What is infectious arthritis?
- Infectious arthritis causes pain and swelling
in the joints. Joints are the places where two
or more bones come together. The pain and swelling
is called inflammation.
- The inflammation is caused by a germ. The
germ can be a bacterium (back-teer-e-um), a
virus, or a fungus.
- Infectious arthritis normally affects only
one joint, but sometimes affects more.
- It does not usually last a long time if it
is treated early.
Infectious arthritis is a form of joint inflammation
caused by a germ. The germ can be a bacterium,
a virus or a fungus. Infection of the joints
usually occurs after a previous infection elsewhere
in the body. There is usually only one joint
involved, though sometimes two or three joints
can become infected. Mostly, infectious arthritis
affects the large joints (shoulders, hips, knees),
but smaller joints (fingers, ankles) can also
be involved.
How common is infectious arthritis?
- Both men and women can get infectious arthritis.
- It can affect people of any age.
- Some people are more likely to get infectious
arthritis than others. For example, a person
who has an illness that makes it harder to fight
off other infections may be more at risk.
Any person, at any
age, can get infectious arthritis. However, some
people are more likely to get infectious arthritis
than others. These include those with conditions
that make it difficult to fight off infection, such
as:
- diabetes
- sickle-cell anaemia
- severe kidney disease
- AIDS
- immune deficiency
- some forms of cancer
- alcoholism
- intravenous drug abuse
People with an existing
arthritis are also more likely to develop infectious
arthritis, because germs tend to infect a joint
that is damaged, and therefore weaker than a healthy
one. If a person has had surgery to replace a joint
with an artificial one, this can also provide a
slight chance of infection developing. If it does,
it usually occurs a short time after the surgical
procedure. However, it is not unheard of for infection
to show up in a person years after having joint
replacement surgery.
Some of the stronger medications used to treat certain
types of inflammatory arthritis also lower the body's
resistance to infection, making it easier for infectious
arthritis to take hold.
People who work in jobs where exposure to animals,
plants, marine life and soil is common also have
a higher chance of contracting infectious arthritis.
What are the warning signs of infectious
arthritis?
- If you have infectious arthritis, the warning
signs are different depending on what type of
germ causes it.
- If it is caused by a bacterium, the pain and
swelling is usually only in one spot. It tends
to come on suddenly. You may also have a fever
and chills.
- If it is caused by a virus, you may have pain
all over. Usually there is no fever.
- If it is caused by a fungus, the pain and
swelling comes on very slowly, over weeks or
months. The pain and swelling can be in one
spot or all over the body. There may be a mild
fever.
The symptoms of infectious
arthritis vary according to the type of germ causing
it. If the arthritis is caused by a bacterium, inflammation
is generally located in only one place or area.
The infection is often accompanied by fever and
chills and its onset is quite sudden. With infectious
arthritis caused by a virus, there is usually no
fever, but there is an aching feeling all over the
body. Inflammation caused by a fungal infection
can be in one area or throughout the body, and it
usually occurs very slowly, over weeks or months.
You may have a mild fever or no fever at all.
What causes infectious arthritis?
- Infectious arthritis is caused by a germ that
has travelled through the body to a joint. The
germ can be a bacterium, a virus or a fungus.
- The germ may have entered your body through
the skin, nose, throat or ears, or through a
wound.
- Often you may have already been sick as a
result of the infection before it travels to
the joints.
With infectious arthritis
a germ has travelled through the body to a joint.
The germ may have entered the body through the skin,
nose, throat or ears, or through an existing wound.
Usually, there has already been an infection elsewhere
in the body. For example, if you develop infectious
arthritis from the bacterium pneumococcus, which
causes pneumonia, you may have already experienced
pneumonia in the lungs. After the initial infection,
the germ can travel through the bloodstream to the
joints, where it then settles and causes inflammation.
Bacteria cause most cases of infectious arthritis.
