Pyogenic Infection of Deep Joint after Major Burn Injury

Lee, Sang Hun; Lee, Dong Hun; Chang, Jun Dong; Jun, Byoung Hyuk

Abstract

PURPOSE
To report the clinical findings and the results of treatment on hematogenous pyogenic arthritis after major burn injury. MATERIALS AND METHODS: A retrospective analysis was made of 11, 797 major burn injury patients from January 1996 to June 2004. Severity of burn by involved body surface area, time of diagnosis, and laboratory findings were analyzed. Direct spread of infection from injured skin to superficial joint was excluded. RESULTS: Hematogenous infection was complicated in 26 joints of 22 patients (0.19% of overall cases). The mean age was 43.6 years, and mean follow-up was 46 months. The body surface area of burn injury was averaged 34.7%. The common involved area was hip in 10 patients, spine and shoulder in five patients, respectively. From the time of injury, average interval to development of symptom was 4.1 weeks, and to establish the diagnosis was 6.3 weeks. The most common isolated pathogen was Methicillin-resistant Staphylococcus aureus. A total of 22 joints underwent surgical treatment. The clinical results of the patients were poor in 72% due to recurrent infection and persistent pain. CONCLUSION: The results of this study suggest that major burn injury may be an important risk factor of hematogenous pyogenic arthritis. Careful clinical suspicion should be important for early diagnosis and treatment.