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[Septic arthritis caused by Campylobacter fetus]
Abstract:
The ten published cases of septic arthritis due to Campylobacter fetus and two more recent cases, one of which was a delayed septic complication of a total hip replacement, are discussed. In 83% of cases, febrile monoarthritis occurred which in 7 out of the 12 cases involved an already diseased joint in a subject over 70 years of age (half of the patients), who was frequently alcoholic and presented either cancer or hepatic cirrhosis and/or diabetes. Hyperleukocytosis of the blood was variable (55% of cases). The joint fluid, which contained a high level of deteriorated polynuclear cells, was routinely cultured on an enriched medium in an anaerobic or microerophilic atmosphere and in 10 out of 12 cases Campylobacter fetus was isolated within 15 days, even in the absence of previous antibiotic therapy. The arthritis, which showed little sign radiographically of destructiveness, was cured, leaving no sequellae in most cases. Treatment usually involved ampicillin or the tetracyclines, either alone or in association with the aminoglycosides.
Insights
Campylobacter fetus can cause septic arthritis, often in older adults with underlying health conditions. Early diagnosis and treatment with antibiotics typically lead to a full recovery without lasting joint damage.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Septic arthritis is a serious joint infection.
- Campylobacter fetus is an uncommon cause of septic arthritis.
Observation:
- This study reviewed 12 cases of septic arthritis caused by Campylobacter fetus.
- Most cases (83%) presented as febrile monoarthritis.
- Affected joints were often pre-existing diseased joints in elderly patients (over 70) with comorbidities like alcoholism, cancer, cirrhosis, or diabetes.
Findings:
- Campylobacter fetus was isolated from joint fluid in 10 out of 12 cases within 15 days using enriched media and microaerophilic conditions.
- Hyperleukocytosis was observed in 55% of patients.
- Radiographic evidence of joint destruction was minimal.
Implications:
- Campylobacter fetus should be considered in the differential diagnosis of septic arthritis, particularly in elderly patients with risk factors.
- Prompt microbiological investigation, including anaerobic or microaerophilic cultures, is crucial for diagnosis.
- Treatment with ampicillin, tetracyclines, or aminoglycosides is generally effective, leading to good outcomes.