The types of bacteria that might cause such infection
include:
- gonococcus
- staphylococcus
- streptococcus
- pneumococcus
- hemophilus
- spirochetes
- tuberculosis
Certain viruses can
also cause infectious arthritis. They include:
- infectious hepatitis
- mumps
- infectious mononucleosis
Fungi are the least
common cause of infectious arthritis. They are usually
found in:
- soil
- bird droppings
- certain plants, such as roses
Infectious arthritis
is not transmittable from one person to the other,
but some germs (such as those causing gonorrhoea
and measles) can be spread by person-to-person contact.
However, while these diseases can be passed on,
this does not automatically mean the development
of infectious arthritis is.
What can you do about infectious
arthritis?
- If your doctor thinks you have infectious
arthritis, he or she may perform a physical
examination, and order x-rays and other tests.
Your doctor will probably also ask questions
about things like whether you have been sick
from other illnesses, or have been in contact
with other people who have infections.
- Most of the time infectious arthritis can
be cured if it is treated early. Without treatment
however, the affected joints can become very
damaged and the infection can spread to other
parts of the body.
- Learn as much as you can about this disease.
Speaking with people who are specialists in
arthritis care can provide you with the information
you need.
Infectious arthritis
is usually not a long-term illness. Most of the
time it can be cured if it is treated promptly and
properly. Without treatment however, the affected
joints can become very damaged and the infection
can spread to other parts of the body.
Establishing the
correct diagnosis is important, so if your doctor
thinks you have infectious arthritis, he or she
may ask questions about the symptoms, other medical
conditions, recent travel, illnesses, and contact
with people who may have had infections. He or she
may also perform a physical examination, and order
x-rays and other tests to find out what germ is
causing the infection. This can be done by using
a needle to removing a sample of fluid from the
joint so it can be examined. If tuberculosis or
a fungus is the suspected cause, sometimes a small
piece of tissue from the joint may need to be cut
away and examined. If a virus is suspected, a blood
test may be done because your body develops cells
called antibodies to fight off the virus. These
antibodies will show up in a blood test.
People with infectious
arthritis are often put in the hospital for treatment.
Sometimes affected joints must be drained of excess
fluid that has built up. This is done by inserting
a needle directly into the joint. This procedure
is usually painless. Sometimes the same joint may
need to be drained several times if fluid build-up
recurs. Further treatment varies depending on what
type of germ has caused the infection. Your active
involvement in developing your treatment plan is
essential.
Medications
- Anti-inflammatory medication
is often given to treat the pain and swelling
of infectious arthritis. Nonsteroidal anti-inflammatory
drugs (NSAIDs) are a type of medication that
helps reduce the pain and swelling of the joints
and decrease stiffness. However, they do not
prevent further joint damage.
- NSAIDs reduce
pain when taken at a low dose, and relieve inflammation
when taken at a higher dose. NSAIDs such as
ASA (Aspirin, Anacin, etc.) and ibuprofen (Motrin
IB, Advil, etc.) can be purchased without a
prescription. Examples of NSAIDs that require
a prescription include Naprosyn, Relafen, Indocid,
Voltaren, Feldene, and Clinoril. The various
NSAIDs and Aspirin®, if taken in full doses,
usually have the same levels of anti-inflammatory
effect. However, different individuals may experience
greater relief from one medication than another.
Taking more than one NSAID at a time increases
the possibility of side effects, particularly
stomach problems such as heartburn, ulcers and
bleeding. People taking these medications should
consider taking something to protect the stomach,
such as misoprostol (Cytotec).
- Antibiotics are
usually given to treat infectious arthritis
caused by bacteria. Antibiotics are usually
given for bacterial infections. There are different
antibiotics for the different germs. Antibiotics
may be taken by mouth or given directly into
a vein (intravenously). Sometimes it may be
necessary to take the antibiotics over a period
of several months. It is important to take all
the antibiotics prescribed, even if the symptoms
may have been relieved, so that the bacteria
do not get stronger and develop a resistance
to antibiotics.
