Pyogenic infection

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Pyogenic infection

Pyogenic infection. The causative agents of pyogenic, i.e., purulent infections are primarily the so-called “banal pyogenic microorganisms,” such as gram-positive staphylococci and streptococci, as well as gram-negative Pseudomonas and Escherichia coli.

Table of contents:

Just by the nature and smell of the exudate, an experienced clinician can determine the predominant type of pathogen. However, you should not neglect taking a smear with an antibiogram, which serves as the basis for choosing an adequate antibiotic for treatment. • Staphylococcus: Creamy yellow, odorless pus. • Streptococci: liquid, yellow-gray pus. • Pseudomonas: blue-green pus with a sweet odor. • Escherichia coii: brownish pus with a fecal odor.

Slide 24 from the presentation “Purulent skin diseases” for medicine lessons on the topic “Skin diseases”

Dimensions: 960 x 720 pixels, format: jpg. To download a free slide for use in a medical lesson, right-click on the image and click “Save Image As.” " You can download the entire presentation “Purulent skin diseases.ppt” in a zip archive of 1390 KB in size.

Skin diseases

“Skin diseases” - There are common warts, flat warts, genital warts and senile warts. Symptoms of plaque scleroderma. A violet ring up to 6 mm wide remains along the periphery. Symptoms of systemic scleroderma. At the beginning of the process they are stained intensely with eosin, and then pale. Skin diseases.

“Skin diseases in dogs” - Recurrent superficial pyoderma. Itchy and inflamed skin in the groin due to a fungal infection. Myopathy and increased tone of the limbs. Pemphigus vegetans. Etiology. Papules and pustules on the lower abdomen. Folliculitis. Food allergies. Bilateral symmetrical baldness. The presence of pustules, erosions and severe conjunctivitis and blepharitis.

“Skin diseases” - Endocrine skin diseases - are caused by an excess or deficiency of the hormone. Nutritionally caused skin diseases. Acrodermatitis from licking. Plan. Superficial pyodermatitis: Allergic skin diseases: Etiology: Photodermatosis. Superficial and deep. Classification of pyoderma: Skin diseases caused by the environment.

“Purulent skin diseases” - Treatment. Eryzepeloid. Carbuncle. Furuncle. Gas gangrene. Types of infections. Pyogenic infection. Hidradenitis. Treatment and prevention. Putrid infection. Classification of purulent skin diseases. Localization of purulent processes in the skin. Erysipelas. Clinic. Purulent diseases of the skin and subcutaneous tissue. Phlegmon.

“Psoriasis” - SRS On the topic: Psoriasis: diagnostic algorithm in SVA conditions. Palmoplantar psoriasis. Pie chart showing the percentage distribution of patients with different severity levels of psoriasis. There are several scales for assessing the severity of psoriasis. Vulgar psoriasis. Pustular psoriasis. Psoriatic arthritis.

“Hormones in dermatology” - Indications for use. When speaking of “hormones” in dermatology, in 90% of cases we are talking about glucocorticoids. Consequences of hormone use. Prednisolone: ​​cats -1-2 mg/kg every 12 hours; dogs - 0.5-1 mg/kg every 12 hours; Therefore... In other words... ALMOST an ideal drug for dermatology! The likelihood of complications.

There are a total of 7 presentations in the topic “Skin diseases”

Source: http://900igr.net/prezentatsii/meditsina/Gnojnye-zabolevanija-kozhi/024-Piogennaja-infektsija.html

Infectious (septic) arthritis

Infectious arthritis (otherwise called pyogenic or septic) is inflammation of the joint due to the activity of any pathogenic microorganisms. The pathological process can involve either one or several joints. The disease most often has an acute onset.

Causes

The disease is caused by viruses, bacteria or fungi. Most often, pathogenic microorganisms enter the joint with lymph or blood from another affected organ, for example, from the nasopharynx or intestines. Less commonly, the infection enters the joint cavity directly, for example, as a result of injuries or intra-articular injections. In the first case, arthritis is called primary, in the second - secondary.

The causative agent of infectious arthropathy in young children (under 2 years of age) is most often staphylococcus and Haemophilus influenzae, and in older children - hemolytic streptococcus. Newborns and infants become infected from the mother when passing through the birth canal or during breastfeeding.

The causative agents of septic arthritis in adults are often gonococcus, salmonella, Pseudomonas aeruginosa, pneumococcus, spirochete pallidum (the causative agent of syphilis) and other microorganisms. During surgical operations, as a rule, infection with epidermal staphylococcus occurs.

Viruses are also the cause of this disease. Most often these are mumps, rubella, hepatitis B viruses, as well as paraviruses. Less commonly, the cause of inflammation is mycobacterium tuberculosis and fungi. In the case of a viral nature of the disease, infectious arthritis usually takes a chronic course.

Bacterial arthritis often has more severe symptoms than viral and fungal arthritis. Due to the purulent inflammatory process, bacterial arthritis often results in complications.

The mechanism of development of the inflammatory process in the joint

Pathogenic microorganisms enter the joint and begin to produce toxins, antigens, and immune complexes. As a result, the inflammatory process mechanism is launched. Leukocytes try to destroy foreign microorganisms, which is accompanied by the release of enzymes that damage the structural elements of the joint. As infectious arthropathy progresses, articular cartilage is gradually destroyed, swelling develops, and pain occurs.

