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PubMed · 644356

Multiple pneumococcal pyarthrosis complicating rheumatoid arthritis.

A E Good·J M Gayes·C A Kauffman·G L Archer
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Abstract

Pneumococcal pyarthrosis was documented in seven and ten joints, respectively, in two patients with rheumatoid arthritis. The recognition of multiple pyarthrosis superimposed upon rheumatoid arthritis can be difficult. The present cases are compared with eight previously reported cases of pneumococcal arthritis in patients with rheumatoid arthritis.

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Arthritis, InfectiousArthritis, RheumatoidHumansMiddle AgedPneumococcal InfectionsCase ReportsJournal Article

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A E Good, J M Gayes, C A Kauffman, G L Archer. 1978. Multiple pneumococcal pyarthrosis complicating rheumatoid arthritis.. https://doi.org/10.1097/00007611-197805000-00008

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A 50-year-old man with alcoholic liver disease presented with fever, tenosynovitis, polyarthritis and a vasculitic rash on the hands and feet for 4 days. He had neutrophilia and raised inflammatory markers. He had no history of sore throat, urethral discharge or travel abroad. His initial blood cultures were negative, and he was treated for vasculitis with steroids. The rash and arthritis seemed to improve initially, but he had another episode of fever. Repeat blood cultures grew Neisseria gonorrhoeae,and he received intravenous ceftriaxone followed by oral ciprofloxacin. He had marked improvement in rash, tenosynovitis and arthritis, and the fever dropped. He also had chlamydial urethritis and received azithromycin. The presentation of disseminated gonococcal infection after a presumptive episode of asymptomatic urethral gonorrhoea is highlighted.

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