Septic arthritis of the hip joint caused by Klebsiella pneumoniae: a case report
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Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient’s pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.
Abstract
Klebsiella pneumoniae is an uncommon cause of septic arthritis in adults. However, late detection can cause serious complications, including joint destruction and immobility. The purpose of this study was to report a case of successfully treated septic arthritis of the hip joint (SAHJ) caused by K. pneumoniae. A 49-year-old female patient presented to our hospital with fever and progressive severe pain in the right hip area. Although there was no abnormality on plain radiographs, ultrasonography revealed diffuse swelling of the right hip joint. Under ultrasonography guidance, the hip joint fluid was aspirated, and Gram staining and culturing were performed. The patient’s pain was significantly reduced after the joint aspiration. The Gram staining and culturing revealed gram-negative bacilli, which were subsequently identified as K. pneumoniae. According to the results, systemic intravenous antibiotic (ceftriaxone) was administered without complications, and the patient was discharged on oral antibiotic (ciprofloxacin). Clinical cases of septic arthritis of the knee or sacroiliac joint have been occasionally reported in adults, but cases of SAHJ are rare. Moreover, K. pneumonia-induced SAHJ has not been reported to date. Therefore, we report this very rare case and its successful treatment.
참고문헌 (20)
- Mathews CJ, "Bacterial septic arthritis in adults", Lancet, 375, pp.846~855 (2010)
- Tseng CC, "Acute septic arthritis caused by Klebsiella pneumoniae", Formos J Musculoskelet Disord, 4, pp.51~52 (2013)
- Schelenz S, "Septic arthritis due to extended spectrum beta lactamase producing Klebsiella pneumoniae", Joint Bone Spine, 74, pp.275~278 (2007)
- Chee YC, "Klebsiella pneumoniae sacroiliac septic arthritis : first case report", IDCases, 14, pp.e00459~ (2018)
- Kaandorp CJ, "Risk factors for septic arthritis in patients with joint disease : a prospective study", Arthritis Rheum, 38, pp.1819~1825 (1995)
- Nade S, "Septic arthritis", Best Pract Res Clin Rheumatol, 17, pp.183~200 (2003)
- Frank G, "Musculoskeletal infections in children", Pediatr Clin North Am, 52, pp.1083~1106 (2005)
- Geirsson AJ, "Septic arthritis in Iceland 1990-2002 : increasing incidence due to iatrogenic infections", Ann Rheum Dis, 67, pp.638~643 (2008)
- Ohl CA, "Mandell, Douglas, and Bennett’s principles and practice of infectious diseases", pp.1302~1317 (2005), Elsevier
- Chew LC, "Septic monoarthritis and osteomyelitis in an elderly man following Klebsiella pneumoniae genitourinary infection : case report", Ann Acad Med Singap, 35, pp.100~103 (2006)
- Barton LL, "Septic arthritis in childhood : a 13-year review", Am J Dis Child, 141, pp.898~900 (1987)
- Lee HC, "Clinical implications of hypermucoviscosity phenotype in Klebsiella pneumoniae isolates : association with invasive syndrome in patients with community-acquired bacteraemia", J Intern Med, 259, pp.606~614 (2006)
- Hsieh PF, "Serum-induced iron-acquisition systems and TonB contribute to virulence in Klebsiella pneumoniae causing primary pyogenic liver abscess", J Infect Dis, 197, pp.1717~1727 (2008)
- Stutz G, "Arthroscopic management of septic arthritis : stages of infection and results", Knee Surg Sports Traumatol Arthrosc, 8, pp.270~274 (2000)
- Goldenberg DL, "Treatment of septic arthritis : comparison of needle aspiration and surgery as initial modes of joint drainage", Arthritis Rheum, 18, pp.83~90 (1975)
- Coakley G, "BSR & BHPR, BOA, RCGP and BSAC guidelines for management of the hot swollen joint in adults", Rheumatology(Oxford), 45, pp.1039~1041 (2006)
- Goldenberg DL, "Septic arthritis", Lancet, 351, pp.197~202 (1998)
- Abdelnour A, "The accessory gene regulator(agr)controls Staphylococcus aureus virulence in a murine arthritis model", Infect Immun, 61, pp.3879~3885 (1993)
- Shirtliff ME, "Acute septic arthritis", Clin Microbiol Rev, 15, pp.527~544 (2002)
- Morgan DS, "An 18 year clinical review of septic arthritis from tropical Australia", Epidemiol Infect, 117, pp.423~428 (1996)