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Septic sacroiliitis revealing an infectious endocarditis
Madiha Mahfoudhi1, Anis Hariz2, Sami Turki1
1Internal Medicine A Department, Charles Nicolle Hospital, EL Manar University, Tunis, Tunisia.
BMJ Case Reports
|August 16, 2014
Summary
This case study highlights a rare instance of Streptococcus viridans causing both sacroiliitis and infectious endocarditis in a middle-aged man. Prompt diagnosis and a 40-day antibiotic regimen led to a full recovery without recurrence.
Area of Science:
- Infectious Diseases
- Rheumatology
- Cardiology
Background:
- Sacroiliitis, inflammation of the sacroiliac joint, can be caused by various pathogens.
- Infectious endocarditis, a serious heart valve infection, requires timely diagnosis and treatment.
Observation:
- A 43-year-old male presented with right hip pain, fever, and limited hip mobility.
- Initial radiographs were normal, but pelvic MRI revealed right sacroiliitis.
- Synovial fluid analysis identified Streptococcus viridans, confirmed by blood culture.
Findings:
- Echocardiography revealed mitral valve vegetation, confirming infectious endocarditis.
- The patient was treated with penicillin G and gentamicin, followed by pristinamycin due to penicillin allergy.
- A 40-day course of antibiotics resulted in complete resolution of symptoms and abnormalities.
Implications:
- This case underscores the importance of considering disseminated infection in patients with sacroiliitis.
- It highlights the potential for Streptococcus viridans to cause severe, multi-system infections.
- Successful treatment demonstrates the efficacy of appropriate antibiotic therapy for combined sacroiliitis and endocarditis.
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