Destructive pneumococcal septic arthritis in end-stage renal disease
Summary
Pneumococcal arthritis generally presents as non-destructive monoarthritis, although some underlying metabolic disorders such as liver failure and diabetes have been suggested to represent a risk factor for severe joint disease. Here we report a case of destructive pneumococcal arthritis of the left hip joint in a patient suffering from chronic renal failure treated with hemodialysis for ten years. Inspite of effective anti-pneumococcal antibiotic treatment, the patient with pre-existing renal osteopathy and a mild osteoarthritis continued to suffer from severe and disabling pain of the left hip. This case demonstrates that pneumococcal joint infection in patients with underlying uremic bone disease can lead to quick deterioration of the affected joint.
Key words
Arthritis Sepsis Streptococcus Pneumoniae Pneumococcal Infection Arthritic Complications Haemodialysis Chronic Renal FailurePreview
Unable to display preview. Download preview PDF.
References
- 1.Cooper C, Cawley MID. Bacterial arthritis in an English health district: a 10 year review. Ann Rheum Dis 1986; 45: 458.PubMedGoogle Scholar
- 2.Goldenberg DL, Reed JI. Bacterial arthritis. New Engl J Med 1985; 312: 764.PubMedGoogle Scholar
- 3.Kluge R, Schmid M, Barth WF. Pneumococcal arthritis. Ann Rheum Dis 1973; 32: 21.PubMedGoogle Scholar
- 4.Keefer CS, Parker FJ, Myers WK. Histologic changes in the knee joint in various infection. Arch Pathol 1934; 18: 199.Google Scholar
- 5.Kauffman CA, Watanakunakorn C, Phair JP. Pneumococcal arthritis. J Rheumatol 1976; 3: 409.PubMedGoogle Scholar
- 6.Vanholder R, Ringoir S. Infectious morbidity and defects of phagocytic function in end-stage renal disease: a review. J Am Soc Nephrol 1993; 3: 1541.PubMedGoogle Scholar
- 7.Churchill D, Taylor D, Cook R, LaPlante P, Barre P, Cartier P, Fay W, Goldstein M, Jindal K, Mandin H, et al. Canadian Hemodialysis Morbidity Study. Am J Kidney Dis 1992; 19: 214.PubMedGoogle Scholar
- 8.Mathews M, Shen F, Lindner A, Sherrard D. Septic arthritis in hemodialyzed patients. Nephron 1980; 25: 87.PubMedGoogle Scholar
- 9.Moseley P, Gold R, Field S, Rodriguez-Erdmann F. Hemophilia, maintenance hemodialysis, and septic arthritis. Arch Internal Med 1981; 141: 138.CrossRefGoogle Scholar
- 10.Muscher D. Streptococcus pneumoniae. In: Mandell J., Bennett J., Dolin R. editors. Principles and practice if infectious diseases. Churchill Livingston, New York, NY, 1995; 1811.Google Scholar
- 11.Argen R. Suppurative pneumococcic arthritis. N Y State J Med 1964; 64: 2573.PubMedGoogle Scholar
- 12.Brzeski M, Smart L, Baired D, Jackson R, Sturrock R. Pneumococcal septic arthritis after splenectomy in Felty's syndrome. Ann Rheum Dis 1991; 50: 724.PubMedGoogle Scholar
- 13.Schwella N, Schwerdtfeger R, Schmidt-Wolf I, Schmid H, Siegert W. Pneumoccal arthritis after allogeneic bone marrow transplantation. Bone Marrow Transpl. 1993; 12: 165.Google Scholar
- 14.Cuesta M, Bernad M, Espinosa A, Herranz P, Mola E, Banos J. Pneumococcal septic arthritis as the first manifestation of multiple myeloma. Clin Exp Rheumatol 1992; 10: 483.PubMedGoogle Scholar
- 15.Latos, D, Stone W. Fulminant pneumococcal bacteriemia in an asplenic chronic hemodialysis patient. Johns Hopkins Medical Journal 1918; 143: 165.Google Scholar