Septic Arthritis Immunosuppressed — RACP Adult Medicine MCQ

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ModerateRheumatologySeptic Arthritis ImmunosuppressedRACP Adult Medicine

A 65-year-old woman with RA on prednisolone and WCC 55,000 in knee aspirate, no crystals, negative Gram stain. Management?

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Correct answer: E — Treat as septic arthritis with empirical IV antibiotics

Immunosuppressed + WCC >50,000 + negative crystals: septic arthritis until proven otherwise. Gram stain only ~50% sensitive.

Reference: eTG – 2025 – Antibiotic