title: Septic arthritis due to Streptococcus pneumoniae in Nottingham, United Kingdom, 1985-1998.
abstract: Pneumonia and meningitis are the 2 most frequent manifestations of Streptococcus neumoniae infection. Pneumococcal septic arthritis is considered to be relatively uncommon. Between 1985 and 1998, 32 (8. 2%) of 389 cases of septic arthritis seen in the 2 hospitals in Nottingham, United Kingdom, were due to S. pneumoniae. Six of 7 children with pneumococcal septic arthritis were aged <2 years. Of the 25 adults, 20 (80%) were aged >60 years, 11 (44%) had concomitant pneumococcal infection elsewhere, and 23 (92%) had articular or nonarticular diseases and/or other risk factors. In the elderly, a lack of febrile response was striking. S. pneumoniae was isolated from blood and joint cultures in >70% of cases, and gram-positive diplococci were seen in the joint fluids of 90% of patients. The mean duration of antimicrobial therapy for adults was twice as long as that for children. Eight (32%) of the adults died.
authors.affiliation: Nottingham Public Health Laboratory, Department of Microbiology, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH, United Kingdom.
authors.forename: P
authors.initials: P
authors.lastname: Ispahani
authors.forename: V C
authors.initials: VC
authors.lastname: Weston
authors.forename: D P
authors.initials: DP
authors.lastname: Turner
authors.forename: F E
authors.initials: FE
authors.lastname: Donald
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005436:Floxacillin / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007596:Joints / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010400:Penicillin G / Q000627:therapeutic use; D010406:Penicillins / Q000627:therapeutic use; D011008:Pneumococcal Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D013296:Streptococcus pneumoniae / Q000187:drug effects / Q000302:isolation & purification*; D016019:Survival Analysis; D013582:Synovial Fluid / Q000187:drug effects / Q000382:microbiology; D016896:Treatment Outcome; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D010406:Penicillins; D005436:Floxacillin; D010400:Penicillin G