Abordaje de artritis séptica en el paciente pediátrico

Abstract

Septic arthritis is an inflammatory process of bacterial origin located in the joints, particularly synovial joints. The most common cause of infection is via hematogenous dissemination and the most frequently involved microorganism is Staphyloccocus aureus. The highest incidence of age ranges between 2 and 6 years old, predominantly in males, and the most affected joints are the knee and hip. The infection is generated when the bacteriostatic activity of the synovial space is overcome by the bacterial load and thereafter a pronounced inflammatory response is produced. Clinical manifestations usually include joint pain, limitation of movement, inability to bear weight, and fever, however it is necessary to identify risk factors and correlate the clinical findings with laboratory studies and imaging studies like X-ray and ultrasound for a better diagnostic approach since the differential diagnosis is ample and symptoms may be similar to the ones found in other causes of arthritis. Blood cultures and joint aspirate culture is a fundamental step for diagnosis, nevertheless the latter is frequently negative, as a result other diagnostic tests have been implemented such as the polymerase chain reaction for better therapeutic adjustment. Considering this information, it is important to start treatment as soon as possible because of the risk of complications. The management of septic arthritis consists mainly of surgical drainage and antibiotic treatment administered ideally after cultures.