A rare case of Salmonella sp septic arthritis in a patient with systematic lupus erythematosus (SLE)

https://doi.org/10.19106/JMedSci005503202306

Mario Steffanus(1), Cindy Yusuf(2), Jessica Novia Hadiyanto(3*)

(1) Department of Internal Medicine, School of Medicine and Health Sciences Atma Jaya, Jakarta, Indonesia
(2) Department of Internal Medicine, School of Medicine and Health Sciences Atma Jaya, Jakarta, Indonesia
(3) Department of Internal Medicine, Faculty of Medicine, Dr. Kariadi Hospital, Diponegoro University, Semarang, Central Java, Indonesia
(*) Corresponding Author

Abstract


Septic arthritis is considered as a medical emergency which can lead to significant morbidity and cause substantial mortality, especially if the diagnosis is delayed. Prolonged use of immunosuppressive and cytotoxic medications as therapy for systemic lupus erythematosus (SLE) causing patient susceptible to secondary infection. However, septic arthritis due to Salmonella sp. is very rare,  makes this is an important extraintestinal manifestation especially in immunosuppressed patients. We presented a case of 25 y.o. female diagnosed with SLE 3 m.o. earlier presented with fever and arthritis on her left genu for 1 wk duration. Genu ultrasonography showed synovitis genu sinistra with fluid volume of 1-2 cc on recessus lateral genu sinistra. The patient was further analysis on her synovial fluid was conducted, the gram stained smear of the fluid showed >25 leucocytes, low power field, and Salmonella sp. was isolated from her synovial fluid analysis. The patient was given intravenous ciprofloxacin and discharged home well. Septic arthritis should always be considered in any patients on long-term immunosuppression state who present with acutely swollen joints. It considered as an important medical emergency with high mortality and morbidity. Hence, prompt recognition, joint aspiration with administration of systemic antibiotics and appropriate surgical intervention plays a pivotal role to minimize morbidity and mortality.


Keywords


arthritis septic, systemic lupus erythematosus, salmonella , case report

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References

Kurniawan A, Sitorus IP, Loho T, Hutami WD. A rare case of septic arthritis of the knee caused by Salmonella typhi with preexisting typhoid fever in a healthy, immunocompetent child – a case report. Int J Surg Case Rep 2021; 78:76-80.
https://doi.org/10.1016/j.ijscr.2020.12.003
2.Nierenberg RJ, Berliner B, Seidenstein A. Infectious arthritis leading to rapid septic shock in a patient with SLE, leukopenia, and end stage renal disease: a case presentation and cautionary notes. Ann Clin Case Rep 2020; 5(1):1779(1-5).
3.Hassan AS, Rao A, Manadan AM, Block JA. Peripheral bacterial septic arthritis: review of diagnosis and management. J Clin Rheumatol 2017; 23(8):435-42.
https://doi.org/10.1097/RHU.0000000000000588
4.Huang CF, Chen PL, Liu MF, Lee CC, Lee NY, Chang CM, et al. Nontyphoidal Salmonella bacteremia in patients with connective tissue diseases. J Microbiol Immunol Infect 2012; 45(5):350-5.
https://doi.org/10.1016/j.jmii.2011.12.013
5.Kunyakham W, Foocharoen C, Mahakkanukrauh A, Suwannaroj S, Nanagara R. Prevalence and risk factor for symptomatic avascular necrosis development in Thai systemic lupus erythematosus patients. Asian Pac J Allergy Immunol 2012; 30(2):152-7.
6.Mathews CJ, Weston VC, Jones A, Field M, Coakley G. Bacterial septic arthritis in adults. Lancet 2010; 375(9717):846-55.
https://doi.org/10.1016/S0140-6736(09)61595-6
7.Umar AA, Ahmed MS, Tuko MT, Usman BO. Salmonella typhi septic sacroiliitis in a young Nigerian. Sub-Saharan Afric J Med 2016; 3(3):166-9.
https://doi.org/10.4103/2384-5147.190863
8.Kim SS, Perino G, Boettner F, Miller A, Goodman S. Salmonella septic arthritis of the knees in a patient with systemic lupus erythematosus. Lupus 2013; 22(7):740-3.
https://doi.org/10.1177/0961203313491022
9.Salar O, Baker B, Kurien T, Taylor A, Moran C. Septic arthritis in the era of immunosuppressive treatments. Ann R Coll Surg Engl 2014; 96(2):11-2.
https://doi.org/10.1308/003588414X13814021678196
10.Wang DA, Tambyah PA. Septic arthritis in immunocompetent and immunosuppressed hosts. Best Pract Res Clin Rheumatol 2015; 29(2):275-89.
https://doi.org/10.1016/j.berh.2015.05.008
11.Shanthi M, Sekar U, Sridharan KS. Septic arthritis of hip caused by Salmonella typhi: a case report. Case Rep Infect Dis 2012; 2012:464527.
https://doi.org/10.1155/2012/464527
12.El-Herte RI, Haidar RK, Uthman IW, Kanj SS. Salmonella enteritidis bacteremia with septic arthritis of the sacroiliac joint in a patient with systemic lupus erythematosus: case report and review of the literature. J Med Liban 2011; 59(4):235-7.
13.Gupta P, Kaistha N, Omar BJ, Gupta P, Singh V, Mohanty A. Salmonella typhi: a cause of septic arthritis knee: a rare entity. Int J Biomed Res 2017; 8(4):242-4.
https://doi.org/10.7439/ijbr.v8i4.4084
14.Wu CJ, Huang CC, Weng SF, Chen PJ, Hsu CC, Wang JJ, et al. Septic arthritis significantly increased the long-term mortality in geriatric patients. BMC Geriatr 2017; 17(1):178.
https://doi.org/10.1186/s12877-017-0561-x
15.Ribeiro DS, Neto CA, D’Almeida F, Galvão VL, Santiago MB. Imaging findings of musculoskeletal disorders associated with systemic lupus erythematosus. Radiologia Brasileira 2011; 44(1):52-8.
https://doi.org/10.1590/S0100-39842011000100013
16.Hohmann EL. Nontyphoidal Salmonellosis. Clin Infect Dis 2001; 32(2):263-9.
https://doi.org/10.1086/318457
17.Sukswai P, Kovitvanitcha D, Thumkunanon V, Chotpitayasunondh T, Sangtawesin V, Jeerathanyasakun Y. Acute hematogenous osteomyelitis and septic arthritis in children: clinical characteristics and outcomes study. J Med Assoc Thai 2011; 94 Suppl 3:S209-S216.
18.Munigangaiah S, Khan H, Fleming P, Dolan MA. Septic Arthritis of the adult ankle joint secondary to Salmonella enteritidis: a case report. J Foot Ankle Surg 2011; 50(5):593-4.
https://doi.org/10.1053/j.jfas.2011.04.039
19.Uygur E, Reddy K, Özkan FÜ, Söylemez S, Aydin Ö, Şenol S. Salmonella enteritis septic arthritis: a report of two cases. Case Rep Infect Dis 2013; 2013:642805.
https://doi/org/ 10.1155/2013/642805
20.Mansour E, El-Masri F. Bilateral Salmonella septic arthritis of the hip in a patient with Crohn disease: a case report. JBJS Case Connect 2016; 6(4):e91.
https://doi.org/10.2106/JBJS.CC.16.00045



DOI: https://doi.org/10.19106/JMedSci005503202306

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