array:23 [
  "pii" => "S2173574309700826"
  "issn" => "21735743"
  "doi" => "10.1016/S2173-5743(09)70082-6"
  "estado" => "S300"
  "fechaPublicacion" => "2009-01-01"
  "aid" => "70082"
  "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
  "copyrightAnyo" => "2009"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Reumatol Clin. 2009;5:18-22"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 3021
    "formatos" => array:3 [
      "EPUB" => 45
      "HTML" => 1777
      "PDF" => 1199
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S2173574309700838"
    "issn" => "21735743"
    "doi" => "10.1016/S2173-5743(09)70083-8"
    "estado" => "S300"
    "fechaPublicacion" => "2009-01-01"
    "aid" => "70083"
    "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2009;5:23-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1752
      "formatos" => array:3 [
        "EPUB" => 44
        "HTML" => 1221
        "PDF" => 487
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "The Therapeutic Blockade of TNF Reduces Serum Levels of Interleukin 15 in Patients With Rheumatoid Arthritis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "23"
          "paginaFinal" => "27"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "El bloqueo terapéutico del factor de necrosis tumoral disminuye la concentración sérica de interleucina 15 en pacientes con artritis reumatoide"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Isidoro González-Álvaro, Ana M. Ortiz, Eva G. Tomero, Alejandro Balsa, Javier Orte, Pedro Sabando Suárez, Rosario García-Vicuña"
          "autores" => array:7 [
            0 => array:2 [
              "nombre" => "Isidoro"
              "apellidos" => "González-Álvaro"
            ]
            1 => array:2 [
              "nombre" => "Ana M."
              "apellidos" => "Ortiz"
            ]
            2 => array:2 [
              "nombre" => "Eva G."
              "apellidos" => "Tomero"
            ]
            3 => array:2 [
              "nombre" => "Alejandro"
              "apellidos" => "Balsa"
            ]
            4 => array:2 [
              "nombre" => "Javier"
              "apellidos" => "Orte"
            ]
            5 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Sabando Suárez"
            ]
            6 => array:2 [
              "nombre" => "Rosario"
              "apellidos" => "García-Vicuña"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574309700838?idApp=UINPBA00004M"
    "url" => "/21735743/0000000500000001/v1_201305061551/S2173574309700838/v1_201305061551/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2173574309700814"
    "issn" => "21735743"
    "doi" => "10.1016/S2173-5743(09)70081-4"
    "estado" => "S300"
    "fechaPublicacion" => "2009-01-01"
    "aid" => "70081"
    "copyright" => "Sociedad Española de Reumatología and Colegio Mexicano de Reumatología"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Reumatol Clin. 2009;5:13-7"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 2096
      "formatos" => array:3 [
        "EPUB" => 44
        "HTML" => 1531
        "PDF" => 521
      ]
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Osteopenia in Primary Health Care Patients: Do We Need to Be More Rigorous?"
      "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" => "Oliv&#233; Marqu&#233;s"
          ]
          2 => array:2 [
            "nombre" => "Elisabet"
            "apellidos" => "Garc&#237;a Casares"
          ]
          3 => array:2 [
            "nombre" => "Emma"
            "apellidos" => "Garc&#237;a Melchor"
          ]
          4 => array:2 [
            "nombre" => "Susana"
            "apellidos" => "Holgado P&#233;rez"
          ]
          5 => array:2 [
            "nombre" => "Xavier"
            "apellidos" => "Tena Mars&#224;"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Secci&#243;n de Reumatolog&#237;a&#44; Hospital Universitari Germans Trias i Pujol&#44; Badalona&#44; Barcelona&#44; Spain"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Artritis s&#233;ptica polit&#243;pica&#58; an&#225;lisis 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 s&#233;ptica"
            1 => "Infecci&#243;n poliarticular"
            2 => "Embolia s&#233;ptica"
          ]
        ]
      ]
    ]
    "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&#37; of all septic arthritis&#44; but there are few references in the literature&#46; We describe characteristics of patients with polyarticular septic arthritis in a rheumatology service&#46;</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&#46; Only patients with positive culture of synovial fluid were included&#46; Clinical&#44; analytical&#44; and radiological variables are reviewed&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Nineteen patients &#40;14 male&#41; had a polyarticular infection&#46; Mean age was 55 years&#46; Mean time from onset to diagnosis was 6 days&#46; The knee was the most commonly involved joint&#44; followed by ankle&#46; The mean number of joints involved per patient was 3&#46; Risk factors included diabetes&#44; chronic renal&#44; or hepatic disease&#44; gout&#44; and rheumatoid arthritis&#46; Most commonly isolated agents were <span class="elsevierStyleItalic">S aureus</span> &#40;47&#37;&#41; and <span class="elsevierStyleItalic">S agalactiae</span> &#40;21&#37;&#41;&#46; Blood cultures were positive in 52&#46;6&#37; and 15&#46;8&#37; had septic shock&#46; Scintygraphic bone scan showed a polyarticular uptake&#46; Mean duration of antibiotic therapy was 46 &#40;27&#41; days&#46; Clinical outcome was good in 52&#46;6&#37;&#44; complicated in 26&#37;&#44; and mortality rate was 15&#46;8&#37; &#40;3 cases&#41;&#46; Joint debridement was performed in 21&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Multiple joint involvement does not exclude the diagnosis of septic arthritis&#46; Inflammatory arthritis is an important risk factor&#46; <span class="elsevierStyleItalic">S aureus</span> in the main infectious agent&#46; The morbidity and mortality of this condition are important&#44; so we need to maintain a high index of suspicion for the condition&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">El 15&#37; de las artritis s&#233;pticas corresponde a formas poliarticulares&#44; si bien son escasas las series publicadas&#46; Evaluamos las