Disusun oleh :GUSTAFIANZA F.P

ARTRITIS SEPTIK

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

DEFINITION

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

ETIOLOGI

1.Staphylococcus Colagen Receiptor

2.Inadekuat of basalis mem-brane synovium capillary

3.Inhibition Bacterial fagosite of Synovial fibroblast

PATOGENESISPatogen Bacterial

/Mikroorganism

Direct infection

Indirect infection

Synovial Cartilaginois Junction in intravasculer space and distribute in

synovial fluid

After infected :- Hiperemi synovial- Increase infiltrate

of PMN

Acute Inflamation process(3 weeks)

Articulary cartilage destruction (4-6 days)

T Limfosit proliferation/

activation

Base material degradation

Bacterial Toxin Produced

Difuse to Synovial Fluid

Complete Articulary Cartilage

Destruction

DISLCATION, SUBLUCTATION

, OSTEOMIELITI

S

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

RISK FACTORS

- 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

MANIFESTATION

Physic Exam :1. Pain located on joints2. Movement Disability3. Systemic Signs : Fever, Shiver, and Malaise4. Joints : Swollen, Hidrops, Warm, and

Tenderness5. Aspiration : Turbid liquid, and Pus

EXAMINATION

Support Exam :1. Synovial Fluid appear foggy or purulent2. White Blood Cells > 50.000 cells/uL 90% PMN3. Decreased glukose to 50 mg/dL4. Increase of erythrocyte sedimentation5. 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/mm3Osteoarthritis : Clear and yellowish 1000/mm3SLE : Yellowish/White, and Foggy moderate

10000-20000/mm3Gout : Yellowish/White, and Foggy severe

15000-20000/mm3Raiter Syndrome : Opaq 20000/mm3Septic Arthritis : Gray, Foggy, and Purulent

5000-75000/mm3

EXAMINATION

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

MANAGEMENT

- More than 70% patient with septic arthritis cured with early diagnose and treatment

- Rarely causes death

PROGNOSIS