Septic arthritis at Nakhonophanom Hospital

Abstract

The retrospective study was to review patients with septic arthritis at Nakhonphanom hospital between fiscal year 2014 - 2017. The purpose of this study were to describe the demographic pattern, duration before reaching hospital, signs and symptoms, site of infection, microbiology, treatment, outcome and length of stay. Determine the clinical differentialing between melioidotic and non melioidotic septic arthritis. Analyzed by percentage, mean, standard deviation, Chi-square test and Fisher’s exact test with significant level at p = 0.05.

The results of 96 patients show that male to female ratio was 1.28: 1, while most were older than 40 years (81.26%). The most of them have comorbidity (61.46%), 69.79 percent was farmer. Duration before reaching hospital was 1-7 days (76.04%). All of them presented with pain and swelling, fever (88.54%). The most common site of infection was the knee (66.67%), followed by the ankle (12.50%) and hip (9.38%). The diagnosis was made on basis of the positive culture of microorganism. Hemoculture were positive (47.61%) and synovial fluid culture were positive (95.50%). Streptococcus was the most common organism (41.67%), followed by Staphylococcus (32.30%) and Burkholderia pseudomallei (18.75%). Treatment included antibiotic therapy and arthrotomy (55.21%). The mortality rate was 8.33 percent. In all, length of stays was 8-14 days (52.08%). The patients with melioidotic septic arthritis were diabetes mellitus, agriculturist, upper extrimitries infection significantly higher than those with non melioidotic septic arthitis (p < 0.01, p < 0.001 and p < 0.01 respectively).

Conclusion: septic arthritis is a medical emergency that requires rapid diagnosis and treatment to avoid morbidity and mortality.