Provoking factors

Many people have one or another infection, for example, caries or sinusitis. However, not all of them develop septic arthritis. In order for the inflammatory process in the joint capsule to begin to develop, in addition to the presence of infection in the body, the presence of provoking factors is necessary. The main ones are:

  • metabolic disease;
  • pathology of the immune system;
  • general weakening of the body as a result of chronic diseases;
  • increased load on joints;
  • overweight;
  • injuries;
  • unbalanced diet;
  • lack of vitamins and minerals;
  • smoking;
  • alcohol abuse.

Symptoms

With septic arthritis, exudate forms in the joint capsule. It can be serous, fibrinous or purulent in nature. The activity of foreign microbes causes general intoxication of the body. These factors cause the following symptoms in patients:

  • Pain in the joint and swelling of the surrounding soft tissues.
  • Redness and local increase in temperature in the area of ​​inflammation.
  • Restriction of movement in the affected joint.
  • Weakness, drowsiness, headache.
  • Increased body temperature, which is especially characteristic of a purulent process.

The disease occurs more often in an acute form. With improper treatment, as well as in the presence of some nonspecific microorganisms, for example, fungi or Treponema pallidum, it takes a chronic course. In this case, all the symptoms of the disease are less pronounced.

Gonococcal arthritis is characterized by such a symptom as the appearance of multiple skin lesions - blisters, erosions, ulcers. With this type of bacterial infection, as a rule, several joints become inflamed at once.

With non-gonococcal etiology of the disease, one joint is usually affected (knee, elbow, ankle, wrist, shoulder or hip). In children, the pathological process most often develops in the knee joint, less often in the hip or ankle.

Reactive arthritis

Reactive arthritis, in which neither infectious agents nor their toxins are usually detected directly in the joint, constitutes a special group. The disease usually begins a few weeks after the infection with inflammation of the genitourinary canal. Often, such patients have Reiter's syndrome. In addition to inflammation of the joints, it also includes conjunctivitis, urethritis or cervicitis (inflammation of the cervix), as well as characteristic skin lesions (thickening of the stratum corneum).

With the development of laboratory diagnostic methods, it was still possible to detect DNA fragments of microorganisms and chlamydia, as well as immune complexes, in the joints of patients. However, these data do not establish the true cause of the disease, since normally the joint, even in a healthy person, is not sterile. A relationship was identified between reactive arthritis and a special antigen HLA-B27, reacting with which the patient’s body’s antibodies damage its own tissues.

The cause of reactive arthritis can be many microorganisms: salmonella, shigella, chlamydia, mycoplasma, clostridia and many others. However, the causes of the pathological process have not been fully elucidated. There are several hypotheses explaining the development of the disease. Most of them are associated with the presence of a certain defect in the patient's immune system.

This disease is characterized by predominantly unilateral damage to the large joints of the lower extremities (ankle, knee). Its complications are myocarditis, pericarditis, glomerulonephritis, polyneuritis.

Complications

A long-term inflammatory process can lead to deformation of the joint, including complete loss of mobility. Arthritis of infectious, or any other etiology, can lead to disability.

A complication of pyogenic arthritis is the formation of phlegmon in the soft tissues surrounding the joint. For example, a consequence of infectious arthritis of the knee joint may be the formation of phlegmon in the lower leg or thigh. When bone tissue is involved in the pathological process, osteoarthritis and osteomyelitis can develop. A life-threatening condition is sepsis, when a generalized bacterial infection enters directly into the blood.

Features of the disease in children

Infectious arthritis in children often occurs due to measles, rubella, and mumps. All symptoms of the disease in children are usually pronounced. It begins with a rise in temperature, the affected joint swells significantly, and children complain of severe pain. Infectious arthropathy in children often affects the eyes and many other organs.

Diagnostics

An arthrologist is a specialist in the diagnosis and treatment of diseases associated with joint damage. The doctor establishes the connection between the emerging inflammatory process and the disease preceding it and examines the patient. Biochemical and general blood and urine tests are prescribed, as well as diagnostic tests to identify the causative agent of the disease.

Diagnosis uses a blood test for C-reactive protein. This indicator is a marker of the presence of infection in the body, and its level depends on the stage of the disease. C-reactive protein increases many times during inflammatory processes and decreases with effective treatment. The C-reactive protein test is also effectively used in the diagnosis of sepsis.

For an accurate diagnosis, radiography, computed tomography or magnetic resonance imaging are indicated. If necessary, the doctor examines the joint cavity using a special device (arthroscope), which is inserted through a minor incision in the soft tissues. Diagnostic puncturing may be necessary to collect synovial fluid for examination.

Treatment

The method of treating infectious arthritis depends on what pathogens caused the inflammation, as well as on the form and stage of the disease. It is necessary to treat acute arthritis in a hospital in order to prevent possible complications. In the presence of a purulent process, opening and drainage of the source of infection is indicated. Therapeutic treatment of a chronic disease is usually carried out on an outpatient basis.

The doctor prescribes tests to determine the sensitivity of the identified microorganisms to drugs. Depending on the type of pathogen, treatment is carried out with antibacterial, antifungal or antiviral drugs. Anti-inflammatory drugs are used, and in difficult cases - hormonal. If necessary, medications are injected directly into the joint cavity. To restore cartilage tissue, chondroprotectors are prescribed.

