Klebsiella pneumoniae septic arthritis in a cirrhotic patient with hepatocellular carcinoma.
Despite septic arthritis is increasingly being reported in elderly patients with diabetes or alcoholism, reported cases of spontaneous bacterial arthritis in cirrhotic patients are extremely rare. We present the first reported case of K. pneumoniae septic arthritis and spontaneous bacterial peritonitis in a cirrhotic patient with hepatocellular carcinoma. K. pneumoniae, one of the most common causative organisms of spontaneous bacterial peritonitis in cirrhotic patients, was isolated from both the blood and the joint fluid, which suggests that the route of infection was hematogenous. After the treatment with cefotaxime and closed tube drainage, the condition of the patient was improved, and subsequently, the joint fluid became sterile and the blood cultures were proved negative. Therefore, this case provides further evidence for the mode of infection being bacteremia in cirrhotic patients and suggests that the enteric bacteremia in cirrhotics may cause infection in different organ systems.
Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Chang Hwan
CH
Park
Young Eun
YE
Joo
Sung Kyu
SK
Choi
Jong Sun
JS
Rew
Sei Jong
SJ
Kim
D000368:Aged; D000818:Animals; D001170:Arthritis, Infectious / Q000097:blood / Q000175:diagnosis* / Q000382:microbiology*; D006528:Carcinoma, Hepatocellular / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007596:Joints / Q000737:chemistry / Q000382:microbiology; D007711:Klebsiella pneumoniae / Q000378:metabolism*; D008103:Liver Cirrhosis / Q000382:microbiology*; D008113:Liver Neoplasms / Q000473:pathology; D010538:Peritonitis / Q000097:blood / Q000382:microbiology / Q000503:physiopathology