Streptococcus gordonii septic arthritis : two cases and review of literature

Abstract

BackgroundDespite advances in antimicrobial and surgical therapy, septic arthritis remains a rheumatologic emergency that can lead to rapid joint destruction and irreversible loss of function. In adults, Staphylococcus aureus is the most common microorganism isolated from native joints. Streptococcus gordonii is a prominent member of the viridans group of oral bacteria and is among the bacteria most frequently identified as being primary agent of subacute bacterial endocarditis. To the best of our knowledge, Streptococcus gordonii has not yet been described as agent of septic arthritis.Case PresentationWe describe here two cases of septic arthritis due to Streptococcus gordonii. It gives us an opportunity to review epidemiology, diagnosis criteria and management of septic arthritis.ConclusionAlthough implication of S. gordonii as aetiologic agent of subacute endocarditis is well known, this organism is a rare cause of septic arthritis. In this case, the exclusion of associated endocarditis is warranted.

Metabolic traits of pathogenic streptococci

“…Streptococcus pneumoniae frequently causes community‐acquired pneumonia and S. agalactiae is a leading cause of neonatal pneumonia and meningitis . Nevertheless, other streptococcal species of the human microbiota such as S. gordonii (endocarditis, septic arthritis) , S. mutans (dental caries, endocarditis) or S. sanguinis (endocarditis) may also cause invasive and noninvasive diseases in humans. In spite of being host adapted, some animal pathogenic Streptococcus species such as S. suis, S. equi and S. canis may infect humans causing bacteremia, endocarditis as well as meningitis and the streptococcal toxic shock‐like syndrome .…”

Streptococcus gordoniiprosthetic joint infection in the setting of vigorous dental flossing

“…S. gordonii , however, has been implicated as a cause of endocarditis,15 spontaneous bacterial peritonitis16 and subcutaneous abscesses 17. Cases of septic arthritis caused by S. gordonii are extremely rare with only two cases reported in the literature, one of which was a prosthetic joint infection 18. Our case would be the second reported prosthetic joint infection; and the first to be reported in North America.…”

Structural and dynamical aspects of Streptococcus gordonii FabH through molecular docking and MD simulations

“…Treatment for septic arthritis was undertaken by penicillin, ampicillin, cefotaxime, erythromycin, clindamycin and vancomycin. Gentamycin (5mg/kg/day) and rifampicin (900mg/day) were added to the treatment of endocarditis [5]. These antibiotics are effective in early stages but multi-drug resistance (MDR) complicates the treatment and leads to high failure rate.…”

“…Bacterial biofilms are source of chronic infections because they show resistance to antibiotics and disinfectant chemicals [4]. S. gordonii causes bacterial endocarditis and septic arthritis by entering into the blood stream usually after oral trauma [5].…”