Arthritis, Septic

Description

Medicine Treatment

Referral

---

ICD-10 code: M00.90-99

DESCRIPTION

• An acute infective condition involving one or more joints
• The joint is hot, swollen and very painful, and movement is restricted
• Signs of systemic infection, including fever, are usually present. The infection is usually blood borne, but may follow trauma to the joint. The course may be acute or protracted. A wide spectrum of organisms is involved, including staphylococci and N. gonorrhoea

---

Note:
Haemophiliacs may present with an acute arthritis similar to septic arthritis. This is due to bleeding into a joint and not due to infection

---

MEDICINE TREATMENT

• Infants ≤2 months of age, who fulfil the IMCI criteria for “POSSIBLE SERIOUS BACTERIAL INFECTION” should receive a first dose of ceftriaxone and other IMCI urgent care while arranging transfer
• Ceftriaxone, IM, 80 mg/kg/dose immediately as a single dose. See: dosing table
  • Do not inject more than 1 g at one injection site

---

CAUTION: USE OF CEFTRIAXONE IN NEONATES AND CHILDREN

- If SUSPECTING SERIOUS BACTERIAL INFECTION in neonate, give ceftriaxone, even if jaundiced
- Avoid giving calcium-containing IV fluids ( e.g. Ringer-Lactate) together with ceftriaxone:
- If ≤28 days of age, avoid calcium containing IV fluids for 48 hours after ceftriaxone administered
- If >28 days old, ceftriaxone and calcium-containing IV fluids may be given sequentially provided the giving set is flushed thoroughly with sodium chloride 0.9% before and after
- Preferably administer IV fluids without calcium contents
- Always include the dose and route of administration of ceftriaxone in the referral letter

---

• Children with suspected septic arthritis should be assessed for evidence of septicaemia and septicaemic shock, which should be treated accordingly while awaiting transfer

REFERRAL

Urgent

• All patients for confirmation of diagnosis and surgical drainage

---

Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare Level, 2024 Edition