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Clinical characteristics and outcomes in polyarticular septic arthritis

Sarah B Lieber1, Mary Louise Fowler2, Clara Zhu2

  • 1Department of Medicine, Beth Israel Deaconess Medical center, Harvard Medical School, 330 Brookline Avenue, 02215 Boston, Massachusetts, USA.

Joint Bone Spine
|September 18, 2017
PubMed
Abstract

Insights

Septic polyarthritis, though rarer, presents with systemic infection more often than septic monoarthritis. However, both conditions show similar outcomes and treatment responses, even with rheumatoid arthritis comorbidities.

Area of Science:

  • Rheumatology
  • Infectious Diseases
  • Clinical Medicine

Background:

  • Septic polyarthritis is a rare but serious condition with higher mortality than septic monoarthritis.
  • Distinguishing septic polyarthritis from noninfectious inflammatory arthritis can be clinically challenging.
  • This study aims to differentiate septic monoarthritis from polyarthritis using a large patient sample.

Purpose of the Study:

  • To compare the clinical characteristics, microbial profiles, and outcomes of septic monoarthritis and septic polyarthritis.
  • To investigate the impact of rheumatoid arthritis on patients with septic polyarthritis.
  • To identify factors distinguishing septic polyarthritis from septic monoarthritis.

Main Methods:

  • Retrospective study of adult patients admitted to tertiary care.
  • Analysis of baseline characteristics, microbial profiles, joint involvement, length of stay, and readmission rates.
  • Comparison of septic monoarthritis and septic polyarthritis cases, including those with rheumatoid arthritis.

Main Results:

  • Septic polyarthritis patients were more likely to have rheumatoid arthritis, sepsis, and elevated white blood cell counts.
  • Operative intervention rates were similar, but septic polyarthritis had a longer hospital stay.
  • Patients with septic polyarthritis, with or without rheumatoid arthritis, had similar presentations and outcomes, barring immunosuppressive therapy use in rheumatoid arthritis cases.

Conclusions:

  • Septic polyarthritis is more frequently associated with systemic infection at presentation compared to septic monoarthritis.
  • Despite differences in presentation, septic monoarthritis and polyarthritis generally have similar patient outcomes.
  • Rheumatoid arthritis is more common in septic polyarthritis, but its presence does not significantly alter presenting features or outcomes.
Keywords:
Monoarticular septic arthritisPolyarticular septic arthritisRheumatoid arthritis

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