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.
Anti-Bacterial Agents ; Arthritis, Infectious ; Bacteremia ; Ceftriaxone ; Debridement ; Endocarditis ; Female ; Fever ; Gram-Positive Cocci ; Humans ; Knee ; Meningitis ; Pneumonia ; Sepsis ; Sinusitis ; Streptococcus ; Streptococcus pneumoniae ; Synovial Fluid ; Viscosity