Natural course


























Shoulder infections



shoulder infection


Here you can read:
What is a shoulder infection ?
Signs and symptoms of a shoulder infection
How to treat shoulder infections ?
How does a shoulder infection develop ?
Types of shoulder infections
What about a prognosis after a shoulder infection ?
What is the natural course of a shoulder infection ?
What is a shoulder infection ?
Bacteria are causing a purulent infection of the shoulder joint or its surrounding ( soft tissue ) structures. Most of the time the shoulder itsself is affected, but other joints can be involved, also.


Signs and symptoms of a shoulder infection:
People are feeling pain in the shoulder, sometimes radiating into the upper arm. Local swelling, redness and warmness as well as fever or chill can occur, but are rare.
A lot of shoulder infections will be recognized late, because of the slight clinical symptoms. Night pain might be another possible symptom.
Shoulder infections are a very severe disease, which have to be treated at once, as soon as they are diagnosed.


How to treat shoulder infections ?
The infective source has to be removed in an operation. The shoulder joint itself can be irrigated arthroscopically or in an open procedure. Several operations within a few days might be necessary. Antibiotic chains and irrigation drainages are used to clean the shoulder joint.


X-ray of an antibiotic chain after a shoulder infection beneath the deltoid muscle
X-ray of the left shoulder: antibiotic chain beneath the deltoid muscle after a shoulder infection.


How does a shoulder infection develop ?
Bacteria can get into the shoulder joint from out- or inside. They get into the shoulder joint from the outside after shoulder traumata with open wounds, after injections into the shoulder or operations.
Bacteria can spread from the inside - over the blood vessel system – while people are suffering from a cold, infection of the urinary bladder or teeth, and so on.


Types of shoulder infections:
According to time one can distinguish between chronic and acute shoulder infections.
Shoulder infections may be localized intraarticular - within the main shoulder joint - which has a bad prognosis, because of the destruction of the main joint. Or they may be localized extraarticular, e.g. beneath the deltoid muscle and / or within the subacromial tunnel. The prognosis is a little better.
In hematogenous shoulder infections bacteria spread over the blood vessel system from another focus, like a tooth abscess or urinary bladder infection. These so called secondary shoulder infections might also occur after operations or infections into the shoulder ( also called idiopathic shoulder infections ).
Even in generalized diseases, which which are associated with immunosupression - like diabetes, Parkinsons disease or rheumatoid arthritis - shoulder infections may develop.


What about the prognosis after a shoulder infection ?
The earlier a shoulder infection is diagnosed and the earlier it is treated the better is the prognosis. A common logterm problem after an infection of the shoulder is a partial shoulder stiffness and possible arthritis with joint destruction.

destruction after a shoulder infection

Arthroscopic view from the backside into the right shoulder:
massive destruction of the shoulder joint after an infection.


What is the natural course of a shoulder infection ?
Untreated a shoulder infections most of the time ends in an extraordinary destruction of the shoulder joint, which can make a shoulder arthroplasty necessary. The affected shoulder becomes stiff and chronic pain will develop.
Very bad are situations, when a shoulder infection spread into other areas of the human body, like heart valves, brain, lung, vertebral bodies and others or when a generalized sepsis develops.
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