II. Causes: Septic Arthritis Causes based on age

  1. Infant (age <3 months, contiguous spread from Osteomyelitis)
    1. Staphylococcus aureus (common)
    2. Neisseria gonorrhoeae (common)
    3. Enterobacteriaceae
    4. Group B Streptococcus
  2. Children (age 3 months to 14 years)
    1. No cause identified in one third of cases
    2. Staphylococcus aureus (27%)
    3. Streptococcus (14%)
      1. Streptococcus Pyogenes
      2. Streptococcus Pneumoniae
    4. HaemophilusInfluenzae (<3% of cases, much less common in U.S. since start of Hib Vaccine)
    5. Gram Negative Bacilli
  3. Adults with STD risk
    1. Neisseria gonorrhoeae (most common)
      1. See Gonococcal Arthritis
      2. Gonorrrhea is a still a leading cause in young adults with Septic Arthritis
      3. More common in women by a factor 3-4
      4. Typically Migratory Arthritis
    2. Staphylococcus aureus
    3. Streptococcus
    4. Gram Negative Bacilli
    5. Syphilis
  4. Adults with no STD risk
    1. Staphylococcus aureus (50%)
    2. Streptococcus species
    3. Gram Negative Bacilli

III. Causes: Iatrogenic or Trauma related Septic Arthritis

  1. Joint aspiration or injection
    1. Staphylococcus aureus
  2. Joint Trauma
    1. Gram Negative Bacilli
    2. Anaerobic Bacteria
    3. Staphylococcus aureus
  3. Joint prosthesis
    1. Early infection
      1. Staphylococcus epidermidis
    2. Late Infection
      1. Gram Positive Cocci
      2. Anaerobic Bacteria
  4. Umbilical catheter (UAC or UVC) use in the newborn
    1. Risk of septic hip

V. Causes: Chronic Monoarticular Arthritis

VI. Causes: Acute Polyarticular Septic Arthritis

VII. Causes: Septic Arthritis related to Occupation or Travel

  1. Gardening or agricultural
    1. Sporothrix schenckii
    2. Brucella
  2. Marine related
    1. Mycobacterium marinum
  3. Immigrant
    1. Mycobacterium tuberculosis

VIII. References

  1. Gilbert (2012) Sanford Guide to Antimicrobials
  2. Stimmler (1996) Postgrad Med 99(4):127-39 [PubMed]

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