Physiotherapy is effective, as a rule, when the acute inflammatory process subsides. In the practice of treating the disease, magnetic therapy, mud therapy, and warming are used. Massage and special therapeutic exercises help maintain and restore joint mobility. If therapeutic methods of treatment are ineffective, surgical intervention is required, most often joint replacement.

Prevention

Prevention of this disease consists of timely elimination of all possible foci of infection in the body and treatment of any inflammatory processes. It is necessary to balance the diet by reducing the consumption of easily digestible carbohydrates, animal fats, and carbonated drinks. It is necessary to ensure sufficient intake of magnesium and calcium in the body. It is recommended to eat fatty fish, as it contains polyunsaturated fatty acids that normalize metabolism. You should also stop smoking and drinking alcohol.

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Pyogenic granuloma

Etiology of pyoderma

Pathogenesis of pyoderma

— Skin contamination, non-compliance with hygiene standards, excessive degreasing of the skin.

— Violation of the secretory function of the skin.

— Diseases of the gastrointestinal tract.

— Metabolic disorders.

— Diseases of the endocrine system.

— Neuroses, mental trauma.

— Immune deficiency, HIV infection.

Clinic of pyogenic granuloma

Differential diagnosis of pyogenic granuloma

Treatment of pyogenic granuloma

1. Disinfecting, therapeutic baths with a solution of potassium permanganate, sea salt, 2% soda, 2% boric acid, 5% ichthyol.

2. Disinfectant creams, ointments.

1. Destruction with a sharp spoon, diathermocautery, Sol. Argenti nitrati 10%, etc.

2. Granuloma surgery.

3. Laser surgery.

1. Antibacterial agents (antibiotics, fucidin, sulfonamide drugs).

Laser therapy to improve microcirculation.

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Specializations: Venereology, Dermatology.

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Causative agents of sinusitis - who are they? Staphylococci, streptococci, rhinoviruses, fungi and other microorganisms

Scientists have proven that in all cases of acute sinusitis, the direct cause of the inflammatory process lies in infection. The situation with chronic inflammation of the maxillary sinuses is somewhat more complicated, but even then the infection can play a role in the development of the disease. Who are they, the causative agents of sinusitis?

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general information

Inflammation of the maxillary sinuses can begin for various reasons. Hypothermia (and sometimes, on the contrary, overheating), dental diseases, polyps in the nasal cavity, cysts and many other factors lead to the development of the disease. However, regardless of what was the impetus for the onset of the disease, inflammation will not begin until intensive proliferation of microbes occurs in the sinuses.

It is microbes that are the enemies of the body that spin the flywheel of acute sinusitis, and sometimes “help” it pass into the chronic stage. And you need to know your enemies by sight - after all, it’s very difficult to “blindly” cope with their onslaught.

So, the development of sinusitis may involve:

Let's take a closer look at the representatives of each of these classes.

Viruses that infect the sinuses

Viruses are small infectious agents that can live and reproduce only inside living cells of other organisms. The diversity of viruses amazes the human imagination: today about 5,000 species of these microbes are known.

Rhinosinusitis and sinusitis (including sinusitis) in the vast majority of cases are caused by viruses. At the same time, the most dangerous pathogens for the maxillary sinuses are:

  • rhinoviruses are RNA viruses that cause diseases of the upper respiratory tract (bronchitis, otitis, sinusitis).

Interestingly, within 1–2 years after rhinovirus infection, the human body develops immunity to rhinoviruses;

  • coronaviruses, which are responsible for 4.5–10% of respiratory infections.

    Most often these are bronchitis and lesions of the lungs, much less often - the paranasal sinuses. In addition, coronavirus can cause diseases of the gastrointestinal tract. Thus, if acute sinusitis occurs along with gastroenteritis (inflammation of the mucous membrane of the stomach and intestines, accompanied by vomiting, diarrhea and abdominal pain), a coronavirus infection can be assumed;

  • influenza A and B viruses;
  • parainfluenza viruses.

    Parainfluenza is a disease that resembles the flu in symptoms, but has a milder course and fewer complications;

  • Human respiratory syncytial viruses are the main cause of viral diseases of the lower respiratory tract in children.

    The peculiarity of these viruses is that the diseases they cause are relatively mild. Most often, respiratory syncytial virus causes bronchitis and pneumonia;

  • adenoviruses are DNA viruses that are highly contagious (easily transmitted from person to person).

    Many types of adenoviruses are known, but only six of them cause diseases of the upper and lower respiratory tract, including acute sinusitis;

  • enteroviruses are causative agents of intestinal infections.

    • In half of the cases of infection, the disease occurs in an erased form.

    Viral infection: acute inflammation only!

    Viruses can cause exceptionally acute sinusitis. With a normally functioning immune defense, the body copes with the viral infection on its own, and the microbe dies 7–10 days after infection. That is why there is no doubt about the correctness of the famous phrase “If you treat a cold, it will go away in seven days, and if you leave the situation to its own devices, you will recover in a week.”

    So, you ask, can viral sinusitis be “cured” without treatment? Theoretically, yes. A respiratory virus, passing sequentially through all stages of development - from contact with the mucous membrane to reproduction - inevitably dies. And the inflammation should stop along with the death of the pathogen.

