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Updated: Aug 5, 2026
Murine Renal Transplantation Procedure
Published on: July 10, 2009
Infectious arthritis in renal transplant patients
Abstract:
Infectious complications in the renal transplant patient are common, and infecting agents include opportunistic organisms as well as common pathogens. However, we were only able to document 6 patients who had septic arthritis from more than 800 who received a renal transplant at our institution over an 18-year period. Furthermore, only 16 other cases of infectious arthritis have been reported in the literature. All of our patients had an apparent predisposing factor and 3 patients had prior infection with the same organism. The knee was the most commonly infected joint. The initial synovial fluid white blood cell count was usually greater than 30,000 cells/mm3, but 1 patient with viral arthritis initially had noninflammatory fluid. The peripheral blood white blood cell count may not be elevated. All of our cases of initial joint infection occurred by 18 months posttransplant. Blood cultures were positive in 3 of 4 patients with bacterial infection. Followup of these 6 patients averaged 4.3 years. Numerous other rheumatologic syndromes and disorders peculiar to the posttransplant period may mimic a septic joint. Consequently, despite the low frequency of occurrence of septic arthritis, persistent attention to the locomotor system in the transplant patient is warranted.
Insights
Septic arthritis is rare in renal transplant recipients, occurring in only 6 of over 800 patients. Early diagnosis and attention to the musculoskeletal system are crucial despite its low frequency.
Area of Science:
- Nephrology
- Rheumatology
- Infectious Diseases
Background:
- Infectious complications are common in renal transplant patients.
- Septic arthritis is an infrequent but serious complication.
- Literature review revealed only 16 reported cases of infectious arthritis in transplant patients.
Purpose of the Study:
- To document the incidence and characteristics of septic arthritis in renal transplant recipients.
- To identify predisposing factors and clinical features of septic arthritis in this population.
- To emphasize the importance of monitoring the locomotor system in transplant patients.
Main Methods:
- Retrospective case review of renal transplant recipients over an 18-year period.
- Analysis of clinical data, synovial fluid analysis, and blood cultures.
- Literature search for reported cases of infectious arthritis in transplant patients.
Main Results:
- Six cases of septic arthritis were identified among over 800 renal transplants.
- The knee was the most commonly affected joint.
- Predisposing factors were present in all cases, with 3 having prior infections with the same organism. Initial joint infection occurred within 18 months post-transplant. Synovial fluid white blood cell counts were typically elevated, but peripheral blood counts were not always indicative. Blood cultures were positive in most bacterial cases.
Conclusions:
- Septic arthritis is a rare but significant complication in renal transplant recipients.
- Early recognition and management are essential, considering potential mimics.
- Vigilance regarding the musculoskeletal system is warranted in post-transplant care.
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