caracter&#237;sticas de los enfermos con artritis s&#233;ptica poliarticular recogidos en un servicio de reumatolog&#237;a&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis retrospectivo de las artritis pi&#243;genas con afecci&#243;n oligoarticular o poliarticular&#46; Se incluye &#250;nicamente a los enfermos con aislamiento del germen en el l&#237;quido articular&#46; Se analizan las variables cl&#237;nicas&#44; anal&#237;ticas y radiol&#243;gicas de la serie&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se registraron 19 casos &#40;14 varones y 5 mujeres&#41; con una media de edad de 55 a&#241;os&#46; La media del tiempo hasta el diagn&#243;stico fue 6 d&#237;as&#46; La articulaci&#243;n afectada con mayor frecuencia fue la rodilla&#44; seguida del tobillo&#46; La media de focos infecciosos por paciente fue 3 &#40;intervalo&#44; 2&#8211;6&#41;&#46; Los factores de riesgo m&#225;s frecuentes fueron la diabetes mellitus&#44; la insuficiencia renal cr&#243;nica&#44; la hepatopat&#237;a cr&#243;nica&#44; la gota y la artritis reumatoide&#46; Los g&#233;rmenes aislados fueron <span class="elsevierStyleItalic">Staphylococcus aureus</span> &#40;47&#37;&#41;&#44; <span class="elsevierStyleItalic">S&#46; agalactiae</span> &#40;21&#37;&#41; y bacilos gramnegativos&#46; Los hemocultivos fueron positivos en el 52&#44;6&#37;&#44; y el 15&#44;8&#37; present&#243; shock s&#233;ptico&#46; La gammagraf&#237;a con 99Tc mostr&#243; la afecci&#243;n polit&#243;pica cuando fue realizada&#46; La duraci&#243;n media del tratamiento antibi&#243;tico fue 46<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>27 d&#237;as&#46; La evoluci&#243;n fue satisfactoria en el 52&#44;6&#37; y t&#243;rpida en el 26&#37;&#44; con mortalidad del 15&#44;8&#37; &#40;3 casos&#41;&#46; Se realiz&#243; artrotom&#237;a en el 21&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">La presencia de oligoartritis o poliartritis no excluye el diagn&#243;stico de artritis infecciosa&#46; Entre los factores de riesgo destacan las artropat&#237;as inflamatorias previas&#46; <span class="elsevierStyleItalic">S&#46; aureus</span> es el microorganismo causal m&#225;s frecuente&#46; La morbilidad y la mortalidad de esta forma de infecci&#243;n articular son importantes&#44; por lo que debe mantenerse un alto &#237;ndice de sospecha y realizar una exploraci&#243;n sistem&#225;tica de todas las articulaciones&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:24 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "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&#46;N&#46; Gupta"
                            1 => "R&#46;D&#46; Sturrock"
                            2 => "M&#46; Field"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2001"
                        "volumen" => "40"
                        "paginaInicial" => "24"
                        "paginaFinal" => "30"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11157138"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46;C&#46; Weston"
                            1 => "A&#46;C&#46; Jones"
                            2 => "N&#46; Bradbury"
                            3 => "F&#46; Fawthrop"
                            4 => "M&#46; Doherty"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Rheum Dis"
                        "fecha" => "1999"
                        "volumen" => "58"
                        "paginaInicial" => "214"
                        "paginaFinal" => "219"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10364899"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "American Rheumatism Association nomenclature and classification of arthritis and rheumatism"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;L&#46; Decker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arthritis Rheum"
                        "fecha" => "1983"
                        "volumen" => "26"
                        "paginaInicial" => "1029"
                        "paginaFinal" => "1032"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6603849"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polyarticular septic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Dubost"
                            1 => "I&#46; Fis"
                            2 => "P&#46; Denis"
                            3 => "R&#46; Lopitaux"
                            4 => "M&#46; Soubrier"
                            5 => "J&#46;M&#46; Ristori"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "1993"
                        "volumen" => "72"
                        "paginaInicial" => "296"
                        "paginaFinal" => "310"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8412643"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Septic arthritis in rheumatoid polyarthritis&#46; 24 cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;J&#46; Dubost"
                            1 => "I&#46; Fis"
                            2 => "M&#46; Soubrier"
                            3 => "R&#46; Lopitaux"
                            4 => "J&#46;M&#46; Ristori"
                            5 => "J&#46;L&#46; Bussiere"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Rhum Ed Fr"
                        "fecha" => "1994"
                        "volumen" => "61"
                        "paginaInicial" => "153"
                        "paginaFinal" => "165"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7920511"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concomitant polyarticular septic and gouty arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;H&#46; Alappatt"
                            1 => "G&#46; Clayburne"
                            2 => "R&#46; Schumacher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "2006"
                        "volumen" => "33"
                        "paginaInicial" => "1707"
                        "paginaFinal" => "1708"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16881130"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Concomitant septic and gouty arthritis &#8212;an analysis of 30 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;H&#46; Yu"
                            1 => "S&#46;F&#46; Luo"
                            2 => "L&#46;B&#46; Liou"
                            3 => "Y-J&#46;J&#46; Wu"
                            4 => "W&#46;P&#46; Tsai"
