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Septic arthritis is an infectious
disease emergency, requiring aggressive joint drainage and prompt antibiotic therapy. Because age and joint damage are major risk factors, septic arthritis may become more common as the baby-boom generation reaches senescence. Bacteremic joint infections have a high mortality, and long-term disability from joint damage is common.
Lyme arthritis has a negligible mortality and low morbidity but causes disproportionate popular anxiety. Most patients with
Lyme arthritis respond well to oral antibiotic regimens and recover completely. A few patients develop antibiotic-resistant
Lyme arthritis, which is probably autoimmune in nature and responds to immunosuppressive therapy. This paper reviews the presentation, diagnosis, and management of bacterial and
Lyme arthritis. Septic arthritis caused by Streptococcus pneumoniae and group B streptococci may be increasing in prevalence. Prospective studies are required to determine whether there is any benefit of surgical or arthroscopic joint drainage in septic arthritis, compared with serial arthrocentesis, and to determine the role of corticosteroid therapy in septic arthritis in adults, if any.