    However, a viral inflammatory process in a confined space, such as the paranasal sinus, left to its own devices, has too many chances to further develop and degenerate into a bacterial form. And it is much more dangerous than a viral one, and much more difficult to treat. And then either acute bacterial sinusitis or chronic inflammation of the maxillary sinuses develops. To avoid this, you need to treat viral sinusitis. And on time and with full responsibility.

    Bacterial sinus infections

    Approximately 5–10% of patients with viral sinusitis, despite the measures taken to combat the disease, do not emerge victorious from this battle. They are waiting for a complication of primary viral inflammation - a bacterial infection. In such cases, serious treatment is no longer possible.

    Unlike respiratory viruses, bacteria do not die at the end of their evolutionary path: they are able to reproduce indefinitely and maintain the inflammatory process.

    The only effective countermeasure is antibacterial drugs, that is, antibiotics. And their selection depends on what kind of microbe lives in the body.

    That is why doctors pay special attention to identifying the pathogen. So, what exactly bacteria become the causative agents of acute and chronic sinusitis?

    Pneumonia streptococcus

    Streptococcus pneumoniae is a Gram-positive facultative anaerobic bacterium of the genus Streptococcus.

    It is known that streptococcus pneumoniae can live in the nasopharynx of healthy people without causing any harm, being an opportunistic bacterium. Under unfavorable conditions, for example, in the elderly, children, and patients with weakened immune systems, the microorganism becomes pathogenic. It provokes pneumonia, acute sinusitis, other sinusitis and even meningitis.

    It is known that in 20–43% of cases, acute inflammation of the maxillary sinuses in adult patients is associated with streptococcus pneumoniae. The unstoppable growth of Streptococcus pneumoniae resistance to antibiotics is considered a rather serious problem today. According to the most conservative estimates, about 40% of strains are resistant to penicillins.

    The situation with antibiotic resistance is complicated by the fact that the localization of bacteria in the closed maxillary sinuses helps the bacteria resist the effects of drugs.

    Haemophilus influenzae

    Haemophilus influenzae is a gram-negative anaerobic microorganism. Most strains of Haemophilus influenzae are also opportunistic. They live in the body without causing disease, and cause trouble only when unfavorable factors appear. Despite the fact that an effective vaccine against Haemophilus influenzae was created back in 1990, the bacterium still remains the main cause of lower respiratory tract infections in children.

    Haemophilus influenzae, in addition to acute sinusitis and inflammation of other paranasal sinuses, causes pneumonia, acute meningitis, otitis media, conjunctivitis, osteomyelitis and even infectious arthritis.

    Moraxella

    Moraxella catarrhalis is a Gram-negative aerobic bacterium that causes infections of the respiratory tract, middle ear, eyes, nasopharynx, central nervous system and joints. Moraxella is very fond of the lower respiratory tract, causing bronchitis and bronchopneumonia. A rather severe complication of Moraxella catarrhalis infection is chronic obstructive pulmonary disease. In addition, laryngitis and sinusitis, including acute sinusitis, are associated with Moraxella.

    Peak infection with Moraxella catarrhalis occurs in early childhood—1–2 years of age. In adults, the bacterium “takes root” worse and less often, however, having “taken root”, it causes bacterial pneumonia, acute purulent sinusitis, meningitis, urethritis (inflammation of the urethra) and, quite rarely, sepsis and septic arthritis. We add that Moraxella, like the two previous sinusitis pathogens, is considered an opportunistic pathogen that causes harm to people with a weakened immune system.

    Streptococcus pyogenes

    Streptococcus pyogenes or group A streptococcus is a Gram-positive spherical microorganism that causes a variety of diseases in humans, from mild skin inflammations to life-threatening systemic infections.

    Examples of classic streptococcus pyogenes infections are pharyngitis (inflammation of the lymphoid tissue of the pharynx) and a localized skin infection called impetigo. Streptococcus pyogenes never ceases to amaze doctors with its heteropolarity: it can cause ordinary sore throat and acute grosserulonephritis, rheumatism and the most dangerous streptococcal toxic shock, sinusitis and scarlet fever.

    An undeniably positive feature of streptococcus pyogenes is its high sensitivity to penicillin, which makes it quite easy to combat.

    Staphylococcus aureus

    The famous Staphylococcus aureus is a ball-shaped gram-positive bacterium that affects the respiratory tract and skin. Its remarkable property is that it is not always pathogenic.

    Often, Staphylococcus aureus inhabits our mucous membranes, and we are not even aware of this sad cohabitation. But as soon as the immune system fails, the disease is right there.

    Staphylococcus aureus is responsible for many infections, including furunculosis, carbunculosis, arthritis, endocarditis, pneumonia, nasopharyngeal diseases, including sinusitis, otitis media and others.

    The danger of the pathogen lies in its high resistance to both adverse environmental factors and antibacterial agents. The microbe, depending on the specific strain, can survive from a few hours to weeks or even months on dry surfaces. Treatment of Staphylococcus aureus is often a very serious problem that becomes an insurmountable obstacle to recovery.

