Infective arthritis in adults--experience at a teaching hospital in Kuwait

Infective arthritis (InfectA) has a variable geographical pattern. A 'Medline' search did not yield any earlier series on epidemiological pattern of InfectA from Kuwait or the Gulf region. Therefore, an observational prospective study of sequential cases seen over a period of 4 years was carried out. Of a total of 2021 patients seen during this period, 36 (1.8%) were diagnosed to have InfectA. There were 6 (16.7%) cases of neisserial and 30 (83.3%) of non-neisserial InfectA. Predisposing factors were seen in 17 (47.2%), all with non-neisserial InfectA. Microbiological diagnosis was proven in 15 (41.7%) cases, and included Neisseria gonorrhoeae in 5, Brucella spp. in 4, Staphylococcus aureus in 3, and Neisseria meningitidis, Salmonella spp. and Mycobacterium tuberculosis in 1 each. In the remaining 21 (58.3%) cases the diagnosis was made on clinical grounds and confirmed on therapeutic response. The most common presentation of neisserial InfectA was acute polyarthritis while that of non-neisserial InfectA was acute monoarthritis. All patients recovered with little disability and no mortality.