Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Septic arthritis is treated with antibiotics and drainage of the infected
joint (synovial) fluid from the joint.
Optimally, antibiotics are given immediately. Often, intravenous antibiotics
are administered in a hospital setting. The choice of antibiotics can be guided
by the results of the culture of joint fluid. Until those results are known,
empiric antibiotics are chosen to cover a wider range of possible infectious
agents. Sometimes, combinations of antibiotics are given. Antibiotics can be
required for four to six weeks.
Drainage is essential for rapid clearing of the infection. Drainage can be
done by regular aspirations with a needle and syringe, often daily early on, or
via surgical procedures. Arthroscopy can be used to irrigate the joint and
remove infected joint lining tissue. If adequate drainage cannot be accomplished
with joint aspirations or arthroscopy, open joint surgery is used to drain the
joint. After arthroscopy or open joint surgery, drains are sometimes left in
place to drain excess fluid that can accumulate after the procedure.
What are complications of septic arthritis?
Rapid clearing of the infection is critical to preserve the joint. If
appropriate antibiotics are begun immediately, joint integrity can be
maintained, and return to function is expected. If the infection has been
long-standing, the possibility of joint destruction exists. The keys to
successful outcome are rapid medical attention and drainage and the accurate
administration of antibiotics to which the offending microbes are susceptible.
Septic arthritis is infection of one or more joints by microorganisms.
Septic arthritis can be caused by bacteria, viruses, and fungi.
Risks for the
development of septic arthritis include taking immune-suppression medicines,
intravenous drug abuse, past joint disease, injury or surgery, and underlying
medical illnesses including diabetes, alcoholism, sickle cell disease, rheumatic
diseases, and immune deficiency disorders.
Symptoms of septic arthritis
include fever, chills, as well as joint pain, swelling, redness, stiffness, and
warmth.
Septic arthritis is diagnosed by identifying infected joint fluid.
Septic arthritis is treated with antibiotics and drainage of the infected joint
fluid from the joint.
Diabetes mellitus is a chronic condition characterized by high levels of sugar (glucose) in the blood. The two types of diabetes are referred to as type 1 (insulin dependent) and type 2 (non-insulin dependent). Symptoms of diabetes include increased urine output, thirst, hunger, and fatigue. Treatment of diabetes depends on the type.
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and in worse cases, chest pain, shortness of breath, and coughing up blood. A person with an active infection (a positive TB skin test, abnormal chest x-ray and TB bacteria in their sputum) requires treatment with izoniazid, rifampin, ethambutol and pyrazinaide.
Lyme disease is a bacterial illness, which is spread by ticks when they bite the skin. Initially the disease affects the skin causing a reddish rash associated with flu-like symptoms. It takes weeks to months after the initial redness of the skin for its effects to spread throughout the body. Lyme disease can be treated with antibiotics. Lyme disease can be prevented by using tick avoidance techniques.
Hepatitis C is an inflammation of the liver due to the hepatitis C virus (HCV), which is usually spread by
blood transfusion, hemodialysis, and needle sticks, especially with intravenous
drug abuse. Chronic hepatitis C may be treated with interferon, usually in combination with anti-virals.
Elbow pain is most often the result of tendinitis, which can affect the inner or outer elbow. Treatment includes ice, rest, and medication for inflammation. Inflammation, redness, warmth, swelling, tenderness, and decreased range of motion are other symptoms associated with elbow pain. Treatment for elbow pain depends upon the nature of the patient's underlying disease or condition.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Alcoholism is a disease that includes alcohol craving and continued drinking despite repeated alcohol-related problems, such as losing a job or getting into trouble with the law.
The hepatitis B virus is a unique, coated DNA virus belonging to the Hepadnaviridae family of viruses. The course of the virus is determined primarily by the age at which the infection is acquired and the interaction between the virus and the body's immune system. Successful treatment is associated with a reduction in liver injury and fibrosis (scarring), a decreased likelihood of developing cirrhosis and its complications, including liver cancer, and a prolonged survival.
Coxsackie viruses may be divided into two groups. Type A causes hand, foot, and mouth disease and conjunctivitis, while type B causes pleurodynia. Both types sometimes cause meningitis, myocarditis, and pericarditis. There is no specific treatment for this disease.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
Drug addiction is a chronic disease that causes drug-seeking behavior and drug use despite negative consequences to the user and those around him. Though the initial decision to use drugs is voluntary, changes in the brain caused by repeated drug abuse can affect a person's self-control and ability to make the right decisions and increase the urge to take drugs. Drug abuse and addiction are preventable.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Mumps is an acute viral illness caused by the mumps virus. Symptoms of mumps include fever, headache, muscle aches, tiredness, and loss of appetite; followed by swelling of the salivary glands.
Sickle cell anemia (sickle cell disease), a blood disease which shortens life expectancy, is cause by an inherited abnormal hemoglobin. Symptoms may include bacterial infections, painful swelling of the hands and feet, fever, leg ulcers, fatigue, anemia, eye damage, and lung and heart injury. Treatment for sickle cell anemia aims to manage and prevent the worst manifestations of the disease and focuses on therapies that block red blood cells from stacking together, which can lead to tissue and organ damage and pain.
Mycobacterium marinum (M. marinum) is bacteria found in fresh and saltwater that can infect the skin through cuts or scrapes, causing granulomas to appear on the skin near the site of infection. This infection may be treated with a long course of oral antibiotics.
Plant thorn synovitis (plant thorn arthritis) is joint inflammation caused by a thorn puncturing the joint and leaving residual plant matter in the joint. Symptoms and signs include swelling, reddish discoloration, loss of range of motion, pain, tenderness, and stiffness. Treatment involves a surgical procedure called a synovectomy with joint lavage to remove the affected joint lining tissue and thorn fragments.
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