Letter to the Editor
Septic Arthritis of the Shoulder due to Corynebacterium striatum
Artritis séptica de hombro debida a Corynebacterium striatum
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"tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "383" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carlos Manuel Feced Olmos, Juan José Alegre Sancho, José Ivorra Cortés, José Andrés Román Ivorra" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Carlos Manuel" "apellidos" => "Feced Olmos" "email" => array:1 [ 0 => "carlosfeced@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Juan José" "apellidos" => "Alegre Sancho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "José" "apellidos" => "Ivorra Cortés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span 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elsevierViewall"><span class="elsevierStyleItalic">Corynebacterium</span> species are part of the normal flora of skin and mucous membranes. <span class="elsevierStyleItalic">Corynebacterium striatum</span><span class="elsevierStyleSmallCaps">(</span><span class="elsevierStyleItalic"><span class="elsevierStyleSmallCaps">C.</span> Striatum</span>) is a gram-positive bacillus, which is usually classified as a pollutant. The frequency of infections by this pathogen has increased in immunocompromised patients<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> and is considered an emerging nosocomial agent.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> We report the first case of shoulder arthritis due to this bacterium in an immunocompetent patient. The patient was a 59 year old woman who presented pain and swelling of the right shoulder lasting for 48<span class="elsevierStyleHsp" style=""></span>h and who had a history of mechanical sporadic joint pain, so she initially received a corticosteroid infiltration of the shoulder 4 days before the onset of symptoms. Her history included hypercholesterolemia. On examination she had fever (37.5<span class="elsevierStyleHsp" style=""></span>°C) and loss of function on shoulder abduction and rotation, with swelling and increased local temperature, the rest being normal. Her laboratory studies showed CRP 150<span class="elsevierStyleHsp" style=""></span>mg/dl and ESR of 54<span class="elsevierStyleHsp" style=""></span>mm/h. On plain radiographs, we observed an increase in torque and ultrasound soft parts was evident in the subacromial bursa effusion and posterior recess of the glenohumeral joint. A bursocentesis was performed, obtaining an inflammatory synovial fluid with glucose <5<span class="elsevierStyleHsp" style=""></span>mg/dl and Leukocytes 111.9×10<span class="elsevierStyleSup">9</span>/l. Gram-positive bacilli were evident, so empirical antibiotic therapy was started with ceftriaxone 2<span class="elsevierStyleHsp" style=""></span>g intravenously daily and cloxacillin 2<span class="elsevierStyleHsp" style=""></span>g intravenously every 6<span class="elsevierStyleHsp" style=""></span>h. After 24<span class="elsevierStyleHsp" style=""></span>h of synovial fluid culture, <span class="elsevierStyleItalic">C. striatum</span> was identified (sensitive to penicillin and vancomycin, and quinolone and rifampicin-resistant), so we continued with ceftriaxone alone. Magnetic resonance imaging showed signs of shoulder arthritis, bursitis and tendon, muscle and bone involvement, muscle and bone on the anterior shoulder, with a probable partial tear of the supraspinatus. The trauma service refused surgical intervention. The condition resolved within 15 days after starting the antibiotic, with normalization of acute phase reactants, and ceftriaxone was maintained up to a month. A control MRI at 2 months demonstrated the resolution of the process.</p><p id="par0010" class="elsevierStylePara elsevierViewall">There have been several cases of infections with <span class="elsevierStyleItalic">C. striatum</span>, being more frequent in immunocompromised and hospitalized patients,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and after reviewing the literature, we found cases of respiratory infections, peritonitis, endometritis, chronic ulcers,<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> endocarditis, septicemia, osteomyelitis, a breast abscess, urinary tract infections, eye infections and central catheters infections,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> as well as person to person transmission in intensive care units<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a> meningitis and infections of prosthetic joints.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In recent years, various forms of antibiotic resistance have been described and for this reason, vancomycin is often used with no demonstrated resistance to it. In endocarditis, <span class="elsevierStyleItalic">C. striatum</span>, plus gentamicin or vancomycin alone<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> has been used and penicillin and some patients have shown a good response to daptomycin alone or associated with rifampicin.