bone, joint, and muscle disorders
Infectious Arthritis
Treatment of Infectious Arthritis
Antibiotics or antifungal drugs Removal of pus Splinting of the joint, followed by physical therapy Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) and sometimes other analgesics are used to help reduce pain, inflammation, and fever. It is important to start antibiotics as soon as an infection is suspected, even before the laboratory has identified the infecting organism. Antibiotics that kill the bacteria that are most likely causing the infection are given until the infecting organism is identified, usually within 48 hours of testing the joint fluid. Antibiotics are given by vein (intravenously) at first to ensure that enough of the drug reaches the infected joint. If the antibiotics are effective against the infecting bacteria, some improvement usually occurs within 48 hours. As soon as the doctor receives the laboratory results, the antibiotic may be changed depending on the sensitivity of the particular bacteria to specific antibiotics. Intravenous antibiotics are continued for 2 to 4 weeks. Then, antibiotics are given by mouth at high doses for another 2 to 6 weeks. An infection that lasts a long time and that does not go away after use of conventional antibiotics may be caused by mycobacteria or fungi. Infections caused by fungi are treated with antifungal drugs. Infections caused by mycobacteria are treated with a combination of antibiotics. Infections caused by fungi and mycobacteria require long-term treatment. Infections caused by viruses usually get better without antibiotic treatment. The doctor often removes pus with a needle (aspiration) to prevent its accumulation because accumulated pus may damage a joint and may be more difficult to cure with antibiotics. If drainage with a needle is difficult (as with a hip joint) or unsuccessful, Arthroscopy (a procedure using a small scope to view the inside of the joint directly) or surgery may be needed to drain the joint. Aspiration is often done more than once. Sometimes a tube is left in place to drain the pus. Splinting of the joint (to keep it from moving) is done for the first few days of the infection to help ease pain, but Physical Therapy (PT) is then started to strengthen muscles and prevent stiffness and permanent loss of function. 