Abstract
Group B streptococcal (GBS) infection of a native joint in a nonpregnant adult is uncommon. While many women are colonized with this flora, it rarely becomes pathogenic in its adult host. GBS associated joint infections have been reported, most of which have been related to hematogenous seeding from unknown sources. To our knowledge, there are no published case reports of a GBS joint infection in association with a pelvic exam and Papanicolaou (PAP) smear. In this case report, we present a case of GBS sepsis of a native shoulder, possibly resulting from a routine pelvic exam and PAP smear.
Highlights
Glenohumeral joint sepsis accounts for 10–15% of all infected joints, ranking third behind knee and hip infections [1, 2]
We present a case of Group B streptococcus (GBS) sepsis of a native shoulder, possibly resulting from a routine pelvic exam and Papanicolaou (PAP) smear
Of native joints infected with GBS, the knee is the most commonly reported in the literature (36% of cases), followed by shoulder (25%), hip (16%) [16], the small joints of the hands or feet [19], and less commonly spondylodiscitis [15] and sacroilitis [20]
Summary
Glenohumeral joint sepsis accounts for 10–15% of all infected joints, ranking third behind knee and hip infections [1, 2]. The most common route of joint sepsis is via hematogenous seeding, less commonly as a result of introduction of bacteria at either the time of a prior surgery or joint injection [3,4,5]. Staphylococcus aureus is the most common pathogen in septic shoulders, followed by Streptococcus pyogenes and Gram negative organisms [3, 6,7,8,9]. Propionibacterium acnes and Staphylococcus epidermidis are more common pathogens in shoulders following surgery and are rarely found in virgin shoulders. Group B streptococcus (GBS) is a rare cause of native joint sepsis. We present a case of GBS sepsis of a native shoulder, possibly resulting from a routine pelvic exam and Papanicolaou (PAP) smear
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