[Septic arthritis as an initial manifestation of bacterial endocarditis caused by Staphylococcus aureus].
We describe a case of Staphylococcus aureus mitral valve endocarditis, in a 80-year-old man who presented with abrupt onset of septic arthritis of the glenohumeral joint, without cardiac symptomatology. Fever and articular infection recovery after articular drainage and antimicrobial therapy, but worsening caused by heart failure made valve replacement surgery urgent. He died suddenly before surgery could be done. Until August 2005, in medical literature (Index Medicus, Medline, Embase, Excerpta Medica), we have found 26 cases of bacterial endocarditis with articular infection, as initial manifestation, but none with septic arthritis and only one in the glenohumeral joint. This report highlights that unexplained arthritis should alert us to the possibility of bacterial endocarditis because of its influence on the clinical management and prognostic implications.
Martínez Oviedo
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A
Servicios de Medicina Interna, Hospital General Obispo Polanco, 44002 Teruel. amoviedo25@yahoo.es
Gracia Sánchez
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P
Pueo
E
E
Chopo
J M
JM
D000369:Aged, 80 and over; D001170:Arthritis, Infectious / Q000150:complications / Q000175:diagnosis*; D004697:Endocarditis, Bacterial / Q000150:complications / Q000175:diagnosis*; D006349:Heart Valve Diseases / Q000382:microbiology*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000382:microbiology; D013203:Staphylococcal Infections / Q000175:diagnosis*