Abstract
The pneumococcal septic arthritis is uncommon in healthy adults. In most cases, it occurs in patients with immune deficiency. Its exceptional location at the wrist can maintain doubt with rheumatic causes which are more frequent. IgG4 deficiency found in this patient was the only cause that could be impugned. We report the case of a young woman of 46 years without any evident cause of immunodeficiency and any particular risk factor, managed for septic arthritis of the wrist due to Streptococcus pneumoniae. This case without any apparent risk factors demonstrates that pneumococcal infection in a more distant articulation of the ENT is still possible. Scan has been a very significant contribution in confirming the positive diagnosis that leads to surgical drainage. The approach of the systematic search for the gateway must be done. In the study of the patient’s immune status, the realization of the protein profile could be interesting and then guide the practitioner in the decision to vaccinate the patient against Streptococcus pneumoniae if he was not. We recommend looking always for a cause of immunodeficiency including primary Ig defiencies even among adult.
Highlights
The pneumococcal septic arthritis is a disease of the elderly or weakened [1]-[4]
Our observation in a patient with no apparent risk factors demonstrates that pneumococcal infection in a more distant articulation of the ENT is still possible
Scan has been a very significant contribution in confirming the positive diagnosis that leads to surgical drainage
Summary
The pneumococcal septic arthritis is a disease of the elderly or weakened [1]-[4]. The literature shows that this organism is responsible for 3% to 10% of septic arthritis [2]. As in any septic arthritis, outcome may be severe or by direct systemic consequences of infection either by its local and regional extension. According to Dubost et al, staphylococci and streptococci Group B above are the main germs responsible of septic arthritis in the past three decades [8]. The poverty of the literature on the topic justified that we reported this case to highlight the unusual anatomical location and particularity of the affected patient
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