Bacterial arthritis: Epidemiology, pathogenesis, and microbiology in infants and children
- Paul Krogstad, MD
Paul Krogstad, MD
- Professor of Pediatrics and Molecular and Medical Pharmacology
- Vice Chair for Academic Affairs, Department of Pediatrics
- David Geffen School of Medicine at UCLA
- Section Editors
- Sheldon L Kaplan, MD
Sheldon L Kaplan, MD
- Editor-in-Chief — Pediatrics
- Section Editor — Pediatric Infectious Diseases
- Professor and Vice Chairman for Clinical Affairs
- Baylor College of Medicine
- William Phillips, MD
William Phillips, MD
- Section Editor — Pediatric Orthopedics
- Professor of Pediatrics and Orthopedics
- Baylor College of Medicine
- Robert Sundel, MD
Robert Sundel, MD
- Section Editor — Pediatric Rheumatology
- Associate Professor of Pediatrics
- Harvard Medical School
Infections of the joints (known as septic arthritis, pyogenic arthritis, suppurative arthritis, purulent arthritis, or pyarthrosis) may be caused by bacteria, fungi, mycobacteria, and viruses. The term "septic arthritis" usually refers to bacterial arthritis or fungal arthritis, but bacterial joint infections are most common [1,2].
The epidemiology, pathogenesis, and microbiology of bacterial arthritis in infants and children will be reviewed here. The clinical manifestations, evaluation, diagnosis, treatment, and outcome are discussed separately. (See "Bacterial arthritis: Clinical features and diagnosis in infants and children" and "Bacterial arthritis: Treatment and outcome in infants and children".)
Bacterial arthritis occurs more commonly in childhood than during other periods of life, with approximately 50 percent of cases occurring in individuals younger than 20 years [2-4]. The reported incidence of bacterial arthritis in children ranges from 5 to 37 cases per 100,000 [5,6].
Children younger than three years are affected most frequently [5,7,8]. Boys are affected more often than girls (male-to-female ratio of 1.2-2 to 1) [6,8-10]. The hip and knee are the joints most frequently involved.
Risk factors — Risk factors for bacterial arthritis in the neonate (younger than one month) include [11-16]:
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