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Isolated septic arthritis of the hip secondary to Fusobacterium necrophorum

Yuan-Pin Hsu1, Shih-Hung Tsai, Ling-Yuan Li

  • 1Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. m871023@ndmctsgh.edu.tw

The American Journal of the Medical Sciences
|December 7, 2011
PubMed

Insights

Fusobacterium necrophorum septic arthritis is rare, often linked to Lemierre syndrome. This case highlights isolated hip joint infection by this bacteria, leading to severe sepsis and hip replacement.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Septic arthritis caused by Fusobacterium necrophorum is uncommon, with only five prior case reports.
  • Fusobacterium necrophorum is often associated with Lemierre syndrome, a condition involving pharyngitis, jugular vein thrombosis, and metastatic infection.

Observation:

  • A 24-year-old female presented with delayed medical attention for isolated septic arthritis of the hip.
  • The patient developed severe sepsis secondary to Fusobacterium necrophorum hip infection.

Findings:

  • The patient required aggressive treatment including resuscitation, vasopressors, antibiotics, and surgical drainage via arthrotomy.
  • Despite extensive treatment, the infection led to significant destruction of the hip bone, necessitating a total hip replacement.

Implications:

  • This case underscores the potential for Fusobacterium necrophorum to cause isolated septic arthritis, even without typical Lemierre syndrome features.
  • Delayed presentation and treatment can result in severe outcomes, including joint destruction and the need for joint replacement surgery.
  • Highlights the importance of considering rare pathogens in septic arthritis, particularly in cases with severe sepsis or unusual presentations.

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