                            5 => "J&#46;Y&#46; Chen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/rheumatology/keg297"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatology"
                        "fecha" => "2003"
                        "volumen" => "42"
                        "paginaInicial" => "1062"
                        "paginaFinal" => "1066"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12730521"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pyarthrosis in patients with rheumatoid arthritis&#58; a detailed analysis of 10 cases and literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Nolla"
                            1 => "C&#46; G&#243;mez Vaquero"
                            2 => "J&#46; Fiter"
                            3 => "L&#46; Mateo"
                            4 => "X&#46; Juanola"
                            5 => "J&#46; Rodr&#237;guez Moreno"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Semin Athritis Rheum"
                        "fecha" => "2000"
                        "volumen" => "30"
                        "paginaInicial" => "121"
                        "paginaFinal" => "126"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polyarticular septic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;H&#46; Epstein"
                            1 => "B&#46; Zimmermann 3rd"
                            2 => "G&#46; Ho Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Rheumatol"
                        "fecha" => "1986"
                        "volumen" => "13"
                        "paginaInicial" => "1105"
                        "paginaFinal" => "1107"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3494122"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Septic arthritis in patients with systemic lupus erythematosus&#58; salmonella and nonsalmonella infections compared"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;L&#46; Huang"
                            1 => "J&#46;J&#46; Hung"
                            2 => "K&#46;C&#46; Wu"
                            3 => "W&#46;I&#46; Lee"
                            4 => "C&#46;K&#46; Chan"
                            5 => "L&#46;S&#46; Ou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2006.04.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2006"
                        "volumen" => "36"
                        "paginaInicial" => "61"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16887469"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multiple avascular necrosis of bone and polyarticular septic arthritis in patients with systemic lupus erythematosus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Galindo"
                            1 => "I&#46; Mateo"
                            2 => "J&#46;L&#46; Pablos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00296-004-0444-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rheumatol Int"
                        "fecha" => "2005"
                        "volumen" => "25"
                        "paginaInicial" => "72"
                        "paginaFinal" => "76"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14986062"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Septic arthritis in patients with human immunodeficiency virus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;G&#46; Zalavras"
                            1 => "R&#46; Dellamaggiora"
                            2 => "M&#46;J&#46; Patzakis"
                            3 => "E&#46; Bava"
                            4 => "P&#46;D&#46; Holtom"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/01.blo.0000229305.97888.17"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Orthop Relat Res"
                        "fecha" => "2006"
                        "volumen" => "451"
                        "paginaInicial" => "46"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16906073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polyarticular septic arthritis caused by Streptococcus pyogenes in an immunocompetent women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Mart&#237;"
                            1 => "E&#46; Ant&#243;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Eur J Int Med"
                        "fecha" => "2007"
                        "volumen" => "18"
                        "paginaInicial" => "80"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Spontaneous pyogenic facet joint infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Narv&#225;ez"
                            1 => "J&#46;M&#46; Nolla"
                            2 => "J&#46;A&#46; Narv&#225;ez"
                            3 => "L&#46; Mart&#237;nez Carnicero"
                            4 => "E&#46; De Lama"
                            5 => "C&#46; G&#243;mez Vaquero"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2005.09.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2006"
                        "volumen" => "35"
                        "paginaInicial" => "272"
                        "paginaFinal" => "283"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16616150"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Group B Streptococcus &#40;Streptococcus agalactiae&#41; pyogenic arthritis in nonpregnant adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Nolla"
                            1 => "C&#46; G&#243;mez Vaqueo"
                            2 => "X&#46; Corbella"
                            3 => "S&#46; Ord&#243;&#241;ez"
                            4 => "C&#46; Garc&#237;a-G&#243;mez"
                            5 => "A&#46; P&#233;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2003"
                        "volumen" => "82"
                        "paginaInicial" => "119"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12640188"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pneumococcal polyarticular septic arthritis in a patient with rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Lohse"
                            1 => "J&#46; Despaux"
                            2 => "B&#46; Auge"
                            3 => "E&#46; Toussirot"
                            4 => "D&#46; Wendling"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Rhum Engl Ed"
                        "fecha" => "1999"
                        "volumen" => "66"
