Simultaneous bilateral septic arthritis of the knee after intraarticular steroid injection: A clinical report

Abstract

Osteoarthritis of knee is one of the common problems in elderly population. Intraarticular corticosteroid injection is a conservative management modality in osteoarthritis of knee. Septic arthritis is an infective complication of intraarticular corticosteroid injection. Septic arthritis in rheumatoid arthritis patients have worse prognosis because of delay in diagnosis. A higher rate of infectious complications following intraarticular injection is expected in immunocompromised and rheumatoid patients. We would like to report an extremely rare case of simultaneous bilateral knee septic arthritis after bilateral knee intraarticular steroid injection in a rheumatoid arthritis patient. Patient was treated successfully with multiple bilateral knee arthroscopic washouts and long-term intravenous antibiotics. This case report emphasizes the increased risk of infection in rheumatoid arthritis patients and a risk benefit assessment on individual basis before carrying out intraarticular steroid injection. Patient should be aware of this increased risk of infection.

Bilateral, simultaneous pneumococcal septic arthritis of the knees: a normal immune system, an unknown source

“…Other cases have reported patients with bilateral simultaneous onset of knee SA 8–10. Two such cases describe a single unifying cause: one being an infusion of infliximab,8 and the other an intra-articular steroid injection 9. The most interesting case describes a patient who suffered bilateral simultaneous pneumococcal SA following a splenectomy for Felty's syndrome,10 a patient who would have suffered the dual misfortune of rheumatoid arthritis and an impaired immune system.…”

Comparative Analysis of Immunological and Hematological Indices of Patients with Septic Arthritis after Intra-Articular Injection of Glycocorticoids

“…Але, пригнічуючи місцеві захисні реакції, ГКС пре-парати здатні активізувати латентну внутрішньосуглобову інфекцію, викликаючи запальне ураження суглоба. Інфікування суглоба є найбільш серйозним ускладненням локальної ін'єкційної терапії ГКС препаратами [1,[8][9][10][11][12].…”

Bilateral Septic Arthritis Resulting in Mortality in the Elderly: A Case Report

“…(4,6,7) Bilateral cases are common in elderly individuals. (6)(7)(8)(9)(10)(11) Even rarer is mortality resulting directly from the condition. Factors implicated in mortality include polyarticular involvement and age greater than 60 years.…”