Felis ISSN 2398-2950

Arthritis: infective

Contributor(s): Eithne Comerford

Introduction

  • Arthritis caused by infection with various microorganisms. Mono-articular condition most common.
  • Cause: direct contamination, eg penetrating wound/foreign body, surgery; direct extension from local infection; hematogenous spread from distant focus of infection (considered most common form), eg periodontal, gastrointestinal, dermal.
  • Signs: lameness, painful swollen joint(s), pyrexia, lethargy, anorexia, localized lymphadenopathy.
  • Diagnosis: radiography,  hematology, urinalysis, synovial fluid examination, CBC, serum biochemistry.
  • Treatment: long-term (4-8 weeks minimum) administration of antimicrobial of choice following culture and sensitivity testing +/- non-steroidal anti-inflammatory drugs. Open arthrotomy or arthroscopy lavage, irrigation and surgical provision of drainage may be required.
  • Prognosis: good where early treatment; poor when delayed.

Pathogenesis

Etiology

Bacterial L forms

  • Represent bacteria that are cell-wall-deficient as are Mycoplasma spp. but Bacterial L forms can revert to parental bacteria whereas Mycoplasma spp cannot.
  • Can occur spontaneously and can be induced from most gram-positive and gram-negative bacteria by antibacterial agents that interfere with cell wall synthesis. Can be induced in vivo by penicillins, specific antibodies and other substance involved in host immune response.
  • Infective polyarthritis associated with bacterial L forms has been reported in three cats in 1987.

Clinical signs

  • Polyarthritis characterized by one or more subcutaneous swellings that develop into fistulous tracts in a few days.
  • Asymmetrical polyarthritis and commonly affects the carpii and tarsi, however multiple joints (including metatarsi and coxofermoal joints can be involved).
  • Systemic signs such as anorexia, pyrexia and reluctance to walk upon presentation.
  • No age or gender distribution.

Pathogenesis

  • Cat to cat transmission via exudate.
  • Exposure to a common environmental reservoir.

Mycoplasma spp

  • Two documented reports of Mycoplasma arthritis in cats.
  • Mycoplasma gatae and felis.

Clinical signs

  • Lameness, anorexia, weight loss, arthralgia, facial abscess and pyrexia.
  • Edema of distal limbs.

Lyme disease

  • Cats have been found to be suitable host fo rIxodes dammini the tick vector for Borrelia burgdorferi and have been found to have serum antibodies to this organism.
  • Antibody titers are lower in cats than in dogs, it has not been isolated from serologically positive cats and is therefore not thought to be an important reservoir for Lyme borreliosis.

Predisposing factors

General

Specific

  • Joint penetration (wound or surgery).

Pathophysiology

  • Inflammation of joint caused by infection with various microorganisms introduced via a direct or hematogenous route.
  • Infection    →   synovial proliferation, synovial effusion, joint swelling, pain    →   lameness.
  • May    →   cartilage erosions, bone destruction, osteolysis    →   osteophyte formation, joint destruction.
  • Absence of a basement membrane may predispose synovium to bacterial seeding.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Carr A P (1997) Infectious arthritis in dogs and cats. Vet Med 92 (9), 786-797 VetMedResource.
  • Carro T (1994) Polyarthritis in cats. Compend Contin Educ 16 (1), 57-67 VetMedResource.
  • Hodgin E C, Michaelson F & Howerth E W (1992) Anaerobic bacterial infections causing osteomyelitis/arthritis in a dog. JAMA 201 (6), 886-888 PubMed.
  • Bennett D & Taylor D J (1988) Bacterial infective arthritis in the dog. JSAP 29 (4), 207-230 VetMedResource.


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