Acute septic arthritis due to Streptococcus sanguis

Area of Science:

• Infectious Diseases
• Rheumatology
• Microbiology

Background:

• Septic arthritis is a serious joint infection that can lead to rapid joint destruction.
• Viridans group streptococci, including Streptococcus sanguis, are typically associated with endocarditis and bacteremia, but rarely cause native joint septic arthritis.

Observation:

• A 73-year-old woman developed acute septic arthritis of the knee following treatment for severe periodontal disease.
• Synovial fluid analysis revealed purulent fluid with isolation of Streptococcus sanguis.
• The patient presented with fever, right knee swelling, pain, and effusion.

Findings:

• Intravenous cefotaxime treatment for 3 weeks and repeated knee joint aspiration resulted in gradual resolution of symptoms.
• Streptococcus sanguis was successfully eradicated from the joint.
• The patient experienced a favorable outcome with no long-term joint damage.

Implications:

• This case underscores that Streptococcus sanguis, though uncommon, can be a causative agent of septic arthritis in native joints.
• Dental health, particularly severe periodontal disease and recent dental procedures, should be considered a potential risk factor for S. sanguis septic arthritis.
• Early diagnosis and appropriate antibiotic therapy are crucial for managing septic arthritis and preventing complications.