title: Group B streptococcal arthritis in adults.
abstract: Group B streptococcal arthritis in adults is uncommon. This report describes seven cases seen at these institutions over the past five years and reviews the previous 17 documented cases. Of seven adults, three were diabetics, three had prosthetic hips, and one had undergone splenectomy. Six had undergone no prior dental, genitourinary, or gastrointestinal procedures. The most common clinical presentation was fever and acute joint pain. Five patients had monoarticular arthritis; two had multiple joint involvement. Underlying joint abnormalities included osteoarthritis (two), prosthetic hip (three), and neuropathic joint (one). Bacteremia was documented in three and suspected in the remaining four patients, often without a primary source. Therapy included parenteral antibiotics, usually penicillin G, and drainage of the involved joint. Two of three patients with prosthetic implants required Girdlestone procedures; the third was apparently cured. The three diabetic patients died, one with resolution of group B streptococcal arthritis. The seventh patient was cured. Group B streptococcal arthritis is a serious infection in adults with diabetes and late prosthetic hip infections.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging; D001170:Arthritis, Infectious / Q000209:etiology* / Q000382:microbiology / Q000473:pathology; D001770:Blood Bactericidal Activity; D002701:Chloramphenicol / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011859:Radiography; D012785:Shoulder Joint / Q000000981:diagnostic imaging; D013156:Splenectomy / Q000009:adverse effects; D013290:Streptococcal Infections / Q000473:pathology; D013292:Streptococcus agalactiae / Q000302:isolation & purification
chemical_list: D010406:Penicillins; D002981:Clindamycin; D002701:Chloramphenicol