Septic arthritis secondary to vesicoureteral reflux into single ectopic ureter

Abstract

A 3-week-old male infant, born full term without complication, developed septic arthritis of his left shoulder. His joint fluid, blood, and bone marrow were all positive for Escherichia coli. Urinalysis demonstrated pyuria. Urine culture obtained after one dose of ceftriaxone and several doses of nafcillin was negative. Work-up revealed a refluxing, right single ectopic ureter with severe hydroureteronephrosis and a non-functioning ipsilateral kidney. After appropriate management of the musculoskeletal infection, he underwent a right nephroureterectomy. Coliform septic arthritis is exceedingly rare in children, with only a few cases reported. We report the first case of septic arthritis with anomalous genitourinary tract development as the source of bacterial seeding. This report re-emphasizes the need to screen the urinary tract in all cases of pediatric gram-negative sepsis.

Septic Arthritis in Dogs: A Retrospective Study of 20 Cases (2000-2002)

“…The types of bacteria found in our study are commonly reported in septic arthritis in human medicine and small animal literatures (Abuekteish et al 1996;Egan et al 1999;Knight et al 1996;Dubost et al 2000;Ryan et al 1997). The major pathogens associated with septic arthritis in our patients are staphylococci, streptococci and Pseudomonas spp.…”

“…We suspected that septic joint occurred from the distribution of bacteria causing endocarditis. The positive rate of synovial fluid cultures found in this study was lower than in other investigations (Egan et al 1999;Boon 1997;Fink and Nelson 1986;Ryan et al 1997). However, the negative bacterial culture results are always found in clinical practice due to the method of sampling, methods of bacterial cultivation, the types of transport and culture media selected, and type of bacteria (Boon 1997).…”

“…(Hudgin et al 1992) were reported, the ones that most commonly attack these tissues are Staphylococcus aureus, hemolytic Streptococcus, Pseudomonas aeruginosa, and Klebsiella spp. (Abuekteish et al 1996;Egan et al 1999;Hultgren et al 1998). The infecting organism reaches the joint tissue (by hematogenous spread) as a result of a primary septicemia from a bacterial endocarditis, pneumonia, or abscess in another part of the body (Bennett and Taylor 1988;Egan et al 1999).…”

“…(Abuekteish et al 1996;Egan et al 1999;Hultgren et al 1998). The infecting organism reaches the joint tissue (by hematogenous spread) as a result of a primary septicemia from a bacterial endocarditis, pneumonia, or abscess in another part of the body (Bennett and Taylor 1988;Egan et al 1999). Furthermore, septic arthritis may develop after arthrocenthesis or injection especially in the patient with rheumatoid arthritis or with preexisting joint diseases (Hultgren et al 1998;Laho and Kotilaien 2001;Liu et al 2001;Mclnnes et al 1998).…”

Septic Arthritis in an Infant With Vesicoureteral Reflux and Urinary Tract Infection

“…2,3 To date, 1 such case has been reported, but the urologic abnormality was detected only after discovery of septic arthritis caused by Escherichia coli. 4 We describe the unusual case of an infant who had known congenital VUR and was poorly compliant with antibiotic prophylaxis and developed urosepsis and septic arthritis of the right hip.…”