[Septic arthritis as an initial manifestation of bacterial endocarditis caused by Staphylococcus aureus]

Area of Science:

• Cardiology
• Infectious Diseases
• Rheumatology

Background:

• Bacterial endocarditis can present with diverse symptoms, sometimes mimicking other conditions.
• Septic arthritis, particularly in unusual joints like the glenohumeral joint, can be a rare initial manifestation of endocarditis.

Observation:

• An 80-year-old male presented with acute Staphylococcus aureus mitral valve endocarditis, initially manifesting as septic arthritis of the glenohumeral joint.
• The patient experienced fever and joint infection resolution with drainage and antibiotics, but developed heart failure, necessitating urgent valve surgery.
• Despite medical intervention, the patient died suddenly before surgical treatment could be performed.

Findings:

• This case represents a rare presentation of bacterial endocarditis with septic arthritis, specifically in the glenohumeral joint.
• Literature review revealed 26 prior cases of bacterial endocarditis with initial articular infection, but none with septic arthritis and only one involving the glenohumeral joint.

Implications:

• Unexplained arthritis, especially septic arthritis, should raise suspicion for underlying bacterial endocarditis.
• Early recognition of endocarditis in patients with joint symptoms is crucial for appropriate clinical management and improved patient outcomes.
• This case underscores the importance of considering cardiac involvement in patients presenting with seemingly isolated articular infections.