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Knee Arthrocentesis in Adults
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Chronic Corynebacterium striatum Septic Arthritis in a Patient Referred for Total Knee Arthroplasty

Katharine Hollnagel1, Jacob Willen1, Michael Ellis2

  • 1Department of Orthopaedic Surgery, The University of Toledo Medical Center, USA.

Case Reports in Orthopedics
|March 25, 2020
PubMed
Abstract

Insights

Corynebacterium striatum is increasingly recognized as a pathogen. This case highlights successful treatment of chronic C. striatum septic arthritis in a native knee joint using surgery and daptomycin.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Corynebacterium striatum, once considered a contaminant, is now frequently identified as a pathogen.
  • Septic arthritis is a serious joint infection that requires prompt diagnosis and treatment.
  • Osteoarthritis is a common degenerative joint disease often treated with total knee arthroplasty.

Observation:

  • A 78-year-old male with osteoarthritis presented with chronic knee pain and atypical bony erosions on plain films.
  • Joint aspiration revealed a high white blood cell count (30,548/mm3) and positive cultures for C. striatum.
  • The patient had no pain with passive range-of-motion, which is unusual for septic arthritis.

Findings:

  • This is the first reported case of chronic C. striatum septic arthritis in a native joint.
  • It is only the third reported case of C. striatum septic arthritis affecting the knee.
  • Successful treatment involved open irrigation and debridement, synovectomy, and six weeks of intravenous daptomycin.

Implications:

  • Highlights the emerging role of C. striatum as a pathogen in joint infections.
  • Demonstrates the efficacy of surgical intervention and daptomycin in treating chronic C. striatum septic arthritis.
  • Suggests considering C. striatum in the differential diagnosis of atypical septic arthritis, even in native joints.

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