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[Ureaplasma parvum arthritis affecting knee, hip, and sacroiliac joint]

Cecilie Hviid Christiansen1, Peter Doering2, Jurgita Samulioniené1

  • 1Klinisk Mikrobiologisk Afdeling, Aalborg Universitetshospital.

Ugeskrift for Laeger
|July 5, 2022
PubMed

Insights

This case report details a rare instance of Ureaplasma parvum causing arthritis in a woman's knee, hip, and sacroiliac joint. Effective treatment involved moxifloxacin after initial antibiotics failed, highlighting a novel therapeutic approach.

Area of Science:

  • Infectious Diseases
  • Rheumatology
  • Microbiology

Background:

  • Ureaplasma parvum is a bacterium rarely associated with joint infections.
  • Polyarticular arthritis can present diagnostic challenges, especially with negative initial cultures.

Observation:

  • A 57-year-old woman presented with severe arthritis affecting the left knee, hip, and sacroiliac joint.
  • Initial broad-spectrum antibiotic treatment (piperacillin/tazobactam, meropenem) was ineffective.
  • Post-surgical tissue and synovial fluid cultures were negative for bacterial growth.

Findings:

  • 16S ribosomal RNA (16S rRNA) gene sequencing identified Ureaplasma parvum in affected joint tissues.
  • Intravenous moxifloxacin therapy led to significant clinical improvement.
  • Long-term oral moxifloxacin was prescribed for sustained management.

Implications:

  • This case underscores the importance of considering Ureaplasma parvum in refractory polyarticular arthritis, even with negative conventional cultures.
  • 16S rRNA analysis is a valuable tool for diagnosing difficult-to-culture pathogens.
  • Moxifloxacin demonstrates efficacy in treating Ureaplasma parvum-induced arthritis, suggesting a potential targeted therapeutic strategy.

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