    The drugs of choice for infection with Staphylococcus aureus are penicillins. However, back in the 50s of the last century, bacterial strains learned to resist them: even then, about 40% of microbes in this group were resistant to penicillin antibiotics. By 1960, this figure had risen to 80%. And today, therapy for Staphylococcus aureus is carried out through trial and error, which often results in the transfer of the infection to a “dormant” state. Which, at the first opportunity, easily becomes active.

    One of the most formidable and antibiotic-resistant strains of Staphylococcus aureus is methicillin-resistant (MRSA). It can provoke chronic sinusitis, and in such cases the disease takes a persistent course and is extremely difficult to treat.

    Pseudomonas aeruginosa

    In just over 15% of cases of acute sinusitis, the infection is associated with Pseudomonas aeruginosa, a gram-negative bacterium. It is also considered opportunistic, that is, causing disease only when immunity is reduced. Pseudomonas aeruginosa can “sleep” for many years, only to wake up and cause pneumonia, bronchopneumonia, urogenital tract infections, gastrointestinal infections, skin or soft tissue infections, and sometimes sinusitis (sinusitis).

    Escherichia coli

    Harmless Escherichia coli, which is an important component of the human flora, can also cause the disease. A gram-negative anaerobic bacterium in the form of a stick, which colonizes in huge quantities in the large intestine (it constitutes up to 0.1% of the microbial flora), has many strains. Most of them are useful or, at worst, harmless. However, some virulent E. coli can cause gastroenteritis, urinary tract infections, meningitis in newborns, peritonitis, mastitis, pneumonia and, fortunately, quite rarely, sinusitis.

    Proteus mirabilis

    In 7% of patients with acute sinusitis, the disease develops due to infection with Proteus mirabilis. This rod-shaped gram-negative anaerobic bacterium is often found in kidney stones. It also provokes wound infections, pneumonia and sepsis. Proteus is quite easy to treat with antibiotics.

    Klebsiella pneumonia

    Klebsiella pneumoniae, a gram-negative anaerobe that often causes inflammation in the lungs, typically affects people with weakened immune systems. Most often, middle-aged and elderly people suffering from chronic diseases become victims of the bacteria.

    Enterobacteriaceae

    Enterobacter is a whole genus of gram-negative microorganisms; some strains of enterobacteria are considered pathogenic and cause diseases in people with reduced immunity.

    When the pathogens are fungi

    Fungal sinusitis is a fairly rare disease that most often develops with an insufficient immune response. Among fungi, there are several pathogens that most often cause sinusitis.

    Aspergillus

    Fungi of the genus Aspergillus include several hundred representatives distributed throughout the world. They can cause serious illness in humans. The most common species are A. fumigatus and A. flavus. Aspergilli cause aspergillosis, a group of diseases that have several main forms. In ENT practice, doctors are faced with allergic bronchopulmonary aspergillosis, which affects patients with respiratory diseases, including sinusitis and sinusitis.

    Alternaria

    The Alternaria genus includes about 300 species of fungi, some of which are recognized as causative agents of fungal skin infections, sinusitis (including sinusitis), osteomyelitis and other diseases. In addition, Alternaria are strong allergens that are widespread everywhere and provoke hay fever and other allergic reactions, including bronchial asthma.

    Bipolaris

    Colonies of fungi of the genus Bipolaris are causative agents of fungal keratitis, sinusitis, peritonitis and other infections.

    Culvularia

    Curvularia are fungi that colonize plants and soil. They are more common in the tropics, but cases of their detection have also been recorded in more severe temperature conditions. Culvularia can cause fungal keratitis, sinusitis, endocarditis, peritonitis and other diseases.

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    Infectious (pyogenic) arthritis

    What is Infectious (pyogenic) arthritis?

    Infectious arthritis, also called septic arthritis or pyogenic arthritis, is a serious infectious joint disease characterized by pain, fever, chills, redness and swelling of one or more joints, and loss of motion in the affected joints. This condition is a medical emergency.

    Infectious arthritis occurs in all age groups, including newborns and children. In adults, the disease usually affects the hands or joints that bear a special weight load - most often the knees. Approximately 20% of adult patients experience symptoms in more than one joint. In children, polyarthritis develops due to infection and usually affects the shoulder, knee and hip joints.

    The following patients are at increased risk of developing infectious arthritis:

    - patients with chronic rheumatoid arthritis.

    - patients with serious systemic infections, including gonorrhea and HIV infection.

    - men and women of homosexual sexual orientation are at increased risk of developing gonorrheal arthritis compared to heterosexuals.

    — patients with certain types of oncology.

    - drug and alcohol dependent patients.

    - patients with diabetes, sickle cell disease or systemic lupus erythematosus.

    - patients who have recently undergone injury or surgery on the joints

    - patients receiving intra-articular injections.

