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Clin Infect Dis. 2003 Feb 1;36(3):319-27. Epub 2003 Jan 13.

Pneumococcal septic arthritis: review of 190 cases.

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1
Division of Infectious Diseases, Saint Elizabeth's Medical Center, Boston, MA 02135, USA. jrossmd@cchcs.org

Abstract

This article reports 13 cases of pneumococcal septic arthritis and reviews another 177 cases reported since 1965. Of 2407 cases of septic arthritis from large series, 156 (6%) were caused by Streptococcus pneumoniae. Mortality was 19% among adults and 0% among children. Pneumococcal bacteremia was the strongest predictor of mortality. At least 1 knee was involved in 56% of adults. Polyarticular disease (36%) and bacteremia (72%) were more common among adults with septic arthritis caused by S. pneumoniae than among adults with other causative organisms. Only 50% of adults with pneumococcal septic arthritis had another focus of pneumococcal infection, such as pneumonia. Functional outcomes were good in 95% of patients. Uncomplicated pneumococcal septic arthritis can be managed with arthrocentesis and 4 weeks of antibiotic therapy; most cases of pneumococcal prosthetic joint infection can be managed without prosthesis removal. A fatal case of septic arthritis caused by a beta-lactam-resistant strain of S. pneumoniae is also presented.

PMID:
12539074
DOI:
10.1086/345954
[Indexed for MEDLINE]
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