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[S. pneumoniae sternoclavicular arthritis in a patient with HIV infection]
1Servicio de Medicina Interna, Hospital General de Huelva.
Abstract:
HIV infection is a predisposing factor for pneumococcic infection. While pneumonia is the most frequent location, other locations (articular, meningeal, endocardiac, etc) have been less frequently described. Among the articular infections described in patients with HIV infection, the sternoclavicular affection is extremely rare and it usually develops in association with parenterally drug addiction, being Staphylococcus aureus and Pseudomonas aeruginosa the most frequently germs involved. We describe the first case of sternoclavicular arthritis by Streptococcus pneumoniae in a patient with HIV infection. In our case, the chronic hepatopathy associated to alcohol consumption is a predisposing factor related to the pneumococcic infection. Our case suggests the need to formally investigate the HIV infection in young patients with invasive pneumococcic infection.
Insights
Human immunodeficiency virus (HIV) infection increases the risk of pneumococcal infections. This case report highlights a rare instance of sternoclavicular arthritis caused by Streptococcus pneumoniae in an HIV-positive individual.
Area of Science:
- Infectious Diseases
- Rheumatology
- Public Health
Background:
- HIV infection is a known risk factor for invasive pneumococcal disease.
- Articular manifestations of pneumococcal infections are less common than pneumonia.
- Sternoclavicular arthritis is a rare joint infection, typically associated with intravenous drug use and specific bacterial pathogens.
Observation:
- This report details the first documented case of sternoclavicular arthritis caused by Streptococcus pneumoniae in a patient with HIV infection.
- The patient presented with chronic hepatopathy secondary to alcohol consumption, identified as a predisposing factor for pneumococcal infection.
- Unlike previously reported cases, Staphylococcus aureus and Pseudomonas aeruginosa were not the causative agents.
Findings:
- Streptococcus pneumoniae can cause rare forms of articular infection, such as sternoclavicular arthritis, in HIV-infected individuals.
- Chronic alcohol-related liver disease may act as an additional predisposing factor for invasive pneumococcal infections in this population.
- The identification of Streptococcus pneumoniae in this unusual joint location underscores the diverse clinical presentations of pneumococcal disease.
Implications:
- Healthcare providers should consider HIV testing in young patients presenting with invasive pneumococcal infections, even in the absence of typical risk factors.
- This case broadens the spectrum of known articular complications of pneumococcal infections in immunocompromised individuals.
- Further research is warranted to understand the specific mechanisms and risk factors contributing to rare pneumococcal joint infections in HIV-positive patients.