II. Causes: General
-
Staphylococcus aureus
- Most common cause of Septic Arthritis in all ages
III. Causes: Septic Arthritis Causes based on age
- Infant (age <3 months, contiguous spread from Osteomyelitis)
- Children (age 3 months to 14 years)
- No cause identified in one third of cases
- Staphylococcus aureus (27%)
- Streptococcus (14%)
- HaemophilusInfluenzae (<3% of cases, much less common in U.S. since start of Hib Vaccine)
- Gram Negative Bacilli
- Kingella kingae (preschool children
- Adults with STD risk
- Neisseria gonorrhoeae (most common)
- See Gonococcal Arthritis
- Gonorrrhea is a still a leading cause in young adults with Septic Arthritis
- More common in women by a factor 3-4
- Typically Migratory Arthritis
- Staphylococcus aureus
- Streptococcus
- Gram Negative Bacilli
- Syphilis
- Neisseria gonorrhoeae (most common)
- Adults with no STD risk
- Staphylococcus aureus (50%)
- Streptococcus species
- Gram Negative Bacilli
IV. Causes: Iatrogenic or Trauma related Septic Arthritis
- Joint Aspiration or injection
- Joint Trauma or wound
- Gram Negative Bacilli
- Anaerobic Bacteria
- Staphylococcus aureus
- Polymicrobial infections
- Joint prosthesis
- Early infection
- Staphylococcus epidermidis
- Late Infection
- Early infection
- Umbilical catheter (UAC or UVC) use in the newborn
- Risk of septic hip
V. Causes: Septic Arthritis related to Comorbid Medical Conditions
-
Intravenous Drug Abuse
- Atypical Gram Negative Bacilli (e.g. Pseudomonas)
- Rheumatoid Arthritis
- Systemic Lupus Erythematosus or Sickle Cell Anemia
- Hemophilia
- Hemoglobinopathy (e.g. Sickle Cell Anemia)
-
Immunodeficiency
- Staphylococcus aureus
- Mycobacterium species
- Fungus
- Gram-Negative Bacteria
VI. Causes: Chronic Monoarticular Arthritis
- Brucella
- Nocardia
- Mycobacterium
- Fungus
VII. Causes: Acute Polyarticular Septic Arthritis
- See Polyarticular Joint Pain Causes
- Neisseria gonorrhoeae (most common)
- Lyme Disease
- Acute Rheumatic Fever
- Viral Hepatitis
- Parvovirus B19
- Syphilis
VIII. Causes: Septic Arthritis related to Occupation or Travel
- Gardening or agricultural
- Marine related
- Immigrant
IX. References
- Gilbert (2012) Sanford Guide to Antimicrobials
- Stimmler (1996) Postgrad Med 99(4):127-39 [PubMed]