Abstract
Abstract Introduction Native glenohumeral joint septic arthritis is a rare manifestation of an occult bacteraemia. Without urgent diagnosis and intervention, septic arthritis can lead to rapid cartilaginous and joint destruction. We report an unusual presentation of postpartum streptococcal glenohumeral arthritis. Case Description A fit and healthy 34-year-old woman gravida 2 para 3 developed unremitting shoulder pain, reduced range of movement and tachycardia day 1 postpartum after a vaginal delivery associated with a grade two perineal tear. Initial blood work revealed rising inflammatory markers, CRP 275, WCC 16.2. Initial radiographs showed no significant abnormality. T2 weighted MRI revealed a large glenohumeral joint effusion. All samples from joint aspirate grew Group B streptococcus (GBS), concordant with a high vaginal swab taken in the late third trimester. The patient underwent urgent arthroscopic washout and synovial sampling, growing GBS. Transthoracic echocardiogram revealed no imaging evidence of infective endocarditis. The patient was commenced on an appropriate 6-week intravenous antibiotic course and clinically improved. Physiotherapy and rehabilitation improved shoulder range of movements. Discussion There is a scarcity of orthopaedic complications reported with obstetric pathology. Atraumatic joint pain associated with physiological, or biochemical signs of infection should alert the diagnosing surgeon to consider septic arthritis. Haematogenous bacterial translocation can cause atypical presentations of septic arthritis. Routine biochemical parameters and arthrocentesis continues to prove to be the gold standard of diagnosis. A compilation of a case series detailing location, microorganism, complications, and effective treatment would prove useful to tailor management of these rare presentations.
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.