title: Destructive pneumococcal septic arthritis in end-stage renal disease.
abstract: Pneumococcal arthritis generally presents as non-destructive monoarthritis, although some underlying metabolic disorders such as liver failure and diabetes have been suggested to represent a risk factor for severe joint disease. Here we report a case of destructive pneumococcal arthritis of the left hip joint in a patient suffering from chronic renal failure treated with hemodialysis for ten years. Inspite of effective anti-pneumococcal antibiotic treatment, the patient with preexisting renal osteopathy and a mild osteoarthritis continued to suffer from severe and disabling pain of the left hip. This case demonstrates that pneumococcal joint infection in patients with underlying uremic bone disease can lead to quick deterioration of the affected joint.
authors.affiliation: Département de médecine interne et service de rhumatologie, Centre hospitalier universitaire vaudois, Lausanne, Switzerland.
authors.forename: I F
authors.initials: IF
authors.lastname: Ciernik
authors.forename: J C
authors.initials: JC
authors.lastname: Gerster
authors.forename: P
authors.initials: P
authors.lastname: Burckhardt
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D010148:Intractable Pain / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D011008:Pneumococcal Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology*; D011859:Radiography; D006435:Renal Dialysis
chemical_list: D000900:Anti-Bacterial Agents