    What causes infectious (pyogenic) arthritis:

    In general, infectious arthritis is caused by bacterial, viral, or fungal infections that enter the joint through the bloodstream. The causative agents of the disease can enter the joint, bypassing the bloodstream during intra-articular injections or during surgery, as well as from the source of infection in the patient’s body. Pathogenic factors also vary depending on the age group. Newborns most often become infected with gonococcal infection from a mother with gonorrhea. Children may develop infectious arthritis as a result of hospital procedures, usually as a result of catheter insertion. In children under two years of age, the pathogenic organisms are usually either haemophilius influencae or staphylococcus aureus. In older children and adults, streptococcus pyogenes and streptococcus viridans are added to staphylococcus aureus. Involvement of Staphylococcus epidermidis usually occurs as a result of surgical operations. Infectious arthritis in sexually active adolescents and adults usually results from infection with Neisseria gonorrhoeae. Infectious arthritis in older adults is often caused by gram-negative bacteria, including Salmonella and Pseudomonas. Infectious arthritis usually begins suddenly, but sometimes symptoms worsen over a period of 3 days to 2 weeks - the affected joint becomes swollen and painful when moving. Infectious arthritis of the hip joint can manifest as pain in the groin area, which is significantly worse when trying to walk. The joint is painful to touch and may or may not be hot to the touch, depending on how deep the infection is. In most cases, the patient experiences fever and chills, but sometimes the temperature may be raised very slightly. Children may experience nausea and vomiting. Septic arthritis is regarded as a serious threat to the health and even life of the patient, since destruction of bone tissue and cartilage can occur, and there is also a high risk of developing septic shock, which can lead to death. Staphylococcus aureus is capable of destroying cartilage in 1-2 days. The destruction of cartilage and bone tissue subsequently leads to displacement (subluxation) of joints and bones. If the infection is caused by bacteria, it can spread into the blood and surrounding tissues, causing abscesses or even blood poisoning. The most common complication of infectious arthritis is osteoarthritis.

    Pathogenesis (what happens?) during Infectious (pyogenic) arthritis:

    Infectious arthritis is associated with the direct entry of infectious agents into the joint tissue during injury due to their lympho- or hematogenous introduction during septic conditions (actually infectious, septic arthritis) or the formation and deposition of immune cells in the joint tissue that cause inflammation (post-infectious arthritis). A special group consists of reactive arthritis, in which there is an obvious connection with a specific infection, but neither the pathogen itself nor its toxins are detected in the joint cavity. The mechanism of development of these arthritis is not well understood.

    The division of infection-related arthritis into infectious, post-infectious and reactive is very arbitrary, since even with modern advanced technology it is not always possible to identify the causative microbes, as well as their toxins in the joint.

    Symptoms of Infectious (pyogenic) arthritis:

    Local signs of acute purulent arthritis are pain in the joint, severe pain when moving in it, increasing swelling with changes in the contours of the joint, redness and local increase in skin temperature, dysfunction of the limb taking a forced position.

    Diagnosis of Infectious (pyogenic) arthritis:

    The diagnosis of “septic arthritis” is made only on the basis of laboratory tests, a thorough medical examination of the affected joint and a careful study of the patient’s medical record. It is important to keep in mind that similar symptoms - joint pain and fever - can be caused by other reasons, for example, other types of arthritis, gout, rheumatic fever, Lyme disease (borreliosis), etc. In some cases, the doctor is forced to consult a specialist - an orthopedist or rheumatologist to exclude an error in diagnosis.

    History of infectious arthritis

    The patient's medical history will allow the doctor to determine whether the patient belongs to one of the risk groups. Cases of sudden joint pain are also important information. Medical examination The doctor will assess the degree of swelling and tenderness of the affected joint, its temperature and other signs of the infectious process. In some cases, the location may be the key to the correct diagnosis, for example, damage to the sternoclavicular or pelvic joints often occurs in drug-dependent patients. Laboratory tests Laboratory tests are needed to confirm the diagnosis of infectious arthritis. The doctor will perform a puncture of the joint, this procedure involves a puncture with a syringe to extract a sample of synovial fluid. Synovial fluid is a lubricant produced by the tissues surrounding the joint. The sample is sent in a sealed syringe for culture. Synovial fluid from the affected joint usually contains flakes of pus and appears cloudy. Cell count determination usually reveals a high white blood cell count; level above/mm cu. or a neutrophil proportion greater than 90% indicates septic arthritis. For preliminary identification of the infectious agent, the so-called Gram stain (all bacteria are divided into two types: Gram-staining and non-Gram-staining - gram-positive and gram-negative. These groups of bacteria are differently sensitive to antibiotics. For final identification, a culture of the synovial fluid is performed. If the culture of the synovial fluid does not give growth, the doctor may order a biopsy and culture of the synovial tissue around the joint.Other tests, such as culture of urine, blood or mucus secreted by the cervix, may be ordered only in addition to the puncture.

    Hardware diagnostics of infectious arthritis

    Hardware diagnostics are ineffective in the early stages of the development of infectious arthritis. X-rays do not detect bone or cartilage destruction within days of the onset of symptoms. Obtaining any images can only sometimes be effective if the source of infection is in a deep joint.

    Treatment of Infectious (pyogenic) arthritis:

    Infectious arthritis usually requires several days of hospital treatment, followed by medications and physical therapy sessions over several weeks or months.

    If treatment is delayed, there is a risk of serious joint damage and other complications, so intravenous antibiotics should be started immediately, even before the causative agent of the infection is accurately identified. After identifying the causative agent of the infection, the doctor can prescribe a medicine that specifically affects these bacteria or viruses.

    Nonsteroidal anti-inflammatory drugs are usually prescribed for viral infections. The course of treatment with intravenous antibiotics is approximately 2 weeks (or until the inflammation disappears). After this, the patient may be prescribed a 2 or 4 week course of antibiotics in tablets (capsules).

