Pneumococcal sacroiliitis.
We report an unusual case of Streptococcus pneumoniae sacroiliitis in a previously healthy 31-year-old woman. Six cases of pneumococcal sacroiliitis have been reported; the only two cases in adults occurred in young women in the preantibiotic era. Our patient had fever and a depressed level of consciousness, with subsequent right buttock and thigh pain. Blood cultures revealed S pneumoniae, and a bone scan showed increased tracer activity in the right sacroiliac joint. Although the cerebrospinal fluid white blood cell count was only 3/microL, culture of cerebrospinal fluid grew S pneumoniae. Our patient was successfully treated with a 6-week course of intravenous antibiotics (penicillin G after an initial week of ceftriaxone), followed by 2 weeks of oral penicillin therapy.
Pinson
A G
AG
Department of Internal Medicine, Medical College of Virginia, Richmond 23298, USA.
Jolles
P R
PR
Balkissoon
A R
AR
D000284:Administration, Oral; D000328:Adult; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D016470:Bacteremia / Q000382:microbiology; D002081:Buttocks; D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use; D003243:Consciousness; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000382:microbiology; D006801:Humans; D007275:Injections, Intravenous; D010146:Pain / Q000209:etiology; D010400:Penicillin G / Q000008:administration & dosage / Q000627:therapeutic use; D010406:Penicillins / Q000008:administration & dosage / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D012446:Sacroiliac Joint / Q000382:microbiology*; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D013848:Thigh
D002511:Cephalosporins; D010406:Penicillins; D002443:Ceftriaxone; D010400:Penicillin G