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THU0288 Osteoarticular Infections in Elderly Patients: A Study of 44 Cases
  1. H. Sahli,
  2. I. Cherif,
  3. R. Tekaya,
  4. M. Maiza,
  5. I. Mahmoud,
  6. O. Saidane,
  7. L. Abdelmoula,
  8. R. Zouari
  1. Rheumatology, hopital charles nicole, Tunis, Tunisia

Abstract

Background Joint and bone infections are a therapeutic emergency that may occurs at any age but is particular among elderly patients.

Objectives The aim of this study is to identify different features of joint and bone infections in elderly patients.

Methods We performed a retrospective study of medical records of patients hospitalized for management of osteoarticular infections and who were aged more than 65 years old between 2000 and 2012. Clinical, paraclinical and therapeutic characteristics were recorded and analysed.

Results Forty four cases were collected (20 males/24 females). Mean age was 73.8 years (range 65 to 90). The predisposing factors were present in 54,4% of cases (n=24): diabetes mellitus (n=9), renal failure (n=5), cirrhosis (n=3), rheumatoid arthritis (n=2), psoriatic arthritis (n=1), high dose corticoid intake (n=4). Tuberculous and brucellar contage were reported by 4 and 2 patients respectively. Infectious gateway were found in 5 cases: pulmonary (n=2), cutaneous (n=2) and urinary (n=1). Pain was present in all cases. The following symptoms were observed: fever (n=25), impaired general condition (n=20), night sweat (n=13), radiculalgia with neurological signs (n=6). Inflammatory blood tests were rised in all cases with mean CRP of 113.2mg/l (range 4 to 331) and mean ESR of 101.3mm (range 2 to 195). Blood culture was positive in 2 cases and wright serology was positive in 2 cases. Radiological abnormalities were found in 38 of cases. It was an infectious spondylodiscitis in 25 cases, an association of spondylodiscitis and septic arthritis of sternocostal joint in 1 case and a septic arthritis in 18 cases. In the last cases, it was: polyarthritis (n=1), oligoarthritis (n=2) and monoarthritis (n=15). The arthritis involved the: Knee (n=12), elbow (n=2), shoulder (n=2), ankle (n=3) and hip (n=1). The germ was identified in 10 cases: Specific germ in 1 case (Mycobacterium Tuberculosis), and pyogenic germ in 9 cases: Staphylococus (n=3), Pseudomonas (n=1), Escherichia coli (n=1), Streptococcus (n=1), Serratia (n=1), Lactococcus (n=1) Enterobacter (n=1). All patients received antibiotics according to the bacterial agents. Complications were observed in 6 cases: endocarditis (n=1), cauda equina syndrome (n=1), medullar cord compression (n=1) and side therapy effects (n=3). Five patients died.

Conclusions Osteoarticular infections in elderly patients were dominated by spondylodiscitis, characterised by blood inflammation and may cause several complications.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.2755

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