    In some cases, surgical drainage of the infected joint is necessary. This applies to patients who are refractory to antibiotic treatment, or who have lesions in the hip or other joints that are difficult to access, or if the infectious arthritis is caused by a gunshot or other penetrating wound. Patients with severe bone and cartilage lesions may require reconstructive surgery, but surgery should only be performed once the infection has completely resolved.

    Medical observation and concomitant therapy

    During inpatient treatment, the patient is closely monitored, and the doctor must send a daily sample of synovial fluid for culture to monitor the patient's response to antibiotics. Infectious arthritis is often accompanied by severe pain. The patient is prescribed painkillers, and compresses may also be applied to the affected joint. In some cases, immobilization is recommended - applying a splint to the arm or leg to protect the joint from accidental movements. After immobilization, to speed up recovery, the patient must perform a special set of exercises to expand the range of motion (of course, without causing pain).

    Prognosis of infectious arthritis

    A favorable prognosis depends on immediate treatment with antibiotics and drainage of the infected joint. Approximately 70% of patients avoid permanent joint destruction, but many patients develop osteoarthritis or partial joint deformity. In children with infected hip joints, the bone growth plate may be destroyed. If treatment is not started promptly, the mortality rate from complications of infectious arthritis is 5%-30% due to septic shock and respiratory failure.

    Prevention of Infectious (pyogenic) arthritis:

    Some types of infectious arthritis can be prevented by appropriate lifestyle choices: abstinence from drug use, abstinence or monogamous sexual relationships, and prompt evaluation and treatment if gonorrhea is suspected.

    Source: http://www.med-09.ru/bs797.htm

    Infectious (pyogenic) arthritis

    • What is Infectious (Pyogenic) Arthritis?
    • What causes infectious (pyogenic) arthritis?
    • Pathogenesis (what happens?) during Infectious (pyogenic) arthritis
    • Symptoms of Infectious (pyogenic) arthritis
    • Diagnosis of Infectious (pyogenic) arthritis
    • Treatment of Infectious (Pyogenic) Arthritis
    • Prevention of infectious (pyogenic) arthritis
    • Which doctors should you contact if you have Infectious (pyogenic) arthritis?

    What is Infectious (Pyogenic) Arthritis?

    Infectious arthritis occurs in all age groups, including newborns and children. In adults, the disease usually affects the hands or joints that bear a special weight load - most often the knees. Approximately 20% of adult patients experience symptoms in more than one joint. In children, polyarthritis develops due to infection and usually affects the shoulder, knee and hip joints.

    The following patients are at increased risk of developing infectious arthritis:

    - patients with chronic rheumatoid arthritis.

    - patients with serious systemic infections, including gonorrhea and HIV infection.

    - men and women of homosexual sexual orientation are at increased risk of developing gonorrheal arthritis compared to heterosexuals.

    — patients with certain types of oncology.

    - drug and alcohol dependent patients.

    - patients with diabetes, sickle cell disease or systemic lupus erythematosus.

    - patients who have recently undergone injury or surgery on the joints

    - patients receiving intra-articular injections.

    What causes infectious (pyogenic) arthritis?

    In general, infectious arthritis is caused by bacterial, viral, or fungal infections that enter the joint through the bloodstream. The causative agents of the disease can enter the joint, bypassing the bloodstream during intra-articular injections or during surgery, as well as from the source of infection in the patient’s body. Pathogenic factors also vary depending on the age group. Newborns most often become infected with gonococcal infection from a mother with gonorrhea. Children may develop infectious arthritis as a result of hospital procedures, usually as a result of catheter insertion. In children under two years of age, the pathogenic organisms are usually either haemophilius influencae or staphylococcus aureus. In older children and adults, streptococcus pyogenes and streptococcus viridans are added to staphylococcus aureus. Involvement of Staphylococcus epidermidis usually occurs as a result of surgical operations. Infectious arthritis in sexually active adolescents and adults usually results from infection with Neisseria gonorrhoeae. Infectious arthritis in older adults is often caused by gram-negative bacteria, including Salmonella and Pseudomonas. Infectious arthritis usually begins suddenly, but sometimes symptoms worsen over a period of 3 days to 2 weeks - the affected joint becomes swollen and painful when moving. Infectious arthritis of the hip joint can manifest as pain in the groin area, which is significantly worse when trying to walk. The joint is painful to touch and may or may not be hot to the touch, depending on how deep the infection is. In most cases, the patient experiences fever and chills, but sometimes the temperature may be raised very slightly. Children may experience nausea and vomiting. Septic arthritis is regarded as a serious threat to the health and even life of the patient, since destruction of bone tissue and cartilage can occur, and there is also a high risk of developing septic shock, which can lead to death. Staphylococcus aureus is capable of destroying cartilage in 1-2 days. The destruction of cartilage and bone tissue subsequently leads to displacement (subluxation) of joints and bones. If the infection is caused by bacteria, it can spread into the blood and surrounding tissues, causing abscesses or even blood poisoning. The most common complication of infectious arthritis is osteoarthritis.

    Pathogenesis (what happens?) during Infectious (pyogenic) arthritis

    Infectious arthritis is associated with the direct entry of infectious agents into the joint tissue during injury due to their lympho- or hematogenous introduction during septic conditions (actually infectious, septic arthritis) or the formation and deposition of immune cells in the joint tissue that cause inflammation (post-infectious arthritis). A special group consists of reactive arthritis, in which there is an obvious connection with a specific infection, but neither the pathogen itself nor its toxins are detected in the joint cavity. The mechanism of development of these arthritis is not well understood.

