SALMONELLA SEPTIC ARTHRITIS IN SYSTEMIC LUPUS-ERYTHEMATOSUS AND OTHERSYSTEMIC-DISEASES

Salmonella infection is an important problem in immunocompromised pati ents. The synovium is a particular metastatic focus of Salmonella infe ction and can result in many disabilities of life. Systemic lupus eryt hematosus (SLE) patients were highly susceptible to Salmonella infecti on. In the past 6 years, 41 patients with Salmonella septic arthritis have been treated in our hospital. Eleven patients had an underlying s ystemic disease of SLE which presented with a distinctive clinical cou rse. Alcoholic liver disease (six cases) was another common underlying systemic disease. The most frequent predisposing articular factor was avascular necrosis (16 cases). The hip joint was the most commonly in volved site. Salmonella group B was the most common serotype (30/41). Seventy-three per cent (8/11) of the SLE group had involvement of two or more joints compared with only three out of 30 patients in the non- SLE group. The sex differentiation shows a predominance of young femal es (10/11) in the SLE group and middle-aged males in the non-SLE group . Moreover, in the SLE group, all Il patients shared the risk of lupus nephritis and steroid use. Ten patients had Salmonella group B bacter aemia and five had urinary tract infections simultaneously. In the non -SLE group, there were 10 patients with a history of steroid use, thre e with antecedent enteritis, 12 with bacteraemia, and three with necro tising fasciitis. Seven patients in each of the groups had a recurrent course. However, three patients in the non-SLE group had died during the episode of septic arthritis.