Treatment and Outcome

The principles of treatment are aggressive, appropriate antibiotic therapy and drainage of the infected synovial fluid. Antibiotics are usually given intravenously for the first week or two to ensure that blood levels are high. once an infection is under control oral antibiotics can be used. The choice of antibiotic ideally depends on the identity of the infecting organism. However, when treatment is started before the results of the joint fluid cultures are back from the laboratory, a choice is made based on the most likely organism in that setting and the appearance of organisms seen under the microscope. The initial antibiotic therapy is usually chosen to cover staphylococcal infection and is often cephazolin for infections that started in the community and vancomycin for infections acquired in a hospital. If a gram-negative infection is suspected, different antibiotics are selected or another antibiotic is added to broaden the spectrum of organisms covered. once an organism is cultured from the joint fluid, then the antibiotic treatment can be changed to target that organism specifically. Antibiotics treatment often lasts four to six weeks.

Joint fluid can usually be drained by aspirating it through a needle. This may need to be repeated if the fluid reaccumulates. The number of white blood cells in the synovial fluid decreases as the infection responds to treatment. completely draining a joint using a needle can sometimes be difficult because the fluid is thick and accumulates in pockets. If this happens arthroscopy is often performed to drain the fluid. Because draining the hip joint through a needle is difficult, surgical drainage is usually performed, either directly or by arthroscopy. The outcome of septic arthritis varies a lot depending on the causative organism, how long the infection has been present, and the response to antibiotic therapy. Gonococcal arthritis usually responds rapidly and completely to treatment, while staphylococcal infection responds much more slowly and often causes permanent joint damage. The outcome is worst in patients with other serious medical problems, immunosuppres-sion, and polymicrobial infection.

Prosthetic joints In patients with infected artificial joints the joint often needs to be surgically removed to allow the antibiotics to clear the infection. Prolonged antibiotic therapy, often for many months, is required to clear such an infection. If the infection clears, the surgeon may be able to reoperate and put in a new artificial joint.

Tuberculous or fungal arthritis Tuberculous arthritis requires standard treatment with a combination of drugs used to treat tuberculosis. Fungal arthritis is treated with an antifungal drug that is selected according to the sensitivity of the organism.

infective endocarditis This is an infection of the inner lining of the heart, usually involving one of the valves that controls the flow of blood through the heart. Of people who develop infective endocarditis, 75 percent have a previously damaged heart valve. This can be following previous rheumatic fever, an aortic valve with two rather than the normal three cusps, a leaking mitral valve (mitral valve prolapse), congenital heart disease, or an artificial heart valve. others at risk of developing infective endocarditis include intravenous drug users and those with long-standing intravenous lines for various reasons such as intravenous feeding and chemotherapy.

Arthritis Relief Now

Arthritis Relief Now

When you hear the word arthritis, images of painful hands and joints comes into play. Few people fully understand arthritis and this guide is dedicated to anyone suffering with this chronic condition and wants relief now.

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