Streptococcus pneumoniae septic arthritis in adults

Abstract

Streptococcus pneumoniae septic arthritis is an uncommon infection. The classic clinical picture is that of concomitant pulmonary and/or meningeal and joint infections in the presence of predisposing local and systemic factors. Initial laboratory tests are usually inconclusive, and joint aspiration is required for a definitive diagnosis. Treatment options include antibiotic therapy (usually with penicillin) combined with closed or open joint drainage. Increasing reports of infections involving penicillin-resistant strains are a concern. The prognosis is usually favourable, but early recognition and aggressive management are essential to reduce the likelihood of significant joint injury.

Intra-abdominal Tuberculosis Presenting with Acute Pancreatitis

“…Several mechanisms have been proposed to explain pancreatic infection by TB. Contiguous spread from adjacent lymph nodes is felt to be most likely but direct hematogenous seeding has also been proposed (15,16). The pancreas is relatively resistant to infection by TB.…”

Differential Diagnosis of a Patient Presenting With a Knee Effusion

“…If the Gram stain does not yield any microorganisms (which happens in nearly half of the cases), the patient's age and sexual activity muse be taken into consideration. When there is no evidence to suggest an infectious process, antibiotics must still cover S. aureus, streptococci, and gonococci (Baraboutis & Skoutelis, 2004;Brusch, 2005).…”

“…Gram-negative anaerobes account for the remainder of the cases (20%) (Munoz & Raycraft, 2006). Septic arthritis can also be caused by other pathogens (Table 2) (Baraboutis & Skoutelis, 2004;Holder, 2007;Munoz & Raycraft, 2006;Read & Peacock, 2004).…”

“…This pathogen is also the cause of nearly 80% of the infected joints in patients with rheumatoid arthritis. The remaining 20% of patients culture out Streptococcus viridans, S. pneumoniae, and group B streptococci (Baraboutis & Skoutelis, 2004). Most of the infections occur in individuals who are young, old, or at high-risk (e.g., immunosuppressed, IV drug user, sexually active young adults ages 15-24).…”

Pneumococcal septic arthritis as the initial presentation of multiple myeloma

“…Polyarticular disease occurs in only approximately 36% of patients. Most pneumococcal septic arthritis occurs with coexistant joint disease, prosthesis, alcoholism, HIV infection, or rheumatoid arthritis (Baraboutis & Skoutelis, 2004; Raad & Peacock, 2004). We report a case of polyarticular septic arthritis as the first manifestation of an underlying disease.…”