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Knee Arthrocentesis in Adults
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Persistent synovial actinomycosis in a native knee joint: A case report.
Manuel Ramírez-González1, Norberto J Torres-Lugo1, Luis Bisbal-Matos1
1Department of Orthopaedic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico.
International Journal of Surgery Case Reports
|March 20, 2022
Summary
Actinomycosis is a rare musculoskeletal infection. This case highlights the diagnostic challenges of synovial actinomycosis, emphasizing the need for high clinical suspicion for early diagnosis and effective management.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Actinomycosis is a chronic granulomatous disease caused by Actinomyces species.
- Musculoskeletal actinomycosis, particularly synovial involvement, is rare and poses diagnostic challenges due to non-specific symptoms.
- High clinical suspicion and appropriate diagnostic methods are crucial for identification.
Purpose of the Study:
- To present a case of persistent synovial actinomycosis in a native knee joint.
- To underscore the diagnostic difficulties and management considerations for this rare condition.
Main Methods:
- Case report of a 39-year-old female with chronic knee pain and purulent secretions.
- Review of clinical presentation, diagnostic workup, and treatment course including arthrotomy and antibiotics.
Main Results:
- The patient presented with persistent synovial actinomycosis despite surgical intervention and prolonged antibiotic therapy.
- Actinomyces species are rare causes of musculoskeletal infections, often presenting with non-specific signs like swelling, fibrosis, or abscesses.
Conclusions:
- Synovial actinomycosis of the native knee is a rarely reported entity.
- Early diagnosis and appropriate management, including adequate antibiotic selection and potentially surgical intervention, are vital to prevent persistent infection.
