Septic Arthritis in Patients with Systemic Lupus Erythematosus: Salmonella and Nonsalmonella Infections Compared
Section snippets
Patients and Methods
The clinical charts of SLE patients with septic arthritis who were admitted to our hospital between January 1984 and June 2003 were retrospectively reviewed. All of the cases fulfilled the criteria of the 1982 American Rheumatism Association revised classification criteria for SLE (10, 11). Patients were considered to have septic arthritis only when they presented with joint swelling and pain, and a bacterial organism was isolated from the synovial fluid or a synovial tissue specimen. In this
Characteristics of Patients with Septic Arthritis
Over the 20-year study period, there was a total of 10,732 inpatient records for 3,128 SLE patients, of which 29 were cases of septic arthritis. The characteristics of the 29 patients are summarized in Table 1. Of the 29 patients with septic arthritis, 21 had chronic renal disease and 16 had hypertension; 17 patients (59%) had salmonella infection and 12 (41%) had nonsalmonella infections.
Risk Factor Analysis
The age of the 29 SLE patients with septic arthritis ranged from 14 to 68 years (mean, 35.1 ± 14.1 years)
Discussion
Infection is a major problem during the treatment of patients with SLE. Although bacterial arthritis is not a common infection in these patients, it may cause rapid joint destruction and result in permanent loss of joint function. Thus, physicians should suspect bacterial arthritis when SLE patients present with acute joint pain and swelling.
In non-SLE patients, the risk factors for septic arthritis are trauma, recent joint surgery or arthroscopy, presence of arthritis, and a prosthetic joint.
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