Extract
Septic arthritis in a native joint is most commonly caused by
Staphylococcus aureus, whereas coagulase-negative staphylococcal,
streptococcal, and gram-negative organisms are common infections involving
joints with
prostheses1-3.
Streptococcus pneumoniae is an uncommon cause of infection in a total
knee joint, and pneumococcal infections resistant to multiple antibiotics are
encountered even more rarely. In one study of 3210 total hip replacements,
none of the forty-two documented infections were secondary to
Streptococcus
pneumoniae4.
Poss et al. reviewed the records on 4240 hip, knee, and elbow replacements
performed over a ten-year period and found that only one of fifty-three
infections was due to Streptococcus
pneumoniae5.
In reviewing the literature, we were able to find only four case reports
involving penicillin-resistant pneumococcal septic arthritis in adults and
only one case involving both penicillin and ceftriaxone-resistant
Streptococcus pneumoniae in septic arthritis.