Bilateral Acromioclavicular Septic Arthritis as an Initial Presentation ofStreptococcus pneumoniaeEndocarditis

Abstract

Infective endocarditis (IE) is infrequently associated with septic arthritis. Moreover, septic arthritis of the acromioclavicular (AC) joint is rarely reported in the literature. We report a case of Streptococcus pneumoniae IE in a patient who presented with bilateral AC joint septic arthritis and we review the literature on the topic.

Septic arthritis of the acromioclavicular joint: a case series and review of the literature

“…In the current literature, over 75% (20 of 26) of cases have been in patients with an immunocompromised state or high-risk behavior. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] This is comparable to our study in which all three patients were either immunocompromised or engaged in high-risk behavior ( Table 2). The average age of the patients is 49.7 years (range: 17-79).…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14] The average duration of symptoms prior to presentation was 21.7 days. [1][2][3][4][5][6][7][8][9][10][11][12][13][14] High suspicion for this condition is necessary for correct and early diagnosis of this condition which is crucial to prevent morbidity and mortality, as septic AC arthritis can be rapidly destructive. 10 Physical examination findings for AC septic arthritis can be difficult to differentiate from glenohumeral septic arthritis, as patients will often have restricted painful shoulder motion with both active and passive motion.…”

“…This disease is most commonly seen in patients with a preexisting immunocompromised state; however, it has also been reported in patients without any predisposing comorbidities. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] With an increasing number of patients with compromised immune systems from etiologies such as diabetes, drug abuse, cancer, and chemotherapy, this disease process may become more prevalent in the future. We present a case series of three patients along with a review of the literature and propose an algorithm for diagnosing and treating septic arthritis of the AC joint.…”

Acromioclavicular Septic Arthritis Caused by Veillonella parvula

“…To our knowledge, primary septic ACJ infection has been reported 32 times. In 2014, Hashemi et al described a case from bilateral acromioclavicular septic arthritis with a literature review [3]. They showed a total number of 30 cases.…”

“…They are mostly caused by Staphylococcus aureus , then Staphylococcus epidermidis , streptococci, and Gram-negative rods [2]. Acromioclavicular joint (ACJ) septic arthritis is rare: 32 cases were reported in the literature so far [3–5].…”