Q: 58 year old male with PMH of Diabetes, HTN and renal insufficiency is transferred from floor  to ICU with sepsis. On examination, you find various unsuccessful attempts of inserting femoral central line. Subsequent workup diagnosed him with polymicrobial hip septic arthritis. What could be the causes of polymicrobial septic arthritis?


Answer: Septic arthritis is mostly monomicrobial and if joint aspiration proved it to be polymicrobial than there should be worry of few life-threatening conditions

1. Penetrating trauma
2. Direct extension (mostly after ruptured colonic diverticular disease)
3. Polymicrobial bacteremia

Most interesting in polymicrobial septic arthritis are case reports after (multiple) femoral venipunctures.


References:

1. Fromm SE, Toohey JS. Septic arthritis of the hip in an adult following repeated femoral venipuncture. Orthopedics 1996; 19:1047.