Abstract
Septic arthritis of the knee is commonly caused by aerobic organisms. Rarely, it can be caused by Clostridium perfringens, usually due to penetrating trauma. This is a rare case of C. perfringens septic arthritis in a patient with colostomy due to hematogenous spread. The patient was treated successfully with a synovectomy and a prolonged intravenous antibiotic course. The case report summarizes the existing literature on the topic and discusses the diagnosis, management, and prognosis of such cases as well.
Highlights
Septic arthritis is an infection of the synovium in any joint of the body
We present a rare case of C. perfringens septic arthritis in an immunocompetent patient by hematogenous spread
We summarize the patient’s presentation and successful treatment and review the literature as well. This is the case of a 98-year-old female with a long history of severe end-stage osteoarthritis, for which a total knee arthroplasty had been recommended for many years but the patient refused any kind of surgery due to her advanced age
Summary
Septic arthritis is an infection of the synovium in any joint of the body. Acute monoarticular arthritis, especially that of the knee, is most often caused by aerobic organisms, with only approximately one percent accounted for by anaerobic species [1,2]. We summarize the patient’s presentation and successful treatment and review the literature as well This is the case of a 98-year-old female with a long history of severe end-stage osteoarthritis, for which a total knee arthroplasty had been recommended for many years but the patient refused any kind of surgery due to her advanced age. The morning, the patient presented to the emergency room She stated that she had experienced marked improvement in her symptoms following treatment in the office, awoke the morning with a hot, erythematous, swollen knee with limited range of motion or ability to ambulate. In week six of treatment, she developed an allergic reaction to penicillin (rash) and was readmitted to the hospital with a medication change to clindamycin An aspiration of her knee at that time did not return fluid. Throughout her course, the patient did not develop fevers, chills, or any other constitutional symptoms
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