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Trusted Resources: Evidence & Education
Scientific literature and patient education texts
Septic Arthritis in Sickle Cell Anemia
source: Family Practice Notebook
year: 2018
summary/abstract: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)
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