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Destructive polyarthritis due to a group B streptococcus
C Straus1, D Caplanne, A M Bergemer
1Rheumatology Department, Ambroise-Paré Teaching Hospital, Boulogne, France.
Abstract:
A new case of destructive polyarthritis due to a Group B streptococcus is reported. The patient was a 55-year-old male whose predominantly axial manifestations in the absence of evidence of an infection initially suggested psoriatic arthritis. Although rare, Group B streptococcal arthritis has been reported outside the postpartal and neonatal periods. Monoarthritis with a favorable outcome has been the most common clinical pattern. Several cases of destructive polyarthritis with axial involvement have been reported in which the joint destruction and longer time to diagnosis as compared with monoarticular forms resulted in permanent functional impairment.
Insights
A rare case of destructive polyarthritis caused by Group B Streptococcus in a 55-year-old male mimicked psoriatic arthritis. This finding highlights the potential for severe joint damage and functional impairment in non-neonatal Group B Streptococcus infections.
Area of Science:
- Rheumatology
- Infectious Diseases
- Microbiology
Background:
- Group B Streptococcus (GBS) is a significant cause of neonatal infections but can also affect adults.
- Adult GBS infections are typically associated with monoarthritis and favorable outcomes.
- Destructive polyarthritis from GBS is uncommon, particularly outside of postpartum or neonatal contexts.
Observation:
- A 55-year-old male presented with destructive polyarthritis with predominantly axial involvement.
- Initial presentation lacked clear signs of infection, leading to a differential diagnosis including psoriatic arthritis.
- The patient's condition involved significant joint destruction.
Findings:
- The underlying cause of the destructive polyarthritis was identified as Group B Streptococcus.
- The axial manifestations and severity mimicked other inflammatory arthropathies.
- Delayed diagnosis contributed to permanent functional impairment.
Implications:
- This case underscores the importance of considering GBS in adult-onset destructive polyarthritis, even with atypical presentations.
- Early diagnosis and treatment are crucial to prevent severe joint damage and long-term disability.
- Further research may be needed to understand the pathogenesis of severe GBS-induced arthritis in non-neonatal populations.