SEPTIC ARTHRITIS- AN OVERVIEW

Also known as infectious arthritis or joint infection, Septic Arthritis is a very painful infection in which a joint is attacked by germs (virus, bacteria, fungus) that travel from another part of the body through the bloodstream. Septic arthritis is considered a medical emergency and prompt medical attention is required. This is because, if untreated, it may destroy the joint within a few days. Also there is a risk of the infection spreading to other parts of the body.

Symptoms Of Septic Arthritis:

Young children and elderly are more prone to septic arthritis. Pre-existing joint problems also increases the risk of septic arthritis. Even those who are on medications for the treatment of rheumatoid arthritis are at a risk since the medications used in the treatment of rheumatoid arthritis suppresses the immune system which makes one prone to infections. Anyone who has a suppressed immune system like patients suffering from cancer and other immune deficiency disorders are also at risk of developing septic arthritis. Diabetes also increases the factor of risk for developing septic arthritis. People whose skin breaks easily and heals poorly are also at risk of developing septic arthritis, as bacterial infections can occur through the wounds increasing the risk of septic arthritis.

Septic arthritis is most common in infants and older adults. Although septic arthritis of the knees is most common, it can also occur in hips, shoulders, as well as other joints. There is the risk of quick and severe damage to cartilage and bone within the joint, hence prompt treatment is the key.

Causes Of Septic Arthritis:

Septic arthritis is most commonly caused by bacterial infection, but can be caused by viral and fungal infections too. This happens when the infection spreads through the bloodstream to a joint.

The lining of the joints do not have the ability to protect itself against the infection leaving the body to fight it out due to which there is increased pressure and reduction in blood flow in the joint, which results in damage.

The infection causing germs include,

• Bacterial:
  • Streptococcus.
  • Staphylococcus.
  • Hemophilus influenza.
• Viral:
  • Mumps.
  • Herpes viruses.
  • Hepatitis A, B, and C.
  • HIV.
  • Adenovirus.
  • HTLV-1.
  • Coxsackie virus.
  • Parvovirus B19.
• Fungi:
  • Histoplasma.
  • Coccidiomyces.
  • Blastomyces.

Symptoms Of Septic Arthritis:

The onset of symptoms is pretty rapid and include,

• Fever.
• Severe/intense joint pain.
• Tiredness and general weakness.
• Joint swelling due to fluid collection within the joint.
• Red and warm to touch.
• Difficulty in moving the infected joint.

Risk Factors For Septic Arthritis:

Older adults and young children are more prone to developing septic arthritis. Also people with open wounds are at higher risk of developing septic arthritis. A weakened immune system and pre-existing conditions such as cancer, diabetes, IV abuse, and immune deficiency disorders have a higher risk of septic arthritis. Previously damaged joints have increased chance of developing septic arthritis too.

Treatment Of Septic Arthritis:

Treatment of septic arthritis includes a combination of drainage of fluid as well as antibiotics.

• Drainage of fluid: It is very important to drain the fluid that has accumulated in the joint as the fluid is infected. This can be done by inserting a needle into the joint space. Sometimes, an arthroscopic procedure is required wherein a small incision is done and a flexible tube with a video camera at the tip inserted. Suction and drainage tubes are then inserted to drain the fluid from the joint. Sometimes, it may be difficult to drain fluid with a needle or even through arthroscopic procedure, such as when the infection is in the hip joint. In such cases, surgery might be required.
• Antibiotics: Powerful antibiotics are started immediately in order to stop the spread of infection. Usually broad-spectrum antibiotics are started intravenously at first to cover a wide range of infections. As soon as the doctor identifies the microbe causing the infection, antibiotics targeting that microbe are started. Since, the antibiotics are given intravenously initially, hospitalization is required. However, later the treatment may be continued on an outpatient basis. The treatment usually lasts from two to six weeks. It must be remembered, however, that antibiotics do carry a risk of side effects including nausea, vomiting, and diarrhea. There is also a chance of developing allergic reactions. The doctor will explain the side effects that might be experienced and may even start on medications to minimize the side effects.
• Ayurvedic Treatment for Septic Arthritis: The role of Ayurveda in the treatment of an acute case of septic arthritis is very limited. It can only be used as a supportive therapy along with modern Anti Biotic therapy and Drainage. Once the acute phase is over treatment is aimed at building the immunity so as to prevent a recurrence. This is achieved by virtue of administering various medical formulations. In cases where the patient has developed Anti Biotic resistance Ayurveda helps in limiting the damage to the joint and also in rehabilitation to minimize the effects of the damage caused to the joint. This is achieved through various procedures like Kashaya sekam (pouring medicated decoctions over the joint) Pizhichil ( pouring medicated fats over the joints ) , Kashaya and sneha vastis ( Enemas with medicated decoctions and fats) and other internal medications which have Guggulu (Commiphora mukul) as their main ingredient.