{"id":10157,"date":"2023-09-07T21:55:41","date_gmt":"2023-09-07T21:55:41","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/?p=10157"},"modified":"2025-12-30T19:13:12","modified_gmt":"2025-12-30T19:13:12","slug":"periprosthetic-joint-infection","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/es\/periprosthetic-joint-infection\/","title":{"rendered":"Criterios Diagn\u00f3stico de Infecci\u00f3n Articular Periprot\u00e9sica"},"content":{"rendered":"<div class=\"7ca9444b8380138fe077da07353677a4\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>La infecci\u00f3n articular periprot\u00e9sica es una complicaci\u00f3n severa que puede ocurrir despu\u00e9s de una cirug\u00eda de reemplazo de articulaci\u00f3n, como una artroplastia de cadera o rodilla. Los criterios diagn\u00f3sticos para una infecci\u00f3n articular periprot\u00e9sica pueden variar seg\u00fan la fuente y las pautas cl\u00ednicas, pero generalmente implican una combinaci\u00f3n de hallazgos cl\u00ednicos, radiol\u00f3gicos y de laboratorio. <!--more--><\/p>\n<p><strong>Criterios de la Sociedad de Infecciones Musculoesquel\u00e9ticas (MSIS) para el diagn\u00f3stico de infecci\u00f3n de pr\u00f3tesis articulares<\/strong><\/p>\n<p>Criterios principales*<\/p>\n<ul>\n<li>Tracto sinusal comunicante a articulaci\u00f3n o pr\u00f3tesis.<\/li>\n<li>Organismo aislado en dos cultivos diferentes de tejido\/l\u00edquido.<\/li>\n<\/ul>\n<p>Criterios menores**<\/p>\n<ul>\n<li>VSG\/PCR elevada<\/li>\n<li>Recuento elevado de leucocitos sinoviales<\/li>\n<li>Porcentaje de PMN sinovial elevado<\/li>\n<li>Material purulento<\/li>\n<li>Organismo aislado en un cultivo de tejido\/l\u00edquido<\/li>\n<li>&gt;5 neutr\u00f3filos por cap en an\u00e1lisis de tejido histol\u00f3gico de 5 cap \u2715400 aumentos<\/li>\n<\/ul>\n<p>*Se necesita 1 criterio para establecer el diagn\u00f3stico de infecci\u00f3n de pr\u00f3tesis articular<br \/>\n**Se necesitan 4 de 6 criterios menores para establecer el diagn\u00f3stico de infecci\u00f3n de pr\u00f3tesis articular.<br \/>\nPCR, prote\u00edna C reactiva; VSG: velocidad de sedimentaci\u00f3n globular; cap, campo de alto poder; % PMN, porcentaje de neutr\u00f3filos polimorfonucleares<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Nueva definici\u00f3n basada en puntuaci\u00f3n<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 380px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 24px;\">\n<td style=\"width: 100%; height: 24px;\" colspan=\"4\">Criterios mayores (al menos uno de los siguientes)<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 75%; height: 24px;\" colspan=\"3\">Dos cultivos positivos de organismo<\/td>\n<td style=\"width: 25%; height: 24px;\">Infectado<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 100%; height: 24px;\" colspan=\"4\">F\u00edstula con evidencia de comunicaci\u00f3n a la articulaci\u00f3n o visualizaci\u00f3n de la pr\u00f3tesis.<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\">Diagn\u00f3stico Prequir\u00fargico<\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Criterios Menores<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">Score<\/td>\n<td style=\"width: 25%; height: 24px;\">Decisi\u00f3n<\/td>\n<\/tr>\n<tr style=\"height: 34px;\">\n<td style=\"width: 22.6714%; height: 34px;\"><\/td>\n<td style=\"width: 35.3493%; height: 34px;\">PCR o D\u00edmero D elevado<\/td>\n<td style=\"width: 16.9793%; height: 34px; text-align: center;\">2<\/td>\n<td style=\"width: 25%; height: 164px;\" rowspan=\"6\">\u22656 Infectado<br \/>\n2\u20135 Posible infecci\u00f3n<sup>a<\/sup><br \/>\n0\u20131 No infectado<\/td>\n<\/tr>\n<tr style=\"height: 34px;\">\n<td style=\"width: 22.6714%; height: 34px;\"><\/td>\n<td style=\"width: 35.3493%; height: 34px;\">VSG elevado<\/td>\n<td style=\"width: 16.9793%; height: 34px; text-align: center;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Conteo de gl\u00f3bulos blancos o leucocitos sinovial elevado<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Alfa-defensina positiva<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">PMN sinovial elevado<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">2<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">PCR sinovial elevado<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">1<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\">Intraquir\u00fargico<\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Score pre-quir\u00fargico inconcluso<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">Score<\/td>\n<td style=\"width: 25%; height: 24px;\">Decisi\u00f3n<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Score prequir\u00fargico<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">&#8211;<\/td>\n<td style=\"width: 25%; height: 96px;\" rowspan=\"4\">\u22656 Infectado<br \/>\n4\u20135 Inconcluso<sup>b<\/sup><br \/>\n\u22643 No infectado<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Histolog\u00eda positiva<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Pus positivo<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">3<\/td>\n<\/tr>\n<tr style=\"height: 24px;\">\n<td style=\"width: 22.6714%; height: 24px;\"><\/td>\n<td style=\"width: 35.3493%; height: 24px;\">Cultivo positivo \u00fanico<\/td>\n<td style=\"width: 16.9793%; height: 24px; text-align: center;\">2<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><sup>a<\/sup> Para pacientes con criterios menores no concluyentes, tambi\u00e9n se pueden utilizar criterios quir\u00fargicos para cumplir con la definici\u00f3n de PJI.<br \/>\n<sup>b<\/sup> Considerar m\u00e1s diagn\u00f3sticos moleculares, como la secuenciaci\u00f3n de pr\u00f3xima generaci\u00f3n.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Bibliograf\u00eda:<\/strong><\/p>\n<ol>\n<li>Patel R. Periprosthetic Joint Infection. N Engl J Med. 2023 Jan 19;388(3):251-262. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/36652356\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<li>Tripathi S, Tarabichi S, Parvizi J, Rajgopal A. Current relevance of biomarkers in diagnosis of periprosthetic joint infection: an update. Arthroplasty. 2023 Aug 1;5(1):41. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37525262\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Creado Ago 31, 2023.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>La infecci\u00f3n articular periprot\u00e9sica es una complicaci\u00f3n severa que puede ocurrir despu\u00e9s de una cirug\u00eda de reemplazo de articulaci\u00f3n, como una artroplastia de cadera o rodilla. Los criterios diagn\u00f3sticos para una infecci\u00f3n articular periprot\u00e9sica pueden variar seg\u00fan la fuente y las pautas cl\u00ednicas, pero generalmente implican una combinaci\u00f3n de hallazgos cl\u00ednicos, radiol\u00f3gicos y de laboratorio.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[1917],"tags":[2617,16,15,14,13,266,267,380,2619,2618],"class_list":["post-10157","post","type-post","status-publish","format-standard","hentry","category-orthopedic","tag-articular","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-infeccion","tag-infection","tag-joint","tag-periprosthetic","tag-periprotesica"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10157","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/comments?post=10157"}],"version-history":[{"count":12,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10157\/revisions"}],"predecessor-version":[{"id":10175,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/posts\/10157\/revisions\/10175"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/media?parent=10157"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/categories?post=10157"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/es\/wp-json\/wp\/v2\/tags?post=10157"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}