[Septic arthritis in tropical environment. 176 cases report in Brazzaville]

We report epidemiologic, clinic, para clinic, therapeutic and evolution aspects of septic arthritis in African tropical zone.

Retrospective survey in rheumatologic department of Brazzaville University Teaching Hospital over a period of 15 years and 6 months carrying on 176 septic arthritis observed among 3042 hospitalized patients.

70 men (39.77%) and 106 women (60.23%) average 35.25 years old, extremes 6 and 81 years. It was 158 cases of banal germ arthritis (89%) and 18 cases of tuberculosis arthritis (11%). The arthritis localised on knee in 42% of cases, hip 30%, sacroiliac joint 17% and shoulder 7%. Localization was multiple in 12%. A portal of entry was identified in 54% of cases. It was cutaneous in 21.5% and obstetrical in 16.5%. Risk factors were alcohol and tobacco (5.6%), diabetes mellitus (4%), sickle cell anaemia (4%) and HIV (3%). The diagnosis delay beyond of one month has been noted in 2/3 of cases. The causal germ can be isolated only in 30% of cases. It was staphylococcus aureus in 46.4% of cases, streptococcus in 10,7% and enterobacteria in 10.7% of cases. Koch bacillus has been isolated in 32% of cases. Inflammatory syndrome was important with an erythrocyte sedimentation rate upper 50 mm in 71% of cases. On X-ray, we noted in 64% of cases cartilaginous destruction signs and erosions in mirror. Antibiotics treatment associated to plastered immobilization were successful in 78% of cases but with functional prognostic in half of cases. The middle length of hospitalization was 25 days. Four patients died.

Septic arthritis are very frequent in African tropical environment, localized to knee, hip and sacroiliac joint. Staphylococcus is recovered in the half of cases and Koch bacillus in 1/3 of cases. Late diagnosis explains cartilaginous destructions and ulterior functional prognostic.