Makki D, Elgamal T, Evans P, Harvey D, Jackson G, Platt S
Wirral University Teaching Hospital NHS Trust, Arrowe Park Road, Upton, Wirral CH49 5PE, UK.
Department of Trauma and Orthopaedics Wirral University Teaching Hospital NHS Trust , Arrowe Park Road, Upton, Wirral CH49 5PE, UK.
Bone Joint J. 2017 Nov;99-B(11):1545-1551. doi: 10.1302/0301-620X.99B11.BJJ-2016-1093.R1.
The aim of this paper was to present the clinical features of patients with musculoskeletal sources of methicillin-sensitive (MSSA) septicaemia.
A total of 137 patients presented with MSSA septicaemia between 2012 and 2015. The primary source of infection was musculoskeletal in 48 patients (35%). Musculoskeletal infection was considered the primary source of septicaemia when endocarditis and other obvious sources were excluded. All patients with an arthroplasty at the time were evaluated for any prosthetic involvement.
The most common site of infection was the spine, which occurred in 28 patients (58%), and was associated with abscess formation in 16. Back pain was the presenting symptom in these patients, with a positive predictive value of 100%. A total of 24 patients had a total of 42 arthroplasties of the hip or knee . Prosthetic joint infection occurred in six of these patients (25%). In five patients, the infection originated outside the musculoskeletal system. Three patients (6%) with MSSA septicaemia from a musculoskeletal sources died.
Amongst the musculoskeletal sources of MSSA septicaemia, the spine was the most commonly involved. We recommend an MRI scan of the whole spine and pelvis in patients with MSSA septicaemia with back pain, when the primary source of infection has not been identified or clinical examination is unreliable. Cite this article: 2017;99-B:1545-51.
