Septic polyarthritis caused by Streptococcus pneumoniae: primary pneumococcal pneumonia as a risk factor in older patients? A case report

Septic polyarthritis associated to Streptococcus pneumoniae pneumonia is rarely seen and deserves description. In the present report, the case of a 77-year-old man with a 3-day clinical history of arthritis lacking anamnesis of trauma is discussed. Physical examination showed inflammatory signs and elevated inflammatory parameters in blood samples. The patient experienced pneumonia with blood cultures positive for S pneumoniae simultaneously. Arthrotomy revealed putride arthritis with S pneumoniae in culture. Therapy was initiated with intravenous benzylpenicillin. Surgical drainage and frequent retesting managed the local infection. Antibiotics had to be changed according to the specific sensitivity to ceftriaxone. Antimicrobial therapy was given intravenously for a total of 6 weeks. On follow-up no inflammatory signs were observed after 4 and 9 months. A bistrategical approach with surgical drainage and frequent retesting and antimicrobial chemotherapy may lead to a good result in the treatment of pneumococcal septic arthritis.