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Published on: February 15, 2013

An atypical pneumococcal arthritis

Pascal Rossi1, Brigitte Granel, Philippe Mouly

  • 1Department of Internal Medicine, Hopital Nord, Marseille, France. pascalmaurice.rossi@ap-hm.fr

BMJ Case Reports
|July 14, 2012
PubMed

Insights

Streptococcus pneumoniae can cause bone and joint infections, even in healthy individuals. This case highlights the importance of checking multiple sites for infection, as it may spread from the mouth.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Bone and joint infections are typically seen in immunocompromised patients and affect a single site.
  • Streptococcus pneumoniae is a common pathogen, but severe disseminated infections are less frequent in immunocompetent individuals.

Observation:

  • A 49-year-old immunocompetent male presented with sepsis and polyarticular septic arthritis affecting the shoulder and knee.
  • The patient also had cervical spondylodiscitis, a rare spinal infection, caused by Streptococcus pneumoniae.

Findings:

  • This case represents a unique presentation of Streptococcus pneumoniae causing simultaneous, multiple-site bone and joint infections in an immunocompetent host.
  • The likely origin of the infection was the gingiva, a common colonization site for S. pneumoniae.

Implications:

  • Streptococcus pneumoniae should be routinely considered in the differential diagnosis of bone and joint infections, regardless of immune status.
  • Clinicians should actively investigate for multiple infected sites, even in the absence of overt symptoms, to ensure comprehensive diagnosis and treatment.

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