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Bacteria can enter the joint by: The bloodstream from an infection elsewhere (most common) Direct penetration into the joint (arthrocentesis, arthroscopy, trauma) [2] A surrounding infection in the bone or tissue (uncommon, from osteomyelitis, septic bursitis, abscess) [2] [13] [14]
The presence of intracellular bacteria in chronic osteomyelitis is likely an unrecognized contributing factor in its persistence. [citation needed] In infants, the infection can spread to a joint and cause arthritis. In children, large subperiosteal abscesses can form because the periosteum is loosely attached to the surface of the bone. [13]
There are four species of Kingella: K. kingae, the most common, is part of the bacterial flora of the throat in young children and is transmitted from child to child. When it causes disease, the clinical presentation is often subtle and preceded by a recent history of stomatitis or upper respiratory infection.
Rheumatic fever primarily affects children between ages 5 and 17 years and occurs approximately 20 days after strep throat. In up to a third of cases, the underlying strep infection may not have caused any symptoms. [citation needed] The rate of development of rheumatic fever in individuals with untreated strep infection is estimated to be 3%.
In skin infections and secondary infection sites, topical mupirocin is used successfully. For bacteremia and endocarditis, vancomycin or daptomycin is considered. For children with MRSA-infected bone or joints, treatment is individualized and long-term. Neonates can develop neonatal pustulosis as a result of topical infection with MRSA. [4]
Transient synovitis usually affects children between three and ten years old (but it has been reported in a 3-month-old infant and in some adults [3]). It is the most common cause of sudden hip pain and limp in young children. [4] [5] Boys are affected two to four times as often as girls. [5] [6] [7] The exact cause is unknown.
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The predominant anaerobic bacteria isolated are Peptostreptococcus spp. and Propionibacterium acnes (frequently found in prosthetic joint infection), B. fragilis and Fusobacterium spp. (frequently found in infections of hematogenic origin), and Clostridium spp. (frequently found in infections after trauma).