Non-traumatic <i>Clostridium septicum</i> Arthritis in a Patient with Caecal Carcinoma

Havenden, J. L.; Murdoch, George; Evans, Andrew

doi:10.1093/rheumatology/31.8.571

Cited by 13 publications

(12 citation statements)

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“…8 We are aware of only five published cases of C. septicum-related arthritis; three of these patients also had colonic cancer. [14][15][16][17] As in our patient, some patients did not have gas detected by radiography. 6,15,16 Treatment consists of a high dose of penicillin given intravenously for at least four weeks and aggressive debridement of the affected joint.…”

Section: Clinical Presentationmentioning

confidence: 48%

“…[14][15][16][17] As in our patient, some patients did not have gas detected by radiography. 6,15,16 Treatment consists of a high dose of penicillin given intravenously for at least four weeks and aggressive debridement of the affected joint. 17 For patients who are allergic to penicillin, either clindamycin or metronidazole can be used.…”

Section: Clinical Presentationmentioning

confidence: 89%

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Septic arthritis and Clostridium septicum: a clue to colon cancer

Dylewski

Luterman²

2010

Canadian Medical Association Journal

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Section: Clinical Presentationmentioning

confidence: 48%

Section: Clinical Presentationmentioning

confidence: 89%

Septic arthritis and Clostridium septicum: a clue to colon cancer

Dylewski

Luterman²

2010

Canadian Medical Association Journal

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“…Since 1986, there have only been two reported cases of nontraumatic septic arthritis caused by C. septicum [2,12]. In the first case, an 85-year-old female presenting with increasing knee pain was diagnosed with septic arthritis.…”

Section: Resultsmentioning

confidence: 99%

“…She died on hospital day twenty-six due to congestive heart failure. Post-mortem autopsy revealed caecal malignancy with local lymph node involvement [12]. In the second case, Burnell et al reported the first case of C. septicum infecting a total knee arthroplasty in 2011.…”

Section: Resultsmentioning

confidence: 99%

Clostridium septicum growth from a total knee arthroplasty associated with intestinal malignancy: a case report

2012

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BackgroundPrevious reports of infection with Clostridium septicum have identified an unexpected association with concurrent malignancy. The reported rate of associated malignancy has been found to be as high as 81 percent. The purpose of this case report was to present a case of a total knee arthroplasty infected with C. septicum and the subsequent finding of an occult colonic malignancy.Case presentationA 74 year-old man underwent uneventful bilateral total knee arthroplasties. Two weeks post-operatively, he presented with acute swelling, redness and pain of the left knee. Aspiration of the knee was sent for cell count and culture. The cell count demonstrated 39,000 white blood cells per cubic millimeter with 71% of white blood cells identified as neutrophils. Synovial fluid cultures identified the presence of C. septicum, Enterobacter and coagulase negative Staphylococcus. After urgent irrigation and debridement and polyethylene exchange of the affected knee, the patient was placed on intravenous Penicillin G for a period of six weeks. Two weeks into his course of antibiotics, the patient developed hematochezia and was found to have an obstructive colonic malignancy. The patient underwent hemi-colectomy and has since made a complete recovery of both his malignancy and total knee arthroplasty infection.ConclusionRecognition of the association between C. septicum and malignancy is especially important considering the large predicted increase in total joint arthroplasty procedures over the coming decades. In addition to the standard treatment for infection after total joint arthroplasty, identification of Clostridium septicum should initiate a search for associated occult malignancy.

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“…5 Three cases of C septicum arthritis have been reported in humans so far. [6][7][8] One case followed an open wound, while the other two were haematogenous infections following adenocarcinoma in the large intestine. Generally C septicum septicaemia seems to be related to underlying malignant tumours, especially large intestinal adenocarcinoma.…”

Section: Daymentioning

confidence: 99%