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Group G streptococcal infection of joints and joint prostheses
Abstract:
Eight cases of septic arthritis caused by beta-haemolytic streptococci of Lancefield group G are presented and compared with others previously reported. Involvement of prosthetic joints is notable (25%) as is accompanying cellulitis (75%) which is probably related to the portal of entry of the organism. Other associated conditions were rheumatoid arthritis (38%) and malignant neoplastic disease (25%). Carriage of the group G streptococcus was detected in two of the eight patients. Serological tests for streptococcal antibodies were found to be less useful in the diagnosis of septic arthritis due to group G streptococci than culture of aspirated fluid. In the absence of endocarditis, which was not present in any of our patients, the prognosis appears to be good after treatment with appropriate antibiotics and open drainage of the joint. Both affected joint prostheses, however, required removal.
Insights
Septic arthritis caused by group G streptococci, particularly in prosthetic joints, often presents with cellulitis. Diagnosis relies on fluid culture over serology, with a good prognosis after antibiotic treatment and drainage, though prostheses may need removal.
Area of Science:
- Infectious Diseases
- Rheumatology
- Orthopedic Surgery
Background:
- Septic arthritis is a serious joint infection.
- Beta-haemolytic streptococci, Lancefield group G, are an uncommon cause of septic arthritis.
- Understanding the clinical features and outcomes of group G streptococcal septic arthritis is important for patient management.
Purpose of the Study:
- To present eight cases of septic arthritis caused by group G streptococci.
- To compare these cases with previously reported cases.
- To identify clinical features, associated conditions, diagnostic methods, and treatment outcomes.
Main Methods:
- Retrospective case series analysis.
- Review of eight cases of septic arthritis due to group G streptococci.
- Comparison with existing literature.
- Analysis of clinical presentation, comorbidities, diagnostic tests (fluid culture, serology), and treatment outcomes.
Main Results:
- Eight cases of group G streptococcal septic arthritis were identified.
- Prosthetic joint involvement occurred in 25% of cases.
- Cellulitis was present in 75% of cases, suggesting a likely portal of entry.
- Associated conditions included rheumatoid arthritis (38%) and malignancy (25%).
- Joint fluid culture was more reliable than serological tests for diagnosis.
- Prognosis was good with appropriate treatment (antibiotics, drainage), but joint prostheses often required removal.
Conclusions:
- Group G streptococci can cause septic arthritis, with a predilection for prosthetic joints and frequent association with cellulitis.
- Diagnosis is best achieved through joint fluid culture.
- Prompt antibiotic therapy and surgical drainage lead to a favorable prognosis in most cases, excluding endocarditis.
- Removal of infected prosthetic joints may be necessary.