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Group F Streptococcus. An unusual cause of arthritis
1Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030.
Abstract:
Bacterial arthritis is a serious infection in children occurring either as the result of direct inoculation of organisms into the joint space, of spreading from a contiguous focus of infection, or of hematogenous seeding of the synovium. Although the etiologic agent can be identified in 60% to 70% of cases, joint fluid cultures may remain negative in a substantial number of patients. The most likely etiologic agent depends both on the route of infection and the age of the child. Overall Staphylococcus aureus, Hemophilus influenzae type b and streptococci are the leading causes of bacterial arthritis. Lancefield groups A, B, C, D, and G have all been implicated. However, septic arthritis due to hematogenous seeding with Group F Streptococcus has not been previously reported. A normal 10-month-old boy presented with acute monoarticular arthritis of the knee and had Group F Streptococcus isolated from the blood. Antimicrobial therapy resulted in complete resolution of the arthritis.
Insights
Bacterial arthritis in children is serious. Group F Streptococcus, a rare cause, was identified in a 10-month-old boy with knee arthritis, leading to full recovery with antibiotics.
Area of Science:
- Pediatric infectious diseases
- Rheumatology
- Microbiology
Background:
- Bacterial arthritis in children is a significant joint infection.
- Common causes include Staphylococcus aureus, Hemophilus influenzae type b, and other streptococci.
- Etiologic agents are identified in 60-70% of cases, but joint fluid cultures can be negative.
Observation:
- A 10-month-old boy presented with acute monoarticular arthritis of the knee.
- Group F Streptococcus was isolated from the patient's blood.
- This represents a previously unreported cause of septic arthritis via hematogenous seeding.
Findings:
- Group F Streptococcus successfully treated with antimicrobial therapy.
- Complete resolution of arthritis was achieved.
- Highlights the importance of considering less common pathogens in pediatric septic arthritis.
Implications:
- Expands the known spectrum of streptococcal species causing pediatric septic arthritis.
- Emphasizes the need for thorough microbiological investigation, including blood cultures, in suspected cases.
- Informs clinical management and antibiotic choices for pediatric bacterial arthritis.