                        "paginaInicial" => "344"
                        "paginaFinal" => "346"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10418064"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neumococcal septic arthritis&#58; review of 190 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;J&#46; Ross"
                            1 => "C&#46;L&#46; Saltzman"
                            2 => "P&#46; Carling"
                            3 => "D&#46;S&#46; Shapiro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/345954"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis"
                        "fecha" => "2003"
                        "volumen" => "36"
                        "paginaInicial" => "319"
                        "paginaFinal" => "327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12539074"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Septic arthritis in the adult caused by Streptococcus pneumoniae&#58; a report of 4cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Raad"
                            1 => "J&#46;E&#46; Peacock Jr&#46;"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2004"
                        "volumen" => "34"
                        "paginaInicial" => "559"
                        "paginaFinal" => "569"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15505773"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polyarticular septic arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Christodoulou"
                            1 => "P&#46; Gordon"
                            2 => "G&#46; Coakley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.39020.401331.68"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2006"
                        "volumen" => "333"
                        "paginaInicial" => "1107"
                        "paginaFinal" => "1108"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17124222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Streptococcal septic arthritis in adults&#46; A study of 55 cases with a literature review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46;J&#46; Dubost"
                            1 => "M&#46; Soubrier"
                            2 => "C&#46; de Champs"
                            3 => "J&#46;M&#46; Ristori"
                            4 => "B&#46; Sauvezie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S1297-319X(03)00122-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Joint Bone Spine"
                        "fecha" => "2004"
                        "volumen" => "71"
                        "paginaInicial" => "303"
                        "paginaFinal" => "311"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15288856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hemophilus influenzae septic arthritis in adults&#46; A report of four cases and a review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46;G&#46; Borenstein"
                            1 => "G&#46;L&#46; Simon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Medicine &#40;Baltimore&#41;"
                        "fecha" => "1986"
                        "volumen" => "65"
                        "paginaInicial" => "191"
                        "paginaFinal" => "201"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Polymicrobial polyarticular septic arthritis&#58; a rare clinical entity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Gilad"
                            1 => "A&#46; Borer"
                            2 => "K&#46; Reisenberg"
                            3 => "M&#46; Klein"
                            4 => "N&#46; Peled"
                            5 => "F&#46; Schlaeffer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Scand J Infect Dis"
                        "fecha" => "2001"
                        "volumen" => "33"
                        "paginaInicial" => "381"
                        "paginaFinal" => "383"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11440226"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Isolated polyarticular septic arhtritis&#58; an atypical presentation of meningococcal infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; McCulloch"
                            1 => "H&#46; Brooks"
                            2 => "K&#46; Kalantarinia"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MAJ.0b013e318142bb0d"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med Sci"
                        "fecha" => "2008"
                        "volumen" => "335"
                        "paginaInicial" => "323"
                        "paginaFinal" => "326"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18414075"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Septic arthritis in patients aged 80 and older&#58; a comparison with younger adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "F&#46; Gavet"
                            1 => "A&#46; Tournadre"
                            2 => "M&#46; Soubrier"
                            3 => "J&#46;M&#46; Ristori"
                            4 => "J&#46;J&#46; Dubost"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1532-5415.2005.53373.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Geriatr Soc"
                        "fecha" => "2005"
                        "volumen" => "53"
                        "paginaInicial" => "1210"
                        "paginaFinal" => "1213"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16108940"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21735743/0000000500000001/v1_201305061551/S2173574309700826/v1_201305061551/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "17338"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Original Article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21735743/0000000500000001/v1_201305061551/S2173574309700826/v1_201305061551/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574309700826?idApp=UINPBA00004M"
]
Share
Journal Information
Vol. 5. Issue 1.
Pages 18-22 (January - February 2009)
Share
Share
Download PDF
More article options
Vol. 5. Issue 1.
Pages 18-22 (January - February 2009)
Full text access
Polyarticular Septic Arthritis: Analysis of 19 Cases
Artritis séptica politópica: análisis de 19 casos
Visits
6474
Lourdes Mateo Soria
Corresponding author
lmateo.germanstrias@gencat.net

