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[Osteoarticular infections caused by Streptococcus agalactiae. Report of 4 cases]
N Gómez-Rodríguez1, J L Ferreiro, A Willisch
1Servicios de Reumatología, Centro Médico POVISA, Vigo.
Background:
Streptococcus agalactiae (group B streptococcus) is a rare etiology of osteoarticular infection in adults. In a literature review (Medline-Embase plus) up until may 1994, we have found only 51 cases. In most patients, diabetes mellitus, liver disease or long-term steroid therapy were documented.
Methods:
Four adult patients with osteoarticular infection due to S. agalactiae from two Galician hospitals were studied from January 1988 to October 1994: prepatellar bursitis (one case), septic monoarthritis (2 cases) and psoas abscess associated to cervical spondylodiscitis and oligoarthritis (left sternoclavicular and left hip joints).
Results:
In the first patient, a young woman with prepatellar bursitis, a previous local trauma was recorded. The second case, a man with septic arthritis of right knee, had degenerative disease of the knees and a prostatic adenocarcinoma. In the third patient, a diabetic woman with septic arthritis of the left shoulder, vulvovaginitis due to Candida albicans was found. The last patient suffered vertebral osteomyelitis of the cervical spine (C3-C4), arthritis of the left sternoclavicular and hip joints and abscess of the ipsilateral psoas. The evolution was favourable in the four cases.
Conclusions:
Although uncommon, osteomyelitis and arthritis caused by group B streptococcus should be considered as opportunistic pathogen in adults with debilitating conditions. Early recognition and prompt institution of adequate therapy can help avoid joint destruction and severe complications.
Insights
Osteoarticular infections in adults caused by Streptococcus agalactiae (group B Streptococcus) are rare but can occur in patients with underlying conditions. Prompt diagnosis and treatment are crucial to prevent severe complications and joint damage.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Streptococcus agalactiae (group B Streptococcus) is an uncommon cause of osteoarticular infections in adults.
- Previous literature identified only 51 cases up to May 1994.
- Risk factors include diabetes mellitus, liver disease, and long-term steroid therapy.
Observation:
- A case series of four adult patients with S. agalactiae osteoarticular infections was studied between 1988 and 1994.
- Presentations included prepatellar bursitis, septic monoarthritis (knee, shoulder), and complex spinal/joint infections with psoas abscess.
- Associated conditions included local trauma, degenerative joint disease, prostate cancer, diabetes, and Candida vulvovaginitis.
Findings:
- All four patients experienced favorable outcomes.
- The study highlights diverse clinical manifestations of S. agalactiae osteoarticular infections.
Implications:
- Group B Streptococcus should be considered an opportunistic pathogen in adults with compromised health.
- Early identification and appropriate treatment are vital to avert joint destruction and serious sequelae.