Reactive Arthritis Due to Subcutaneous Abscess: A Possible Correlation?

Abstract

Reactive arthritis is the specific entity of aseptic inflammatory arthritis and follows the previous infection in other parts of the body. The association of soft tissue infections with this disease is rare. A 63-year-old male patient after blunt trauma to the left knee progressively evolved with inflammatory signals and loss of joint function, followed by additive polyarthritis of large joints. He had bilateral knee arthroplasty, the last one three years ago. On clinical evaluation he had a non-mechanical, asymmetric polyarthritis of left shoulder, elbows, knees and ankles; periarticular edema on the medial left knee. Complementary exams showed leukocytosis. Septic arthritis and bacteraemia was suspected and administration of antibiotic was started after blood culture. A fluid collection of subcutaneous tissue on the medial left knee was demonstrated by ultrasound, which was drained revealing an abscess. Blood cultures and culture of the abscess were shown Streptococcus sp. Patient remained polyarthritis despite antibiotic therapy and drainage of the abscess. Reactive arthritis was considered; corticosteroids were started with complete and functional improvement of the joints in five days.