Case Report

An Unusual Case of Knee Pain: Pseudogout and Abiotrophia defectiva Infection

Authors: Kim M. O’Connor, MD, Pamela Williams, ARNP, Steven A. Pergam, MD

Abstract

A 90-year-old man was diagnosed with monoarticular arthritis due to pseudogout and Abiotrophia defectiva infection. A. defectiva is recognized as a cause of endocarditis, but is rarely described in septic arthritis. To our knowledge, this is one of the few case reports of septic arthritis due to this organism, and the first in association with pseudogout. This report supports the routine culture of synovial fluid and is further evidence for the role of A. defectiva in septic arthritis.


Key Points


* Joint pain with effusion warrants arthrocentesis and synovial fluid analysis for cell counts, crystals, Gram stain and culture.


* In crystal arthropathy, cultures of synovial fluid are important to rule out concomitant infection.


* A search for an endovascular source is essential for Abiotrophia defectiva bacteremia or septic arthritis, as rates of endocarditis are high.


* With no standard treatment recommendations for A. defectiva musculoskeletal infections, consultation with an infectious diseases expert is recommended.

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