ARTRITIS SEPTIK

Disusun oleh :
GUSTAFIANZA F.P

DEFINITION
Th result of bacterial invasion in the joint gap,
which occurs hematogenous dissemination,
direct inoculation by trauma or srgery, or the
spread of osteomielitis or cellucitis adjacent to
the joint gap

ETIOLOGI
- Infeksi dari S. aureus, Haemophillus influenza,
N. gonorrhoeae, Streptococcus

PATOGENESIS
Patogen Bacterial
/
Mikroorganism

Direct infection
Indirect infection

1.Staphylococcus
Colagen
Receiptor
2.Inadekuat of basalis membrane synovium capillary
3.Inhibition Bacterial fagosite of
Synovial fibroblast

T Limfosit
proliferation/
activation

Bacterial Toxin
Produced

Acute Inflamation
process
(3 weeks)

Difuse to Synovial
Fluid

Base material
degradation

Synovial Cartilaginois
Junction in intravasculer
space and distribute in
synovial fluid

Articulary cartilage
destruction (4-6 days)

Complete
Articulary
Cartilage
Destruction

After infected :
- Hiperemi synovial
- Increase infiltrate
of PMN

DISLCATION,
SUBLUCTATION,
OSTEOMIELITIS

RISK FACTORS
Imunosupresed Disease
Imunosupresan Drugs
Carcinoma
Auto Imune Deficiency Syndrome
Malnutrition
Alcohol Adicted

MANIFESTATION
Progressive pain
Swollen and Rigidity Joints
Inflamation sign on joints
More common in adults more than children
In neonatus, asimetric limb position
Systemic symtomps is fever, cold-sweat, and malaise
Sometimes develops on other joints, causing

poliartralgia
Feel like be pressed when patient move
Local tension and warm, caused by soft tissue
swelling

EXAMINATION
Physic Exam :
1. Pain located on joints
2. Movement Disability
3. Systemic Signs : Fever, Shiver, and Malaise
4. Joints
: Swollen, Hidrops, Warm, and
Tenderness
5. Aspiration
: Turbid liquid, and Pus

EXAMINATION
Support Exam :
1. Synovial Fluid appear foggy or purulent
2. White Blood Cells > 50.000 cells/uL 90% PMN
3. Decreased glukose to 50 mg/dL
4. Increase of erythrocyte sedimentation
5. X-Ray Narrowing Gap Joints, Subchondral
bone is not in place

EXAMINATION
Synovial Fluid Analyse :

(Colour and Mucin Clot Leukocyte

Counts)

Normal
: Clear and yellowish
200/mm3
Osteoarthritis
: Clear and yellowish
1000/mm3
SLE
: Yellowish/White, and Foggy moderate 10000-20000/mm3
Gout : Yellowish/White, and Foggy severe
15000-20000/mm3
Raiter Syndrome : Opaq
20000/mm3
Septic Arthritis
: Gray, Foggy, and Purulent
500075000/mm3

MANAGEMENT
GeneraL Treatment :
Analgesic and Splinting (Fixation)
Special Treatment :
Pus drainage in joint and antibiotics (injection and
oral)
Saat tanda lokal teratasi, antibiotik dapat diubah
ke ampisilin oral, 4 x 500 mg/hari selama 7 hari

PROGNOSIS
More than 70% patient with septic arthritis cured

with early diagnose and treatment

Rarely causes death