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 Paediatric dosing tool.
- 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 old, 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.