title: Pyogenic arthritis of native joints due to Bacteroides fragilis: Case report and review of the literature.
abstract: Pyogenic arthritis of native joints due to Bacteroides fragilis seems to be an infrequent disease. We analyzed the cases diagnosed in a tertiary hospital during a 22-year period and reviewed the literature to summarize the experience with this infectious entity.In our institution, of 308 patients with pyogenic arthritis of native joints, B fragilis was the causative organism in 2 (0.6%) cases. A MEDLINE search (1981-2015) identified 19 additional cases.Of the 21 patients available for review (13 men and 8 women, with a mean age, of 54.4 ± 17 years), 19 (90%) presented a systemic predisposing factor for infection; the most common associated illness was rheumatoid arthritis (8 patients). Bacteremia was documented in 65% (13/20) of cases. In 5 patients (24%), 1 or more concomitant infectious process was found. Metronidazole was the most frequently used antibiotic. Surgical drainage was performed in 11 cases (52%). The overall mortality rate was 5%.Pyogenic arthritis of native joints due to B fragilis is an infrequent disease that mainly affects elderly patients with underlying medical illnesses and in whom bacteremia and the presence of a concomitant infectious process are frequent conditions.
authors.affiliation: Rheumatology Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain Infectious Diseases Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain Orthopedic Surgery Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Nolla
authors.forename: Oscar
authors.initials: O
authors.lastname: Murillo
authors.forename: Javier
authors.initials: J
authors.lastname: Narvaez
authors.forename: Carmen Gómez
authors.initials: CG
authors.lastname: Vaquero
authors.forename: Jaime
authors.initials: J
authors.lastname: Lora-Tamayo
authors.forename: Salvador
authors.initials: S
authors.lastname: Pedrero
authors.forename: Javier
authors.initials: J
authors.lastname: Cabo
authors.forename: Javier
authors.initials: J
authors.lastname: Ariza
mesh_terms: D000328:Adult; D000368:Aged; D001170:Arthritis, Infectious / Q000175:diagnosis* / Q000382:microbiology; D001442:Bacteroides Infections / Q000175:diagnosis* / Q000382:microbiology; D001441:Bacteroides fragilis / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult