Pyogenic arthritis complicating varicella infection
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K L Glass1, T A Dillard, G J Dennis
1Department of Medicine, Walter Reed Army Medical Center, Washington, DC 20307-5001.
Abstract:
Arthritis has not previously been reported as a complication in adult patients with chickenpox. In pediatric patients, the arthritis that complicates chickenpox is most commonly aseptic but does rarely result from bacterial infection. We report the case of a 21-year-old man who developed acute monoarticular septic arthritis due to Lancefield Group A beta-hemolytic streptococci. Despite the more common viral cause of arthritis in pediatric patients, physicians should not attribute arthritis associated with varicella in adults to a viral cause without diagnostic arthrocentesis.
Insights
Chickenpox (varicella) can cause septic arthritis in adults, not just viral arthritis seen in children. Diagnostic joint fluid analysis is crucial for accurate diagnosis in adult varicella cases.
Area of Science:
- Infectious Diseases
- Rheumatology
- Clinical Medicine
Background:
- Chickenpox (varicella) is a common viral infection, typically causing mild illness.
- Arthritis is a known, though rare, complication of chickenpox, primarily observed in pediatric patients.
- In children, chickenpox-associated arthritis is usually aseptic (viral) but can rarely be bacterial.
Observation:
- A case report details a 21-year-old adult male who presented with acute monoarticular septic arthritis.
- The causative agent identified was Lancefield Group A beta-hemolytic streptococci, a bacterial pathogen.
- This contrasts with the typical viral etiology of arthritis in pediatric chickenpox cases.
Findings:
- Septic arthritis due to Group A Streptococcus is a documented complication of varicella in adults.
- This case highlights a bacterial cause of arthritis in an adult with chickenpox.
- The presentation was acute and affected a single joint (monoarticular).
Implications:
- Physicians should consider bacterial septic arthritis in adults presenting with joint pain during a varicella infection.
- Diagnostic arthrocentesis (joint fluid analysis) is essential to differentiate between viral and bacterial causes.
- This finding expands the known spectrum of varicella complications in adult patients.