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Korean J Crit Care Med > Volume 28(3); 2013 > Article
Korean Journal of Critical Care Medicine 2013;28(3): 230-233. doi: https://doi.org/10.4266/kjccm.2013.28.3.230
폐렴사슬알균 균혈증과 동반된 양측 무릎의 화농성 관절염
박요한ㆍ이종찬ㆍ조준현ㆍ박진용ㆍ신명철
인천사랑병원 내과
A Case of Bilateral Knee Septic Arthritis Caused by Pneumococcal Bacteremia
Yo Han Park, Jong Chan Lee, Junhyeon Cho, Jinyong Park, Myeungcheol Shin
Department of Internal Medicine, Incheon Sarang Hospital, Incheon, Korea. megeby@naver.com
ABSTRACT
Pneumococcus can cause pneumonia, sinusitis, infective endocarditis, meningitis and primary bacteremia. However, few reports in the literature show bilateral septic arthritis with pneumococcal bacteremia. We report on a case of a 78-year old woman who presented with fever, pain and swelling in both knees. Both knee fluid aspirates were purulent with thick viscosity, and the gram stain revealed gram positive cocci in chains. The patient underwent emergent washing and arthroscopic debridement, followed with empirical antibiotics treatment. Two out of two blood cultures were positive for penicillin-susceptible Streptococcus pneumonia. Synovial fluid cultures were also positive for S. pneumoniae. The patient was treated with intravenous ceftriaxone for 4 weeks. Bilateral knee septic arthritis with pneumococcal bacteremia is rarely reported. Here we report on the case with a review of the literature.
Key Words: pneumococcus; sepsis; septic arthritis; Steptococcus pneumoniae
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