Primary meningococcal arthritis requiring surgical drainage.
Primary meningococcal arthritis (PMA) is a relatively rare diagnosis where the role of early surgical intervention for its treatment is not well defined. We report a case of PMA in a young otherwise healthy patient who developed polyarticular joint pain secondary to Niessieria meningitidis without systemic symptoms of meningitis or meningococcemia. He underwent a prolonged course of intravenous antibiotics and serial aspirations of his shoulder. However, symptoms in his shoulder did not improve and he later underwent surgical irrigation and debridement.Intraoperatively, the patient had no signs of articular damage to his right shoulder despite prolonged clinically symptomatic disease. Six weeks after surgery, he has regained normal strength and full range of motion without any deficits.Nonoperative management of PMA is frequently, but not invariably, successful. We report a patient with this diagnosis who ultimately needed surgical evacuation of his shoulder joint to achieve resolution of his symptoms.
Department of Orthopaedic Surgery, University of Chicago Medical Center, Chicago, IL, USA.
Jimmy J
JJ
Jiang
Shuangqin
S
Zhang
Jovito
J
Angeles
D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D000890:Anti-Infective Agents / Q000008:administration & dosage; D001170:Arthritis, Infectious / Q000382:microbiology* / Q000601:surgery; D002443:Ceftriaxone / Q000008:administration & dosage; D002939:Ciprofloxacin / Q000008:administration & dosage; D003646:Debridement; D004318:Doxycycline / Q000008:administration & dosage; D004322:Drainage; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D008589:Meningococcal Infections / Q000382:microbiology* / Q000601:surgery; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D016059:Range of Motion, Articular; D012785:Shoulder Joint / Q000601:surgery*; D013582:Synovial Fluid / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone; D004318:Doxycycline