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Hematogenous Septic Ankle Arthritis

  • Symposium: Papers Presented at the 2007 Meeting of the Musculoskeletal Infection Society
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Ankle infection is a serious problem with limited published information on microbiology and associated morbidities. We describe the laboratory findings, microbiology, and occurrence of adjacent osteomyelitis in patients with hematogenous septic ankle arthritis. We retrospectively reviewed 30 patients with hematogenous septic arthritis of the ankle admitted over a 10-year period. Twenty-two patients were male and eight female. The mean age was 46 years (range, 23–67 years). C-reactive protein and erythrocyte sedimentation rate were elevated in all patients, but the peripheral white blood cell count was elevated in only 47% of patients. Staphylococcus aureus (S. aureus) was the most common pathogen, isolated in 13 (54%) of the 24 patients with positive cultures; four of these isolates (four of 24; 17% of positive cultures) were oxacillin-resistant. Four (17%) of the 24 patients with positive cultures had a mycobacterial infection. We identified adjacent osteomyelitis in 30% of patients, which was considerably associated with the presence of patient comorbidities. S. aureus is the most common pathogen in septic ankle arthritis and empiric antibiotic therapy is recommended. Adjacent osteomyelitis may be present and a high index of suspicion is necessary in patients with comorbidities.

Level of Evidence: Level III, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

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Authors and Affiliations

  1. Department of Orthopaedics, Keck School of Medicine, University of Southern California, 1200 N State Street, Room 3900, Los Angeles, CA, 90033, USA

    Paul D. Holtom MD, Lawrence Borges BS & C. G. Zalavras MD

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  1. Paul D. Holtom MD
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  2. Lawrence Borges BS
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  3. C. G. Zalavras MD
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Correspondence to Paul D. Holtom MD.

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Each author certifies that he has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article.

Each author certifies that his institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Holtom, P.D., Borges, L. & Zalavras, C.G. Hematogenous Septic Ankle Arthritis. Clin Orthop Relat Res 466, 1388–1391 (2008). https://doi.org/10.1007/s11999-008-0229-0

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  • DOI: https://doi.org/10.1007/s11999-008-0229-0

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