Rothia mucilaginosa: a case of septic arthritis in a native knee and review of the literature

Abstract

Rothia mucilaginosa is a Gram-positive aerobic coccus usually found in the oral and respiratory tract. Septic arthritis is an uncommon condition, but is an orthopaedic emergency. A rare case of knee septic arthritis due to R. mucilaginosa is presented. Patient management and outcomes are discussed, and learning points from this case are outlined to help manage any further cases that may arise.

Native Joint Septic Arthritis Due to Rothia mucilaginosa: A Case Report and Literature Review

“…Most patients were immunocompromised and several patients suffered from periodontal disease or had undergone dental procedures prior to presenting with septic arthritis (Table 1). The causative agent was Rothia mucilaginosa in four reports [27,29,31,33]. In contrast, we report a case of septic arthritis with Rothia mucilaginosa in a patient with osteoarthritis as risk factor but without a known immunosuppressing condition.…”

“…Rothia species are seldom isolated from prosthetic joint infections or native joints. In the literature, ten cases of Rothia species associated infections of prosthetic [25][26][27][28][29][30] or native joint [31][32][33][34] were identified (Table 1). Most patients were immunocompromised and several patients suffered from periodontal disease or had undergone dental procedures prior to presenting with septic arthritis (Table 1).…”

“…Interestingly, two other case reports describe septic arthritis of native knee joints with Rothia mucilaginosa after intraarticular injections with corticosteroids and local anesthetics [31,33]. Kaasch et al (2011) reports septic arthritis with Rothia mucilaginosa in a native knee of a female patient with rheumatoid arthritis on daily prednisone therapy and intra-articular injections with corticosteroids and local anesthetics into the affected knee at two and six days and 12 weeks prior to admission for septic arthritis of the knee [33].…”

“…Kaasch et al (2011) reports septic arthritis with Rothia mucilaginosa in a native knee of a female patient with rheumatoid arthritis on daily prednisone therapy and intra-articular injections with corticosteroids and local anesthetics into the affected knee at two and six days and 12 weeks prior to admission for septic arthritis of the knee [33]. Daoub et al report the case of a 58-yearold woman with serial corticosteroid and local anesthetic intraarticular injections due to osteoarthritis, who was subsequently diagnosed with Rothia mucilaginosa septic arthritis of the right knee [31].…”

Infection or Contamination with Rothia, Kocuria, Arthrobacter and Pseudoglutamicibacter— a Retrospective Observational Study of Non- Micrococcus Micrococcaceae in the Clinic

“…Regarding the identification of the studied bacteria in locations other than blood, seven cases with true infection were found, including septic arthritis caused by R. mucilaginosa and arthritis, peritonitis, and pacemaker infection caused by Kocuria spp. Except for Kocuria peritonitis, these infections have previously been identified although only published in a few case reports, with each making these findings among the first published ( 30 – 34 ). The adjustments for pediatric blood cultures and for infections outside the bloodstream are somewhat less robust than the ones used for adults with bloodstream infection.…”