A Case of Infectious Arthritis due to Staphylococcus lugdunensis in Seronegative Rheumatoid Arthritis, Diabetes Mellitus Patient, after Intraarticular Hyaluronic Acid Injection

Ji Wook Choi; Yeong Seop Yun; Young Jae Doo; Kyung Joong Kim; Jong Wook Kim; Ji-Min Oh

doi:10.4078/jrd.2016.23.5.321

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Choi, Yun, Doo, Kim, Kim, and Oh: A Case of Infectious Arthritis due to Staphylococcus lugdunensis in Seronegative Rheumatoid Arthritis, Diabetes Mellitus Patient, after Intraarticular Hyaluronic Acid Injection

Case Report

J Rheum Dis 2016;23(5):321-325.

Published online: 31 October 2016

DOI: https://doi.org/10.4078/jrd.2016.23.5.321

A Case of Infectious Arthritis due to Staphylococcus lugdunensis in Seronegative Rheumatoid Arthritis, Diabetes Mellitus Patient, after Intraarticular Hyaluronic Acid Injection

Ji Wook Choi, Yeong Seop Yun, Young Jae Doo, Kyung Joong Kim, Jong Wook Kim, Ji-Min Oh

Department of Internal Medicine, Anyang SAM Hospital, Anyang, Korea

Corresponding to: Ji-Min Oh, Department of Internal Medicine, Anyang SAM Hospital, 9 Samdeok-ro, Manan-gu, Anyang 14030, Korea. E-mail: ninijang@hanmail.net

Received 5 November 201529 December 2015 Accepted 30 December 2015

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intraarticular hyaluronic acid injections for symptomatic treatment of osteoarthritis are widely used but can result in complications, such as infectious arthritis. Staphylococcus lugdunensis is a common normal skin flora but can cause severe infectious disease, such as infective endocarditis. We present the first report of infectious arthritis caused by methicillin-sensitive S. lugdunensis after intra-articular hyaluronic acid injection in an immunocompromised patient in Korea.

Keywords: Infectious arthritis, Staphylococcus lugdunensis

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Figure 1.

The patient's clinical course was improved after antibiotics treatment. WBC: white blood cell, CRP: C-reactive protein, d: day, mo: month.

Figure 2.

(A) The anteroposterior view of both knee. (B) The lateral view of right knee. Marginal spurs and mild subchondral sclerosis in medial femo-rotibial (black arrow) & patellofemoral compartments at right knee joint. Marginal erosion and juxtaarticular osteoporosis at lateral tibial plateau are noted in the right knee joint with large amount effusion (white arrow).

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