Corresponding author.
, Alejandro Olivé Marqués, Elisabet García Casares, Emma García Melchor, Susana Holgado Pérez, Xavier Tena Marsà
Sección de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
This item has received
Article information
Abstract
Objective

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.

Patients and method

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.

Results

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 S aureus (47%) and S agalactiae (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%.

Conclusions

Multiple joint involvement does not exclude the diagnosis of septic arthritis. Inflammatory arthritis is an important risk factor. S aureus 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.

Keywords:
Polyarticular septic arthritis
Infectious arthritis
Septic embolism
Resumen
Objetivo

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.

Material y método

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.

Resultados

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 Staphylococcus aureus (47%), S. agalactiae (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±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%.

Conclusiones

La presencia de oligoartritis o poliartritis no excluye el diagnóstico de artritis infecciosa. Entre los factores de riesgo destacan las artropatías inflamatorias previas. S. aureus 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.

Palabras clave:
Poliartritis séptica
Infección poliarticular
Embolia séptica
Full text is only aviable in PDF
References
[1.]
M.N. Gupta, R.D. Sturrock, M. Field.
A prospective study of 75 patients with adultonset septic arthritis.
Rheumatology, 40 (2001), pp. 24-30
[2.]
V.C. Weston, A.C. Jones, N. Bradbury, F. Fawthrop, M. Doherty.
Clinical features and outcome of septic arthritis in a single UK Health District 1982-1991.
Ann Rheum Dis, 58 (1999), pp. 214-219
[3.]
J.L. Decker.
American Rheumatism Association nomenclature and classification of arthritis and rheumatism.
Arthritis Rheum, 26 (1983), pp. 1029-1032
[4.]
J.J. Dubost, I. Fis, P. Denis, R. Lopitaux, M. Soubrier, J.M. Ristori, et al.
Polyarticular septic arthritis.
Medicine, 72 (1993), pp. 296-310
[5.]
J.J. Dubost, I. Fis, M. Soubrier, R. Lopitaux, J.M. Ristori, J.L. Bussiere, et al.
Septic arthritis in rheumatoid polyarthritis. 24 cases and review of the literature.
Rev Rhum Ed Fr, 61 (1994), pp. 153-165
[6.]
C.H. Alappatt, G. Clayburne, R. Schumacher.
Concomitant polyarticular septic and gouty arthritis.
J Rheumatol, 33 (2006), pp. 1707-1708
[7.]
K.H. Yu, S.F. Luo, L.B. Liou, Y-J.J. Wu, W.P. Tsai, J.Y. Chen, et al.
Concomitant septic and gouty arthritis —an analysis of 30 cases.
Rheumatology, 42 (2003), pp. 1062-1066
[8.]
J.M. Nolla, C. Gómez Vaquero, J. Fiter, L. Mateo, X. Juanola, J. Rodríguez Moreno, et al.
Pyarthrosis in patients with rheumatoid arthritis: a detailed analysis of 10 cases and literature review.
Semin Athritis Rheum, 30 (2000), pp. 121-126
[9.]
