Neutrophil-Lymphocyte Ratio in Septic Arthritis Diagnosis and Treatment Follow-Up

Abstract

Aim: This study aimed to determine the availability of neutrophilto- lymphocyte ratio (NLR) in diagnosis and treatment follow-up by determining the changing values when septic arthritis (SA) is diagnosed and during treatment. Material and Method: This retrospective study is based on examining the laboratory results of 44 adult patients with a diagnosis of SA. Laboratory values, white blood cell count (WBC), C-reactive protein (CRP), and NLR of the patients on days 0, 5, 10, and 14 and the results of the joint fluid analysis were evaluated. Results: The mean number of cells in the joint fluid of the patients was 46 thousand, and the mean PMNL rate was 89.4%. Microorganisms were seen in gram staining of joint puncture fluid of only four patients (9.1%). The number of patients with growth in joint fluid culture was only 11 (25%). The mean values for days 0, 5, 10, and 14 were, respectively, 135.2, 88.1, 47.3, and 22.2 for CRP; 9.94, 7.86, 7.42, and 7.44 for WBC; 4.9, 3.8, 3.0 and 2.4 for NLR. Conclusion: NLR may serve as a valuable biomarker for diagnosing and monitoring treatment in SA, particularly given the low prevalence of microorganisms in gram stains and joint fluid cultures and the variability in cell counts in joint fluid samples. In patients diagnosed with SA, the mean NLR value is 4.9 and consistently decreases during treatment. Within two weeks of initiating treatment, NLR typically decreases by approximately half. This biomarker can aid in diagnosing and ongoing managing SA, offering a cost-effective and readily available indicator that should be routinely considered.

Keywords

• arthritis
• septic
• neutrophils
• lymphocytes; biomarkers

References

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