Analysis of factors influencing prognosis in foals with septic arthritis

Nicolas J Vos,Norm G Ducharme

doi:10.1186/2046-0481-61-2-102

Abstract

The purpose of this paper was to identify factors that would positively or negatively affect the short-term survival rate of foals with septic arthritis. Medical records of 81 foals (≤seven months of age) with a clinical diagnosis of septic arthritis, referred to the equine hospital at Cornell University Hospital for Animals, between 1994 and 2003 were reviewed. Signalment, age at presentation, number of affected joints, joint fluid parameters, bacterial agents, treatment modalities and year of treatment were compared between survivors and nonsurvivors. Sixty-two of 81 foals (77%) were discharged from the hospital and classified as 'survivors'. Multiple joint involvement and detection of intra-articular Gram-negative, mixed bacterial infection and degenerate neutrophils were negatively associated with short-term survival. Initiation of treatment within 24 hrs of onset of clinical signs and combination of treatment modalities were positively correlated with survival. Further investigation is needed to determine if these two factors have a similar influence on athletic performance.

Highlights

Septic arthritis is a potentially debilitating condition associated with significant morbidity and mortality in foals (Martens et al, 1986)
The authors of this paper hypothesised that there is a positive effect of the combination of treatment modalities such as arthroscopy, arthrotomy, regional deposition of antibiotics to improve chances for short-term survival as compared to treatment consisting of joint lavage and systemic antibiotics alone
The authors wished to identify factors negatively associated with short-term survival in a population of foals with septic arthritis diagnosed by practitioners and subsequently referred to a university hospital

Summary

Introduction

Septic arthritis is a potentially debilitating condition associated with significant morbidity and mortality in foals (Martens et al, 1986). The principles of treatment of septic arthritis are early recognition, removal of infected tissue/fluids (thorough joint lavage, arthroscopy, arthrotomy, closed suction drainage) and appropriate antimicrobial therapy (Ross et al, 1991; Bertone et al.,1992; Honnas et al.,1992; Schneider et al, 1992a, 1992b; Baxter, 1996; Meijer et al, 2000; Wright, 2003) The high mortality rate (22-58%) associated with septic arthritis despite treatment emphasises its clinical importance (Schneider et al, 1992b; Steel et al, 1999; Meijer et al, 2000). The authors wished to identify factors negatively associated with short-term survival in a population of foals with septic arthritis diagnosed by practitioners and subsequently referred to a university hospital

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