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Original ArticleOpen Access
Quinolones and Salmonella Septic Arthritis
Mootsikapun P 
,
Mahakkanukrauh A ,
Suwannaroj S ,
Nanagara R
,
Mahakkanukrauh A ,
Suwannaroj S ,
Nanagara R AJANEE MAHAKKANUKRAUH, M.D.*,
RA TANAVADEE NANAGARA, M.D.*
Salmonella
septic arthritis is an infrequent infectious disease but can cause progressive joint
destruction resulting in disability. The authors retrospectively reviewed cases with culture proved
Salmonella
septic arthritis in Srinagarind Hospital, Khon Kaen from 1994 to 2000. There were 23
episodes in 16 cases; all had underlying diseases and a history of steroid abuse or steroid and immuno-
suppressive therapy. Systemic lupus erythematosus was the most commonly found underlying disease
(56%).
Salmonella
group D and group B were isolated in 13 and 3 cases.
Most first episodes had acute onset of monoarthritis. The antibiotics used as initial treatment
of the first episodes were beta lactam, cotrimoxazole or quinolones.
There were 8 cases with disabled sequelae and 7 cases with relapse. For 13 evaluable first
episodes, relapse occurred in 3 cases in the cephalosporin/penicillin and 4 cases in the cotrimoxazole
treated group but none in the quinolones.
Six relapse cases were treated successfully with quinolones as well as one with cotrimo-
xazole. Although
5
relapse cases treated with quinolones had previous progressive joint destruction
or avascular necrosis, there was no further joint damage after re-treatment with quinolones.
In conclusion, quinolones were more effective than beta-lactams and cotrimoxazole for the
treatment of
Salmonella
septic arthritis to prevent relapse and progressive joint destruction.
Key word :
Salmonella,
Septic Arthritis, Quinolones
RA TANAVADEE NANAGARA, M.D.*
Salmonella
septic arthritis is an infrequent infectious disease but can cause progressive joint
destruction resulting in disability. The authors retrospectively reviewed cases with culture proved
Salmonella
septic arthritis in Srinagarind Hospital, Khon Kaen from 1994 to 2000. There were 23
episodes in 16 cases; all had underlying diseases and a history of steroid abuse or steroid and immuno-
suppressive therapy. Systemic lupus erythematosus was the most commonly found underlying disease
(56%).
Salmonella
group D and group B were isolated in 13 and 3 cases.
Most first episodes had acute onset of monoarthritis. The antibiotics used as initial treatment
of the first episodes were beta lactam, cotrimoxazole or quinolones.
There were 8 cases with disabled sequelae and 7 cases with relapse. For 13 evaluable first
episodes, relapse occurred in 3 cases in the cephalosporin/penicillin and 4 cases in the cotrimoxazole
treated group but none in the quinolones.
Six relapse cases were treated successfully with quinolones as well as one with cotrimo-
xazole. Although
5
relapse cases treated with quinolones had previous progressive joint destruction
or avascular necrosis, there was no further joint damage after re-treatment with quinolones.
In conclusion, quinolones were more effective than beta-lactams and cotrimoxazole for the
treatment of
Salmonella
septic arthritis to prevent relapse and progressive joint destruction.
Key word :
Salmonella,
Septic Arthritis, Quinolones
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