Factors Influencing Treatment Options
- Initial cause of the infection
- Whether the infection is superficial or deep and which tissues are involved
- Length of time the infection has been present
- Type of organism causing the infection
- General medical condition and nutrition of the patient
- Whether an implant is present or another type of foreign body
Superficial infections can be treated with oral antibiotics, warm soaks and resting the extremity.
Spreading infections with lymph node involvement bring on fevers and chills and hospital admission for intravenous antibiotics, fluids and systemic support is preferred.
If the infection is well loculated and fluctuant (soft), it is an abscess. This is a surgical condition requiring incision and drainage.
When a joint replacement has been done, it is prudent to admit the patient to the hospital for IV antibiotics in the first few days after surgery and have a low threshold for washing out the wound.
If the infection of the joint replacement occurs weeks or months after the surgery, then cultures are taken prior to giving antibiotics and the implant is usually removed. The implant can later be re-implanted after the organism has been identified and IV antibiotics have been given for six weeks. If the patient with a joint replacement has poor health or a poor immune status, then leaving the joint without an implant may be the best option.