    The division of infection-related arthritis into infectious, post-infectious and reactive is very arbitrary, since even with modern advanced technology it is not always possible to identify the causative microbes, as well as their toxins in the joint.

    Symptoms of Infectious (pyogenic) arthritis

    Local signs of acute purulent arthritis are pain in the joint, severe pain when moving in it, increasing swelling with changes in the contours of the joint, redness and local increase in skin temperature, dysfunction of the limb taking a forced position.

    Diagnosis of Infectious (pyogenic) arthritis

    The diagnosis of “septic arthritis” is made only on the basis of laboratory tests, a thorough medical examination of the affected joint and a careful study of the patient’s medical record. It is important to keep in mind that similar symptoms - joint pain and fever - can be caused by other reasons, for example, other types of arthritis, gout, rheumatic fever, Lyme disease (borreliosis), etc. In some cases, the doctor is forced to consult a specialist - an orthopedist or rheumatologist to exclude an error in diagnosis.

    History of infectious arthritis

    The patient's medical history will allow the doctor to determine whether the patient belongs to one of the risk groups. Cases of sudden joint pain are also important information. Medical examination The doctor will assess the degree of swelling and tenderness of the affected joint, its temperature and other signs of the infectious process. In some cases, the location may be the key to the correct diagnosis, for example, damage to the sternoclavicular or pelvic joints often occurs in drug-dependent patients. Laboratory tests Laboratory tests are needed to confirm the diagnosis of infectious arthritis. The doctor will perform a puncture of the joint, this procedure involves a puncture with a syringe to extract a sample of synovial fluid. Synovial fluid is a lubricant produced by the tissues surrounding the joint. The sample is sent in a sealed syringe for culture. Synovial fluid from the affected joint usually contains flakes of pus and appears cloudy. Cell count determination usually reveals a high white blood cell count; level above/mm cu. or a neutrophil proportion greater than 90% indicates septic arthritis. For preliminary identification of the infectious agent, the so-called Gram stain (all bacteria are divided into two types: Gram-staining and non-Gram-staining - gram-positive and gram-negative. These groups of bacteria are differently sensitive to antibiotics. For final identification, a culture of the synovial fluid is performed. If the culture of the synovial fluid does not give growth, the doctor may order a biopsy and culture of the synovial tissue around the joint.Other tests, such as culture of urine, blood or mucus secreted by the cervix, may be ordered only in addition to the puncture.

    Hardware diagnostics of infectious arthritis

    Hardware diagnostics are ineffective in the early stages of the development of infectious arthritis. X-rays do not detect bone or cartilage destruction within days of the onset of symptoms. Obtaining any images can only sometimes be effective if the source of infection is in a deep joint.

    Treatment of Infectious (Pyogenic) Arthritis

    Infectious arthritis usually requires several days of hospital treatment, followed by medications and physical therapy sessions over several weeks or months.

    If treatment is delayed, there is a risk of serious joint damage and other complications, so intravenous antibiotics should be started immediately, even before the causative agent of the infection is accurately identified. After identifying the causative agent of the infection, the doctor can prescribe a medicine that specifically affects these bacteria or viruses.

    Nonsteroidal anti-inflammatory drugs are usually prescribed for viral infections. The course of treatment with intravenous antibiotics is approximately 2 weeks (or until the inflammation disappears). After this, the patient may be prescribed a 2 or 4 week course of antibiotics in tablets (capsules).

    In some cases, surgical drainage of the infected joint is necessary. This applies to patients who are refractory to antibiotic treatment, or who have lesions in the hip or other joints that are difficult to access, or if the infectious arthritis is caused by a gunshot or other penetrating wound. Patients with severe bone and cartilage lesions may require reconstructive surgery, but surgery should only be performed once the infection has completely resolved.

    Medical observation and concomitant therapy

    During inpatient treatment, the patient is closely monitored, and the doctor must send a daily sample of synovial fluid for culture to monitor the patient's response to antibiotics. Infectious arthritis is often accompanied by severe pain. The patient is prescribed painkillers, and compresses may also be applied to the affected joint. In some cases, immobilization is recommended - applying a splint to the arm or leg to protect the joint from accidental movements. After immobilization, to speed up recovery, the patient must perform a special set of exercises to expand the range of motion (of course, without causing pain).

    Prognosis of infectious arthritis

    A favorable prognosis depends on immediate treatment with antibiotics and drainage of the infected joint. Approximately 70% of patients avoid permanent joint destruction, but many patients develop osteoarthritis or partial joint deformity. In children with infected hip joints, the bone growth plate may be destroyed. If treatment is not started promptly, the mortality rate from complications of infectious arthritis is 5%-30% due to septic shock and respiratory failure.

    Prevention of infectious (pyogenic) arthritis

    Some types of infectious arthritis can be prevented by appropriate lifestyle choices: abstinence from drug use, abstinence or monogamous sexual relationships, and prompt evaluation and treatment if gonorrhea is suspected.

    Which doctors should you contact if you have Infectious (pyogenic) arthritis?

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