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Serratia marcescens - caused arthritis with negative and positive birefrengent crystals
Archives of Internal Medicine
|November 1, 1976
Abstract:
We encountered an unusual case of arthritis caused by Serratia marcescens, with both positive and negative birefringent crystals in the same inflammatory synovial fluid. This combination of events is most likely to occur in men over 40 years old who have a predisposing illness or are receiving immunosuppressive drugs. This case shows the need to consider multiple pathological processes occurring in the same joint.
Insights
This case study highlights arthritis caused by Serratia marcescens bacteria. It found both positive and negative birefringent crystals in the same joint fluid, a rare occurrence.
Area of Science:
- Rheumatology
- Infectious Diseases
- Crystal Arthropathies
Background:
- Serratia marcescens is a Gram-negative bacterium that can cause opportunistic infections.
- Crystal-induced arthritis is common, but mixed crystal types in a single joint are rare.
Observation:
- An unusual case of infectious arthritis caused by Serratia marcescens was identified.
- The patient presented with inflammatory synovial fluid containing both positively and negatively birefringent crystals.
Findings:
- The co-occurrence of different crystal types (urate and calcium pyrophosphate dihydrate) in the same joint fluid is uncommon.
- This specific presentation was observed in a male patient over 40, with underlying conditions or immunosuppression.
Implications:
- This case underscores the importance of considering concurrent pathological processes in joint inflammation.
- Accurate crystal identification in synovial fluid is crucial for diagnosing and managing complex arthritis cases.
- Clinicians should maintain a high index of suspicion for unusual infectious agents in inflammatory arthritis.