Septic polyarthritis due to Bacteroides fragilis in a patient with rheumatoid arthritis. A case report. 1982

D Schorn, and J A Pretorius

Gram-negative septic arthritis is an uncommon but serious complication of rheumatoid arthritis and is usually mono-articular. The present case is unusual in that a septic polyarthritis due to Bacteroides fragilis developed in nine joints. The organism was grown only in anaerobic synovial fluid and blood cultures. The patient recovered after treatment which included repeated needle aspirations of the joints under anaesthesia and oral metronidazole (Flagyl; Maybaker). Any patient with rheumatoid arthritis who develops an acute flare-up of disease in one or more joints should have these aspirated to exclude the possibility of septic arthritis. Both anaerobic and aerobic cultures of synovial fluid and blood should be done. Prompt antibiotic treatment and joint drainage are the cornerstones of treatment.

UI MeSH Term Description Entries
D008795 Metronidazole A nitroimidazole used to treat AMEBIASIS; VAGINITIS; TRICHOMONAS INFECTIONS; GIARDIASIS; ANAEROBIC BACTERIA; and TREPONEMAL INFECTIONS. 2-Methyl-5-nitroimidazole-1-ethanol,Bayer 5360,Clont,Danizol,Flagyl,Gineflavir,Metric,MetroGel,Metrodzhil,Metrogyl,Metronidazole Hydrochloride,Metronidazole Monohydrochloride,Metronidazole Phosphate,Metronidazole Phosphoester,Satric,Trichazol,Trichopol,Trivazol,Vagilen,2 Methyl 5 nitroimidazole 1 ethanol
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001170 Arthritis, Infectious Arthritis caused by BACTERIA; RICKETTSIA; MYCOPLASMA; VIRUSES; FUNGI; or PARASITES. Arthritis, Bacterial,Arthritis, Septic,Arthritis, Viral,Arthritides, Bacterial,Arthritis, Suppurative,Bacterial Arthritides,Bacterial Arthritis,Infectious Arthritis,Suppurative Arthritis,Septic Arthritis,Viral Arthritis
D001172 Arthritis, Rheumatoid A chronic systemic disease, primarily of the joints, marked by inflammatory changes in the synovial membranes and articular structures, widespread fibrinoid degeneration of the collagen fibers in mesenchymal tissues, and by atrophy and rarefaction of bony structures. Etiology is unknown, but autoimmune mechanisms have been implicated. Rheumatoid Arthritis
D001441 Bacteroides fragilis Gram-negative bacteria occurring in the lower intestinal tracts of man and other animals. It is the most common species of anaerobic bacteria isolated from human soft tissue infections.
D001442 Bacteroides Infections Infections with bacteria of the genus BACTEROIDES. Infections, Bacteroides,Bacteroides Infection,Infection, Bacteroides
D013396 Suction The removal of secretions, gas or fluid from hollow or tubular organs or cavities by means of a tube and a device that acts on negative pressure. Aspiration, Mechanical,Drainage, Suction,Aspirations, Mechanical,Drainages, Suction,Mechanical Aspiration,Mechanical Aspirations,Suction Drainage,Suction Drainages,Suctions

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