J.H. Epstein, B. Zimmermann 3rd, G. Ho Jr..
Polyarticular septic arthritis.
J Rheumatol, 13 (1986), pp. 1105-1107
[10.]
J.L. Huang, J.J. Hung, K.C. Wu, W.I. Lee, C.K. Chan, L.S. Ou.
Septic arthritis in patients with systemic lupus erythematosus: salmonella and nonsalmonella infections compared.
Semin Arthritis Rheum, 36 (2006), pp. 61-67
[11.]
M. Galindo, I. Mateo, J.L. Pablos.
Multiple avascular necrosis of bone and polyarticular septic arthritis in patients with systemic lupus erythematosus.
Rheumatol Int, 25 (2005), pp. 72-76
[12.]
C.G. Zalavras, R. Dellamaggiora, M.J. Patzakis, E. Bava, P.D. Holtom.
Septic arthritis in patients with human immunodeficiency virus.
Clin Orthop Relat Res, 451 (2006), pp. 46-49
[13.]
J. Martí, E. Antón.
Polyarticular septic arthritis caused by Streptococcus pyogenes in an immunocompetent women.
Eur J Int Med, 18 (2007), pp. 80
[14.]
J. Narváez, J.M. Nolla, J.A. Narváez, L. Martínez Carnicero, E. De Lama, C. Gómez Vaquero, et al.
Spontaneous pyogenic facet joint infection.
Semin Arthritis Rheum, 35 (2006), pp. 272-283
[15.]
J.M. Nolla, C. Gómez Vaqueo, X. Corbella, S. Ordóñez, C. García-Gómez, A. Pérez, et al.
Group B Streptococcus (Streptococcus agalactiae) pyogenic arthritis in nonpregnant adults.
Medicine, 82 (2003), pp. 119-128
[16.]
A. Lohse, J. Despaux, B. Auge, E. Toussirot, D. Wendling.
Pneumococcal polyarticular septic arthritis in a patient with rheumatoid arthritis.
Rev Rhum Engl Ed, 66 (1999), pp. 344-346
[17.]
J.J. Ross, C.L. Saltzman, P. Carling, D.S. Shapiro.
Neumococcal septic arthritis: review of 190 cases.
Clin Infect Dis, 36 (2003), pp. 319-327
[18.]
J. Raad, J.E. Peacock Jr..
Septic arthritis in the adult caused by Streptococcus pneumoniae: a report of 4cases and review of the literature.
Semin Arthritis Rheum, 34 (2004), pp. 559-569
[19.]
C. Christodoulou, P. Gordon, G. Coakley.
Polyarticular septic arthritis.
[20.]
J.J. Dubost, M. Soubrier, C. de Champs, J.M. Ristori, B. Sauvezie.
Streptococcal septic arthritis in adults. A study of 55 cases with a literature review.
Joint Bone Spine, 71 (2004), pp. 303-311
[21.]
D.G. Borenstein, G.L. Simon.
Hemophilus influenzae septic arthritis in adults. A report of four cases and a review of the literature.
Medicine (Baltimore), 65 (1986), pp. 191-201
[22.]
J. Gilad, A. Borer, K. Reisenberg, M. Klein, N. Peled, F. Schlaeffer.
Polymicrobial polyarticular septic arthritis: a rare clinical entity.
Scand J Infect Dis, 33 (2001), pp. 381-383
[23.]
M. McCulloch, H. Brooks, K. Kalantarinia.
Isolated polyarticular septic arhtritis: an atypical presentation of meningococcal infection.
Am J Med Sci, 335 (2008), pp. 323-326
[24.]
F. Gavet, A. Tournadre, M. Soubrier, J.M. Ristori, J.J. Dubost.
Septic arthritis in patients aged 80 and older: a comparison with younger adults.
J Am Geriatr Soc, 53 (2005), pp. 1210-1213
Copyright © 2009. Sociedad Española de Reumatología and Colegio Mexicano de Reumatología
Download PDF
Idiomas
Reumatología Clínica (English Edition)
Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?