Septic Joint: Difference between revisions
From Guide to YKHC Medical Practices
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Any children with a red, swollen joint with or without fever and refusal to use the limb should be evaluated in Bethel. Suspected toxic synovitis should also be evaluated here and not managed in the village. Some joints can be tapped in Bethel for | Any children with a red, swollen joint with or without fever and refusal to use the limb should be evaluated in Bethel. Suspected toxic synovitis should also be evaluated here and not managed in the village. | ||
'''Source of Infection:''' | |||
*Most commonly hematogenous seeding due to bacteremia | |||
*can be caused by MSSA, MRSA, or Haemophilus influenzae A (Hia) | |||
'''Diagnosis:''' | |||
*Usually confirmed by culture of synovial fluid | |||
*Some joints can be tapped in Bethel for initial fluid collection prior to starting antibiotics; several of the family practitioners and ER providers are trained in aspiration of some joints, although hip joints and other complicated joint aspirations are usually done by ortho in Anchorage. | |||
'''Management:''' | |||
*Usually requires orthopedic surgical involvement. | |||
*IV antibiotics: Vancomycin for staph coverage. if concern for Hia, add Ceftriaxone | |||
*Consult with other providers here or with ortho in Anchorage (ANMC for beneficiaries and Providence for non-beneficiaries) as needed to determine management of the patient. | |||
===Resources/References=== | ===Resources/References=== | ||
Revision as of 19:46, 24 November 2020
Any children with a red, swollen joint with or without fever and refusal to use the limb should be evaluated in Bethel. Suspected toxic synovitis should also be evaluated here and not managed in the village.
Source of Infection:
- Most commonly hematogenous seeding due to bacteremia
- can be caused by MSSA, MRSA, or Haemophilus influenzae A (Hia)
Diagnosis:
- Usually confirmed by culture of synovial fluid
- Some joints can be tapped in Bethel for initial fluid collection prior to starting antibiotics; several of the family practitioners and ER providers are trained in aspiration of some joints, although hip joints and other complicated joint aspirations are usually done by ortho in Anchorage.
Management:
- Usually requires orthopedic surgical involvement.
- IV antibiotics: Vancomycin for staph coverage. if concern for Hia, add Ceftriaxone
- Consult with other providers here or with ortho in Anchorage (ANMC for beneficiaries and Providence for non-beneficiaries) as needed to determine management of the patient.
Resources/References
- Samraj, R S., & Fergie, J. Septic arthritis and hemarthroses caused by Haemophilus influenzae serotype A in children. Infectious Disease Reports, 8(3). (2016). DOI: doi.org/10.4081/idr.2016.6494
