Septic Arthritis in Sickle Cell Anemia

Septic Arthritis in Sickle Cell Anemia: II. Causes Staphylococcus aureus (most common cause) Streptococcus Pneumoniae Salmonella III. Labs Synovial Fluid (obtain in all suspected cases) 1. Normal Synovial Fluid cell count in >50% of Septic Arthritis cases 2. Gram Stain Test Sensitivity is only 50% (high False Negative Rate) 3. Synovial Fluid is the gold standard for diagnosis IV. Management A. Obtain Synovial Fluid culture and start empiric antibiotics B. Total antibiotic course: 6 weeks C. Initial empiric management 1. Cephaloporin sensitive a. Ceftriaxone 50-75 mg/kg up to 2 g/dose OR b. Ceftriaxone 75-100 mg/kg in high S. Pneumoniae resistance regions 2. Cephalosporin resistance a. Clindamycin 10-15 mg/kg/dose (preferred) OR b. Vancomycin 15 mg/kg/dose (if systemic Sepsis or Clindamycin reactions) Abstract source