MiscellaneousMethicillin-Resistant Staphylococcus aureus Arthritis in Adults: Case Report and Review of the Literature
Section snippets
Case Report
A 55-year-old man, an actively employed maintenance engineer, presented to our hospital with a 3-day history of fever, progressive right hip pain without antecedent trauma, and difficulty ambulating. He had a poor appetite and extreme fatigue. On the day of presentation, he developed labored and rapid breathing. He had a history of untreated chronic hepatitis C infection, gouty arthritis, and knee osteoarthritis. The latter was treated with arthroscopic knee surgery 20 months earlier and
Methods
Reports of MRSA septic arthritis in adults (age >18 years) published in the English language were identified using the PubMed and the Embase databases. The following keywords were utilized: “methicillin-resistant Staphylococcus aureus,” “drug resistance, bacterial,” “arthritis, infectious,” and “septic arthritis.” The search was conducted on May 21, 2010. These sources were augmented by hand searches of reference lists in the accessed articles. Cases were excluded if the infection involved a
Results
The characteristics of MRSA native-joint septic arthritis were detailed in the published literature for 56 adult patients, of whom 42 (76%) were men (Table 1) (3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21). The majority represented nosocomial infections occurring in the context of comorbid medical conditions. Only 5 patients developed MRSA septic arthritis in the absence of nosocomial exposures and of other identifiable risk factors. Rheumatologic diseases were reported
Discussion
The occurrence of fatal MRSA native joint septic arthritis in a health care–naive patient has rarely been reported. Although our patient had hepatitis C and gout, he enjoyed good health and was actively employed at the time that he became ill. He died from overwhelming CA-MRSA sepsis. Right hip pain was the patient's initial symptom, suggesting that the septic arthritis was an early feature of the illness. Septic arthritis of the hip is almost always derived from hematogenous seeding of the
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Cited by (19)
Bilateral glenohumeral septic arthritis secondary to mastitis with subsequent avascular necrosis: A case report
2021, International Journal of Surgery Case ReportsCitation Excerpt :It is an orthopaedic emergency, managed with either open or arthroscopic drainage of the joint with a course of culture-sensitive antibiotics. Mortality rates vary from 4 to 42% [2], with values as high as 50% in polyarticular disease [3]. This occurs in patients with comorbidity or the immunocompromised, such as those with sepsis, liver cirrhosis, HIV, Diabetes mellitus, and Intravenous drug abusers [4].
Staphylococcus aureus native arthritis over 10 years
2020, Medecine et Maladies InfectieusesCitation Excerpt :The frequency of MRSA infection in our study (24.1%) was comparable to other reports [5,6,9–11]. As in previous studies, we observed an association between MRSA infection and age, comorbidities, and healthcare-associated and hospital-acquired infections [5,6,8,10,19,26]. A literature review of S. aureus native arthritis studies is presented in Table 3.
Clinical findings of bacteremic septic arthritis according to the site of acquisition: The overlap between health care-related and community- and nosocomial-acquired cases
2016, European Journal of Internal MedicineSeptic arthritis due to methylcyllin-resistant Staphylococcus aureus in adults
2015, Reumatologia ClinicaPyogenic arthritis of native joints in non-intravenous drug users: A detailed analysis of 268 cases attended in a tertiary hospital over a 22-year period
2015, Seminars in Arthritis and RheumatismCitation Excerpt :The incidence of MRSA infection did not show significant changes over time, this being in accordance with previous data from our institution [25] or from other European authors [5]. Our results also seem to be in agreement with others from elsewhere in Europe, which have reported the lower frequency of community-acquired MRSA infections compared with the USA [26,27]. Consistent with these reports, MRSA was only treated empirically for SA occurring in hospitalized patients or those from other healthcare environments.
Efficacy of Hip Arthroscopy for the Management of Septic Arthritis: A Systematic Review
2015, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :In this review tremendous variability existed in the following, in addition to other factors: (1) optimal number of arthroscopic portals; (2) portal location; (3) patient positioning; (4) use and specific type of postoperative drain; (5) use, dosage, route, and timing of antibiotics; and (6) volume and type of irrigation fluid. There exists a thorough, evidence-based algorithm for diagnosing septic arthritis of the native hip.2,26 Ultimately, ascertaining the effect of these and other variables on outcomes and complication rates might be essential in an effort to define the optimal surgical approach.
This work was supported by NIH (Contract NOI-DE-32636) and the Jerome L. Greene Foundation.
The authors have no conflicts of interest to disclose.