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> There are only 2 cases described in the literature of ntive joint infections by <span class="elsevierStyleItalic">C. striatum</span>,<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,10</span></a> both in patients with an compromised immune status. One was an elbow arthritis after injury adjacent skin,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> which was treated with intravenous vancomycin, aztreonam and surgery, with change to ciprofloxacin due to side effects, and another was a spontaneous knee arthritis that resolved with vancomycin and surgery.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">This is the first published case of shoulder arthritis by <span class="elsevierStyleItalic">C. striatum</span> in an immunocompetent patient without risk factors, probably secondary to a local injection with corticosteroids. It showed sensitivity to penicillin and the condition resolved with ceftriaxone intravenously after one month, without surgery.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Feced Olmos CM, et al. Artritis séptica de hombro debida a Corynebacterium striatum. Reumatol Clin. 2013;9:383.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Corynebacterium striatum</span> infecting a malignant cutaneous lesion: the emergence of an opportunistic pathogen" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Vargas Superti" 1 => "D. De Souza Martins" 2 => "J. Caierão" 3 => "F. Soares" 4 => "T. Prochnow" 5 => "V.V. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 14 | 21 |
| 2024 October | 51 | 28 | 79 |
| 2024 September | 63 | 18 | 81 |
| 2024 August | 67 | 29 | 96 |
| 2024 July | 78 | 31 | 109 |
| 2024 June | 75 | 35 | 110 |
| 2024 May | 64 | 39 | 103 |
| 2024 April | 48 | 24 | 72 |
| 2024 March | 59 | 27 | 86 |
| 2024 February | 40 | 19 | 59 |
| 2024 January | 42 | 19 | 61 |
| 2023 December | 54 | 25 | 79 |
| 2023 November | 38 | 23 | 61 |
| 2023 October | 43 | 27 | 70 |
| 2023 September | 54 | 29 | 83 |
| 2023 August | 42 | 13 | 55 |
| 2023 July | 38 | 26 | 64 |
| 2023 June | 45 | 19 | 64 |
| 2023 May | 42 | 28 | 70 |
| 2023 April | 27 | 9 | 36 |
| 2023 March | 54 | 27 | 81 |
| 2023 February | 33 | 28 | 61 |
| 2023 January | 24 | 18 | 42 |
| 2022 December | 57 | 32 | 89 |
| 2022 November | 60 | 30 | 90 |
| 2022 October | 43 | 27 | 70 |
| 2022 September | 89 | 36 | 125 |
| 2022 August | 41 | 38 | 79 |
| 2022 July | 30 | 40 | 70 |
| 2022 June | 42 | 44 | 86 |
| 2022 May | 44 | 38 | 82 |
| 2022 April | 44 | 41 | 85 |
| 2022 March | 55 | 46 | 101 |
| 2022 February | 42 | 26 | 68 |
| 2022 January | 28 | 33 | 61 |
| 2021 December | 29 | 47 | 76 |
| 2021 November | 36 | 45 | 81 |
| 2021 October | 55 | 55 | 110 |
| 2021 September | 40 | 46 | 86 |
| 2021 August | 44 | 39 | 83 |
| 2021 July | 41 | 36 | 77 |
| 2021 June | 55 | 55 | 110 |
| 2021 May | 44 | 34 | 78 |
| 2021 April | 98 | 52 | 150 |
| 2021 March | 64 | 29 | 93 |
| 2021 February | 47 | 23 | 70 |
| 2021 January | 45 | 16 | 61 |
| 2020 December | 39 | 29 | 68 |
| 2020 November | 79 | 21 | 100 |
| 2020 October | 57 | 12 | 69 |
| 2020 September | 56 | 25 | 81 |
| 2020 August | 35 | 18 | 53 |
| 2020 July | 34 | 24 | 58 |
| 2020 June | 41 | 26 | 67 |
| 2020 May | 34 | 9 | 43 |
| 2020 April | 28 | 23 | 51 |
| 2020 March | 20 | 4 | 24 |
| 2020 February | 1 | 0 | 1 |
| 2020 January | 2 | 0 | 2 |
| 2019 September | 2 | 0 | 2 |
| 2019 June | 1 | 0 | 1 |
| 2019 April | 2 | 0 | 2 |
| 2019 January | 1 | 0 | 1 |
| 2018 December | 2 | 0 | 2 |
| 2018 May | 8 | 1 | 9 |
| 2018 April | 72 | 5 | 77 |
| 2018 March | 96 | 9 | 105 |
| 2018 February | 40 | 5 | 45 |
| 2018 January | 38 | 7 | 45 |
| 2017 December | 42 | 8 | 50 |
| 2017 November | 51 | 9 | 60 |
| 2017 October | 46 | 3 | 49 |
| 2017 September | 59 | 3 | 62 |
| 2017 August | 60 | 9 | 69 |
| 2017 July | 51 | 4 | 55 |
| 2017 June | 97 | 7 | 104 |
| 2017 May | 78 | 8 | 86 |
| 2017 April | 85 | 3 | 88 |
| 2017 March | 91 | 5 | 96 |
| 2017 February | 47 | 6 | 53 |
| 2017 January | 45 | 3 | 48 |
| 2016 December | 108 | 17 | 125 |
| 2016 November | 83 | 10 | 93 |
| 2016 October | 106 | 8 | 114 |
| 2016 September | 119 | 8 | 127 |
| 2016 August | 102 | 9 | 111 |
| 2016 July | 50 | 8 | 58 |
| 2016 June | 2 | 0 | 2 |
| 2016 April | 1 | 0 | 1 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 0 | 18 | 18 |
| 2015 September | 2 | 0 | 2 |
| 2015 August | 4 | 0 | 4 |
| 2015 July | 28 | 7 | 35 |
| 2015 June | 32 | 5 | 37 |
| 2015 May | 81 | 10 | 91 |
| 2015 April | 62 | 6 | 68 |
| 2015 March | 40 | 7 | 47 |
| 2015 February | 71 | 7 | 78 |
| 2015 January | 43 | 8 | 51 |
| 2014 December | 61 | 7 | 68 |
| 2014 November | 33 | 10 | 43 |
| 2014 October | 40 | 8 | 48 |
| 2014 September | 34 | 11 | 45 |
| 2014 August | 48 | 15 | 63 |
| 2014 July | 41 | 11 | 52 |
| 2014 June | 62 | 20 | 82 |
| 2014 May | 63 | 20 | 83 |
| 2014 April | 53 | 12 | 65 |
| 2014 March | 60 | 19 | 79 |
| 2014 February | 59 | 16 | 75 |
| 2014 January | 64 | 24 | 88 |
| 2013 December | 63 | 32 | 95 |
| 2013 November | 18 | 8 | 26 |
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