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Streptococcal endocarditis initially seen as septic arthritis.

A E Good, J M Hague, C A Kauffman

    Archives of Internal Medicine
    |May 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    Bacterial endocarditis can present as streptococcal arthritis. Delayed joint fluid analysis may lead to false-negative results in septic arthritis associated with endocarditis.

    Area of Science:

    • Infectious Diseases
    • Rheumatology
    • Cardiology

    Background:

    • Bacterial endocarditis is a serious infection affecting heart valves.
    • Arthritis can be an uncommon early manifestation of bacterial endocarditis.
    • Streptococcal species are known pathogens in infective endocarditis.

    Observation:

    • Two cases of culture-positive streptococcal arthritis as an early sign of bacterial endocarditis are presented.
    • One patient experienced persistent septic monarthritis.
    • The second patient presented with migratory arthritis, showing a transient positive synovial culture.

    Findings:

    • The identified streptococci were an alpha-hemolytic, nongroup D strain and a beta-hemolytic, group B strain.
    • A key observation was a positive synovial fluid culture followed by a negative culture from the same joint prior to antibiotic therapy in one patient.

    Related Experiment Videos

  • This suggests that the timing of joint fluid aspiration is critical.

    • Implications:

    • The study suggests that delayed arthrocentesis (joint fluid aspiration) may result in sterile synovial fluid findings in patients with bacterial endocarditis.
    • This highlights the importance of considering bacterial endocarditis in patients presenting with unexplained arthritis, even with initially negative joint cultures.
    • Early and appropriate diagnostic procedures are crucial for timely diagnosis and treatment of infective endocarditis and its musculoskeletal manifestations.