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Liðsýkingar á Borgarspítala og Landspítala 1986-1990

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Authors
Hrefna Guðmundsdóttir
Helgi Jónsson
Haraldur Briem
Issue Date
1992-10-01

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Other Titles
Septic arthritis. A retrospective survey from Borgarspitalinn and Landspitalinn in Reykjavik 1986-1990
Citation
Læknablaðið 1992, 78(8):335-9
Abstract
A retrospective study was made on 40 patients with septic arthritis admitted to Borgarspitalinn and Landspitalinn during 1986 to 1990. Bacteria were cultured from joint fluid of 23 patients. Ten of those had history of intraarticular manipulation, 7 had infections in other locations, 10 had symptoms of rheumatic diseases, and 5 had other predisposing factors. The most common joints involved were the knees (n=12) and shoulders (n=7). S. aureus was the most common pathogen. Eleven patients developed serious joint damage. Three patients died during hospitalization and the infection was associated with death in two. Ten patients were highly suspected of bacterial infection but joint fluid culture was negative. Five of them had wounds in close proximity of the joint and they also had signs of osteomyelitis. Seven patients had infections in joint prostheses. Staphylococci were the most common pathogens with S. aureus in 3 patients and S. epidermidis in 2 patients. In these patients gram negative bacilli (n=3) and mixed infecions (n=2) were more common than in patients without joint prostheses. Compared to earlier investigations the incidence of culture proven bacterial arthritis has increased significantly during the last two decades in the Reykjavik area.
Gerð var afturvirk rannsókn á 40 sjúklingum eldri en 16 ára sem legið höfðu á Borgarspítala og Landspítala vegna sýkingar í liði á árunum 1986 til 1990. Tuttugu og þrír sjúklingar höfðu jákvæðar liðvökvaræktanir og töldust þeir hafa staðfesta liðsýkingu. Tíu þeirra höfðu sögu um inngrip í lið, sjö höfðu aðra sýkingu, tíu höfðu gigtareinkenni og fimm höfðu aðra áhættuþætti. Aðeins einn sjúklingur hafði engan þekktan áhættuþátt. Algengustu liðsýkingar voru í hnjám (n=12) og axlarliðum (n=7). Staphylococcus aureus var algengasti sýkillinn (n=17). Ellefu sjúklingar hlutu verulegar liðskemmdir. Þrír dóu í legunni og tengdist sýkingin dánarorsök hjá tveimur þeirra. Hjá tíu sjúklingum var sterkur grunur um sýkingu í liði en liðvökvaræktun var neikvæð. Fimm þeirra höfðu sár yfir liðnum og höfðu þeir jafnframt merki um sýkingu í beini og ræktaðist S. aureus í öllum tilvikunum. Sjö sjúklingar voru með sýkingu í gerviliði. Klasakokkar voru algengastir, S. aureus (n=3) og S. epidermidis (n=2). Meira bar á gram neikvæðum stöfum (n=3) og blandaðri sýkingu (n=2) heldur en hjá sjúklingum sem ekki höfðu gervilið. Miðað við fyrri sambærilegar rannsóknir hérlendis hefur tíðni liðsýkinga farið vaxandi og er algengara að sjúklingar sýkist vegna liðástungu.
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