- Anti-fungal medications
may be given to treat infectious arthritis as
a result of a fungus.
Infectious arthritis caused by a fungus is the
most resistant to treatment. Anti-fungal medications
may be prescribed and may have to be taken for
months. Surgery to remove the infection from
the joint may also be needed. Recurrence of
this type of infection is always a possibility.
- Usually no medications,
besides those for pain and swelling, are given
for infectious arthritis caused by a virus.
The infection normally goes away on its own.
- Viral infections
cannot be treated with antibiotics. The infections
usually resolve themselves on their own. If
you have infectious arthritis from a virus you
can help the healing process by getting plenty
of rest and drinking extra fluids.
Exercise
Once your infectious
arthritis is under control, doing exercises can
help you strengthen your joints and muscles.
As the infection subsides, you may be instructed
to do exercises that strengthen your muscles. A
program of muscle strengthening will help with a
favourable recovery. Exercises to improve the range
of motion of the joints will also assist with your
ability to resume normal activities. Always consult
a doctor before beginning an exercise program.
Heat/Cold
- Applying heat helps relax aching muscles,
and reduces joint pain and soreness. For example,
take a hot shower.
- Applying cold helps to lessen the pain and
swelling in a joint. For example, put an ice
pack on the area that is sore.
Heat or cold application can provide temporary
relief of pain. Heat helps to reduce pain and
stiffness by relaxing aching muscles and increasing
circulation to the area. There is some concern
that heat may worsen the symptoms in an already
inflamed joint. Cold helps numb the area by
constricting the blood vessels and blocking
nerve impulses in the joint. Applying ice or
cold packs appears to decrease inflammation
and therefore is the method of choice when joints
are inflamed.
Protect Your Joints
- Be kind to your body. After doing heavy work,
or doing the same task over and over, stop.
Slow down by doing an easy task, or by taking
a rest.
- Use your back, arms and legs in safe ways
to avoid putting stress on joints. For example,
carry a heavy load close to your body.
- Use helpful devices such as a cart to carry
your grocery bags, or an enlarged handle that
fits over a knife handle so you can hold it
easily. A cart will help you to walk more safely.
A grab bar, which attaches to a shower, will
help you to get in and out of the tub more easily.
- Maintain a healthy weight to avoid putting
extra stress on your joints.
Protecting your joints means using them in ways
that avoid excess stress. Benefits include less
pain and greater ease in doing tasks.
Three main techniques to protect
your joints are:
Pacing, by alternating heavy or repeated tasks with
easier tasks or breaks, reduces the stress on painful
joints and allows weakened muscles to rest.
Positioning joints wisely helps you
use them in ways that avoid extra stress. Use larger,
stronger joints to carry loads. For example, use
a shoulder bag instead of a hand-held one. Also,
avoid keeping the same position for a long period
of time.
Using helpful devices, such as canes,
luggage carts, grocery carts and reaching aids,
can help make daily tasks easier. Small appliances
such as microwaves, food processors and bread makers
can be useful in the kitchen. Using grab bars and
shower seats in the bathroom can help you to conserve
energy and avoid falls.
Maintaining a healthy weight can also
reduce stress on joints, and therefore reduce pain.
If you plan to lose weight, discuss the best program
for you with your doctor and a dietician.
Relaxation
- Relaxing the muscles around an inflamed joint
reduces pain.
- There are many ways to relax. Try deep breathing
exercises. Listen to music or relaxation tapes.
Meditate or pray. Another way to relax is to
imagine or visualize a pleasant activity such
as lying on a beach, or sitting in front of
a fireplace.
Developing good relaxation and coping skills
can give you a greater feeling of control over
your arthritis and a more positive outlook.
Surgery
- If your infectious arthritis is caused by
a fungus, you and your doctor may consider surgery
to remove the infection from the joint.
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