Overwhelming Streptococcus pyogenes sepsis in an elderly patient with septic arthritis

Abstract

Introduction: The signs of Streptococcus pyogenes, group A streptococci (GAS) bacteremia are non-specific and patients can have wide presentations ranging from flu-like symptoms to life-threatening toxic-shock syndrome in just a few hours.

Case presentation: We report a case of fulminant S. pyogenes sepsis in an elderly woman with septic arthritis and remarkable past medical history/risk factors. She was febrile, hypotensive and had a swollen and tender right knee. Multiple blood cultures and the synovial fluid culture yielded S. pyogenes. Despite adequate antimicrobial therapy with penicillin and clindamycin the patient succumbed to her infection within 4days of presentation in our hospital.

Conclusion: GAS remains penicillin sensitive most of the time but prompt appropriate antibiotic therapy is very crucial to survival.

Keywords: Arthritis; Elderly patient; S. pyogenes; Sepsis.