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Guidelines
Pathogens
Antimicrobials
Key Messages
Septic arthritis should be suspected in patients with acute monoarthritis.
ALWAYS obtain synovial fluid cultures AND blood cultures prior to initiating empiric antimicrobial therapy.
Strongly consider both Infectious Diseases and Orthopedic Surgery consultations.
Staphylococcus aureus (MSSA)
Staphylococcus aureus (MRSA)
Group A Streptococcus
Initial Investigations
Interpreting Lab Results
Initial Empiric Antibiotics
Tailor Antimicrobial Therapy Based on Gram Stain
Further Management
References
(1) Gupta et al. A prospective 2-year study of 75 patients Rheumatology 2001:40(1)
(2) Smith, Piercy. Infectious Arthritis Clinical Infectious Disease 1995:20(2)
(3) Shah et al. Does the presence of crystal arthritis rule out septic arthritis? Journal of Emergency Medicine 2006:32(1)
(4) Margaretten et al. Does this Adult Patient have Septic Arthritis? JAMA 2007:297(13)
(5) Kortekagas et al. Synovial Fluid Leukcytosis in Bacterial Arthritis vs. Reactive Arthritis and Rheumatoid Arthritis in the Adult Knee. Scandinavian Journal of Rheumatology 1992:21(6)
