Acute infectious arthritis is a joint infection that evolves
over hours or days. The infection resides in synovial or
periarticular tissues and is usually bacterial—in younger
adults, frequently Neisseria gonorrhoeae. However, nongonococcal
bacterial infections can also occur and can rapidly destroy
joint structures. Symptoms include rapid onset of pain,
effusion, and restriction of both active and passive range of
motion, usually within a single joint. Diagnosis requires
synovial fluid analysis and culture. Treatment is IV antibiotics
and drainage of pus from joints. Acute infectious arthritis may
occur in children. About 50% of children with joint infection
are < 3 yr. However, routine childhood vaccination for
Haemophilus influenzae and Streptococcus pneumoniae is
decreasing the incidence in this age group. Risk factors are
listed in Table 1: Infections of Joints and Bones: Risk Factors
for Infectious Arthritis. Risk is substantially increased in
patients with RA and other disorders causing chronic joint d