Corticosteroids for septic arthritis in children

Abstract

Septic arthritis is a serious disease with rapidly progressive clinical course; the most frequently isolated pathogen is Staphylococcus aureus by 56%. To reach the joint space evade the immune response using a variety of virulence factors, while large number of signals triggered exacerbating the humoral immune response that activates CD4 and increases expression of cytokines TNF and IL-6 involved in the destruction articular process that develops over a period of approximately seven days and extending gradually over time even with appropriate antibiotic treatment. Inflammatory response leading to joint destruction. Systemic corticosteroids have proven to be beneficial in murine models with Staphylococcus aureus septic arthritis, where the use of corticosteroid therapy reduces the severity of septic arthritis modifying the course of disease. To date there have been two controlled clinical trials aim to demonstrate the benefit of using corticosteroids; in 2003, states that the use of Dexamethasone reduces the duration of symptoms and residual joint dysfunction, later Harel in 2011, shows as the use of intravenous dexamethasone reduces hospital stay without the adverse effects attributed to this therapy. It is necessary to carry out further studies with greater evidence establishing the benefit of the use of corticosteroids in septic arthritis.