Dawaa Reference

chronic

Bacterial (septic) arthritis

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class LD01.00 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Septic Arthritis - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK538176/

Verified against2 documents
  • No dose - referral pathway, no medicine given in primary care
  • Bacterial (septic) arthritis - disease-level clinical article (bacterial-septic-arthritis-clinical.txt)

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • Sudden-onset pain, fever and swelling in a single joint, with reluctance to move it [fever · refusing to use a limb]
  • Fever is present in only 40 to 60 percent of cases, so its absence does not rule out infection [fever]
  • Suspected gonococcal arthritis typically occurs in young, healthy, sexually active adults
  • In children, local symptoms include pain, swelling, limp, and refusal to use the joint [limp · refusing to use a limb]
  • Children may also show systemic illness: fever, fast heart rate, irritability, and poor appetite [fever · irritability · poor appetite · tachycardia]

Signs — what you find (4)

  • Gonococcal arthritis can present with skin rash, tendon sheath inflammation and a migratory joint pattern [rash]
  • The knee is the joint most often involved, followed by the hip, shoulder and ankle
  • Joint effusion is common, with limited range of motion and pain on palpation [joint swelling · reduced range of movement]
  • Most prosthetic joint infections present with a draining sinus tract

Tests (9)

  • Synovial fluid analysis, culture, gram stain, crystals, cell count, is the key diagnostic test
  • A synovial white cell count above 50,000 with over 90 percent neutrophils suggests bacterial infection
  • Peripheral blood count is usually elevated with a left shift
  • A high ESR and CRP back up the diagnosis without being conclusive by themselves
  • In a prosthetic joint, a synovial count of 1100 with 64 percent neutrophils suggests infection
  • Two sets of blood cultures should be drawn to check for bacteremia
  • Plain x-rays may show a widened joint space or soft-tissue swelling, but a normal film does not exclude the diagnosis
  • MRI is sensitive for early joint fluid and can show soft-tissue or bone involvement
  • Bone scan is nonspecific but useful for localized infection of the hip or sacroiliac joint

If not this — what else fits (7)

  • Non-bacterial infectious arthritis: fungal, viral, spirochete or mycoplasma organisms
  • Crystal arthropathy such as gout or pseudogout
  • An intra-articular injury: fracture, meniscal tear, or a foreign body
  • An inflammatory arthritis such as rheumatoid arthritis, lupus, or a spondyloarthropathy
  • A systemic infection: endocarditis, HIV, or Lyme disease presenting with joint symptoms
  • A joint tumor, including metastasis or pigmented villonodular synovitis
  • Bleeding into the joint, a clotting disorder, anticoagulant use, or avascular necrosis

SourceStatPearls "Septic Arthritis" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

An orthopaedic emergency that risks permanent joint destruction; the GP recognises it and refers urgently for joint aspiration and inpatient intravenous antibiotics rather than treating as an outpatient. - Refer, with advice

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

An orthopaedic emergency that risks permanent joint destruction; the GP recognises it and refers urgently for joint aspiration and inpatient intravenous antibiotics rather than treating as an outpatient.

Cautions
  • Hot, swollen, immobile joint, inability to bear weight, fever, rapid onset, prosthetic joint involvement.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Staphylococcal septic arthritis carries a mortality rate exceeding 50%, requiring urgent emergency orthopedic evaluation.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.