this case study describes about septic arthritis @ the left knee , which details about the treatment, management , diagnosis, patient counselling, pharmacist interventions & discussions are followed in this case . please comment thank u

1. CASE STUDY ON SEPTIC ARTHRITIS AT
LEFT KNEE
MARTIN SHAJI
Pharm D

2. DEMOGRAPHIC DETAILS
Patient Name: Mr. H Age/Gender: 60y/M
Admission (IP) No.: 19661 Ward/Unit: Orthopaedics
Date of Admission: 4/02/19 Date of Discharge: 11/02/19
Name of the Consultant Doctor/Physician:
Provisional/Admitting diagnosis:
Septic arthritis

3. Chief Complaints: swelling and puss around the knee, oozing from
the wound, inability to move the limb
Past Medical History: Before 10 days he had admitted for the same
septic arthritis and later was cured.
Allergies (Drug/Food/Other): Nothing Significant
Personal/Social history and habits:
Height/Weight: 53 kg Education: 10th standard
Diet (veg/non-veg): Mixed Appetite: Normal
Sleep: Decreased Alcoholic:
Bowel & Bladder habit: normal Occupation: Nil

4. SOAP NOTE:
SUBJECTIVE EVALUATION
A 60years old male patient was admitted in orthopaedics ward with the chief
complaints of : swelling and puss around the knee, oozing from the wound,
inability to move the limb and his past medical history reveals before 10 days
he had admitted for the same septic arthritis and later was cured.
OBJECTIVE EVALUATION
On general examination, the patient was conscious and coherent.
On physical examination, he had temperature of 100.5°F,pulse rate was 82
bpm and B.P was found to be 124/80mmHg so he was send to lab
investigations.
On lab investigations Hb – 9gm,TC – 9000cells,ESR-30mm/hr,RBS-96mg/dl

5. ASSESMENT
Based upon the subjective and objective evaluation, the
patient was diagnosed as SEPTIC ARTHRITIS @ Lt
KNEE.

6. DRUG CHART
SL.
NO
DRUG
NAME
GENERIC
NAME
CLASS DOSE ROA FRE
Q
DURATION
1 Inj.
Amikin
Amikacin Aminoglycosides 1gm IV BD 04/2/19-10/2/19
2 Inj. Diclo Diclofenac Analgesic 3cc IM BD 04/2/19-10/2/19
3 Inj.
Rantac
Ranitidine H2 receptor
antagonist
2cc IV BD 04/2/19-10/2/19
4 Inj. Piptaz Piperacillin and
Tazobactam
Penicillin antibiotic+
beta lactamase
inhibitor
4.5gm IV BD 04/2/19-10/2/19
5 T. BC B-complex Vitamin supplement 67mg p/o OD 04/2/19-10/2/19
6. T. Ca Calcium Vitamin supplement 500mg p/o OD 04/2/19-10/2/19
7 T. IFA Ironfolic acid Vit.suppliment 333.5mg p/o OD 04/2/19-10/2/19

7. PLANNING
As the patient was diagnosed as SEPTIC ARTHRITIS @ Lt KNEE. So planned to
treat him as follows
On Day 1
The patient complains about swelling and puss around the knee, oozing from the
wound, inability to move the limb so he was treated with
• Inj. Amikacin 1gm IV BD
• Inj. Piptaz 4.5gm IV BD
• Inj. Rantac 2cc IV BD
• Inj. Diclo 3cc IM BD
• T. BC 67mg P/O OD
• Ca 500mg P/O OD and surgical profile was advised.

8. On Day 2&3
As patient have similar complaints as like day1 so he was treated with
same medication.
On Day 4
2 (.) compatible blood for transfusion was advised and same treatment
was continued.
On Day 5
As patient was in prognosis state so he was treated with same
medication.
On day 6& 7
No fresh complaints were seen so same treatment was continued but
the Inj. Rantac was replaced with T. Rantac 150mg P/O BD

9. On day 8
The patient feels better and so he was discharged with the following
medication.
T. Diclofenac 100 mg P/O SOS
T. BC 67 mg P/O OD
T. Rantac 150mg P/O BD
T. IFA 333.5mg P/O OD
And was advised to refer Ortho- OP after 1 week.

10. PHARMACEUTICAL CARE ISSUES/CLINICAL
PHARMACIST INTERVENTION
The above prescription was Rational.
PATIENT COUNSELLING
Regarding Disease:
Septic arthritis is also known as infectious
arthritis, and is usually caused by bacteria, or fungus. The
condition is an inflammation of a joint that's caused by
infection.

11. Regarding medications:
T. Ca: It is used for strengthen the bones and should be taken once
a day at afternoon after food.
T. IFA: It is used for anaemia and should be taken once a day at
morning after food.
T. B-Complex: It is a vitamin supplement and should be taken once
daily.
T. Rantac: It is an anti ulcerative agent and should be taken twice a
day before food

12. Regarding lifestyle modifications:
Strictly adhere to the prescription
Avoid staying in one position for too long.
Avoid positions or movements that place extra stress on your sore
joints.
Try stress reducing activities such as meditation, yoga
Eat a healthy diet full of fruits and vegetables which contains vitamins
and minerals especially vitamin-E.
Eat foods rich in omega-3 fatty acids such as cold water fish,
soybeans, walnuts.
Do any low impact aerobic activities like walking.
Get plenty of sleep i.e., 8 to 10 hours.

13. DISCUSSION
Septic arthritis usually is caused by bacteria that spread through the blood stream from
another area of the body. It can also be caused by a bacterial infection from an open
wound or an opening from a surgical procedure, such as knee surgery.
common bacteria that cause acute septic arthritis include Homophiles influenza,
staphylococcus, and streptococcus. And viruses like
• Hepatitis A, B, and C
• Parvovirus B19
• Herpes viruses
• HIV (AIDS virus)
• HTLV-1
• Adenovirus
• Coxsackie viruses

14. Symptoms:
• Chills
• Fatigue and generalized weakness
• Fever
• Inability to move the limb with the infected joint
• Severe pain in the affected joint, especially with movement
• Swelling

15. Diagnosis:
X-ray
Arthrocentesis
Complete blood picture
Treatment:
Antibiotics
Vitamin supplements
Analgesics

16. THANK
YOU