[Septic arthritis and gout--a case report].
The authors describe a 54 year-old male patient, admitted after presenting in the emergency room with acute oligoarthritis affecting the shoulders and right tibiotarsal and sternoclavicular joints, with a week's duration. He was non-febrile and related a purulent discharge from the stump of a traumatic amputation of the left thumb, starting a few days prior to the presenting complaints. There was a previous history of gouty arthritis and moderate alcoholism. Lab work revealed an elevation of the acute phase markers, with marked neutrophilia. Upon admittance, the patient underwent arthrocentesis, revealing a purulent discharge with sodium monourate crystals, which cultured positively for meticillin-sensitive Staphylococcus aureus. Besides antibiotherapy, on Day 5 the patient presented with a cervical abscess with extension to mediastinum; the abscess was drained by a cardiothoracic surgeon, and the right sternoclavicular and first costochondral articulations were found to be destroyed. The authors note that, although it is a rare occurrence septic arthritis can coexist with gout, while discussing the possible mecanisms of this association, as well as particular details of the clinical case presented.
Serviço de Reumatologia, Hospitais da Universidade de Coimbra, Portugal. saramserra@hotmail.com
S
S
Serra
P
P
Monteiro
A
A
Vaz
E
E
Pires
R
R
Monteiro
L
L
Inês
M J
MJ
Salvador
J
J
Bernardo
A
A
Malcata
D001170:Arthritis, Infectious / Q000150:complications* / Q000175:diagnosis; D006073:Gout / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged