Brachial Plexus Neuritis Associated With Streptococcus agalactiae Infection: A Case Report

Area of Science:

• Neurology
• Infectious Diseases
• Orthopedic Surgery

Background:

• Brachial plexus neuritis is typically idiopathic or associated with viral infections.
• A link between Streptococcus agalactiae and brachial plexus neuritis has not been previously reported.
• Pyogenic arthritis of the shoulder can lead to severe local and systemic complications.

Purpose of the Study:

• To report a case of brachial plexus neuritis associated with Streptococcus agalactiae pyogenic arthritis of the shoulder.
• To highlight a novel causative association for brachial plexus neuritis.
• To discuss the clinical presentation, diagnosis, and management of this rare complication.

Main Methods:

• Case report of a 57-year-old male patient.
• Diagnosis of pyogenic arthritis of the shoulder.
• Surgical intervention: open irrigation and debridement.
• Intravenous antibiotic therapy.
• Microbiological analysis: isolation of Streptococcus agalactiae from wound culture.
• Electrodiagnostic studies (nerve conduction studies and electromyography) to assess brachial plexopathy.

Main Results:

• The patient presented with sudden weakness and pain in the left arm.
• Pyogenic arthritis of the shoulder was diagnosed and treated.
• Streptococcus agalactiae was identified as the causative pathogen.
• Electrodiagnostic studies confirmed brachial plexopathy affecting the left upper and middle trunk.
• Significant improvement in muscle strength and electrodiagnostic signs of reinnervation were observed within nine weeks.

Conclusions:

• Streptococcus agalactiae infection, even localized to the shoulder, can lead to neurological complications such as brachial plexus neuritis.
• This case expands the known spectrum of complications associated with Streptococcus agalactiae infections.
• Prompt diagnosis and appropriate treatment of the underlying infection are crucial for neurological recovery.