1 |
| 2015 August | 2 | 0 | 2 |
| 2015 July | 13 | 5 | 18 |
| 2015 June | 20 | 10 | 30 |
| 2015 May | 40 | 15 | 55 |
| 2015 April | 22 | 16 | 38 |
| 2015 March | 17 | 22 | 39 |
| 2015 February | 12 | 27 | 39 |
| 2015 January | 17 | 30 | 47 |
| 2014 December | 23 | 23 | 46 |
| 2014 November | 14 | 21 | 35 |
| 2014 October | 30 | 31 | 61 |
| 2014 September | 14 | 28 | 42 |
| 2014 August | 19 | 27 | 46 |
| 2014 July | 43 | 27 | 70 |
| 2014 June | 46 | 18 | 64 |
| 2014 May | 40 | 25 | 65 |
| 2014 April | 30 | 20 | 50 |
| 2014 March | 50 | 24 | 74 |
| 2014 February | 30 | 28 | 58 |
| 2014 January | 32 | 25 | 57 |
| 2013 December | 21 | 19 | 40 |
| 2013 November | 33 | 29 | 62 |
| 2013 October | 30 | 33 | 63 |
| 2013 September | 31 | 27 | 58 |
| 2013 August | 23 | 18 | 41 |
| 2013 July | 25 | 26 | 51 |
| 2013 June | 20 | 21 | 41 |
| 2013 May | 17 | 22 | 39 |
| 2013 April | 16 | 31 | 47 |
| 2013 March | 20 | 26 | 46 |
| 2013 February | 19 | 21 | 40 |
| 2013 January | 17 | 13 | 30 |
| 2012 December | 17 | 15 | 32 |
| 2012 November | 15 | 33 | 48 |
| 2012 October | 7 | 18 | 25 |
| 2012 September | 6 | 9 | 15 |
| 2012 June | 3 | 0 | 3 |
| 2012 April | 6 | 0 | 6 |
| 2012 March | 5 | 0 | 5 |
| 2012 January | 5 | 0 | 5 |
| 2011 December | 2 | 0 | 2 |
| 2011 November | 8 | 0 | 8 |
| 2011 October | 3 | 0 | 3 |
| 2011 September | 1 | 0 | 1 |
| 2011 August | 1 | 0 | 1 |
| 2011 June | 4 | 0 | 4 |
| 2011 April | 1 | 0 | 1 |
| 2011 March | 3 | 0 | 3 |
| 2011 February | 7 | 0 | 7 |
| 2011 January | 3 | 0 | 3 |
| 2010 December | 4 | 0 | 4 |
| 2010 November | 3 | 0 | 3 |
| 2010 October | 5 | 0 | 5 |
| 2010 September | 4 | 0 | 4 |
| 2010 August | 2 | 0 | 2 |
| 2010 July | 7 | 0 | 7 |
| 2010 June | 6 | 0 | 6 |
| 2010 May | 6 | 0 | 6 |
| 2010 April | 15 | 0 | 15 |
| 2010 March | 15 | 0 | 15 |
| 2010 February | 5 | 0 | 5 |
| 2010 January | 9 | 0 | 9 |
| 2009 December | 9 | 0 | 9 |
| 2009 November | 15 | 0 | 15 |
| 2009 October | 20 | 0 | 20 |
| 2009 September | 10 | 0 | 10 |
| 2009 August | 15 | 0 | 15 |
| 2009 July | 25 | 0 | 25 |
| 2009 June | 30 | 0 | 30 |
| 2009 May | 8 | 0 | 8 |
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