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Journal of Clinical Microbiology, June 2007, p. 2097, Vol. 45, No. 6
0095-1137/07/$08.00+0     doi:10.1128/JCM.00298-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

LETTER TO THE EDITOR

Arthritis Caused by Corynebacterium striatum: Spontaneous Infection?


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LETTER
 
I read with interest the case report by David Scholle of arthritis caused by Corynebacterium striatum (1). The author concluded that the knee joint was most likely infected hematogenously and was, thus, a case of "a spontaneous infection of a natural joint." However, the patient initially presented with a painful knee following trauma for which he underwent a diagnostic aspiration. This aspirate was culture negative; however, 20 days later, the knee joint was again aspirated because of persistent pain and swelling, and the aspirate now showed many neutrophils and a pure culture of Corynebacterium striatum. Although infection is a rare complication of intra-articular injection and may be even more rare after diagnostic needle aspiration of a joint, I would certainly consider this infection with C. striatum to be iatrogenic, with the introduction of this skin commensal organism into the joint during the first aspiration (2).


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REFERENCES
 
    1
  1. Scholle, D. 2007. A spontaneous joint infection with Corynebacterium striatum. J. Clin. Microbiol. 45:656-658.[Abstract/Free Full Text]
    2. 2
  2. Seror, P., P. Pluvinage, F. Lecoq d'Andre, P. Benamou, and G. Attuil. 1999. Frequency of sepsis after local corticosteroid injections (an enquiry on 1 160 000 injections in rheumatological private practice in France). Rheumatology 38:1272-1274.[Abstract/Free Full Text]
P. D. J. Sturm
Department of Medical Microbiology
Radboud University Nijmegen Medical Center
P.O. Box 9101
6500 HB Nijmegen, The Netherlands
Phone: 0031243614356
Fax: 0031243540216
E-mail: P.Sturm{at}mmb.umcn.nl


Author's Reply


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LETTER 
 
Dr. Sturm points out that some patients who have received steroid injections into inflamed joints have developed iatrogenic infections and proposes that this occurred in the case in question (1). Data for the incidence of infection following injection of steroid into inflamed joints have been reviewed (2). Because my patient underwent aspiration and did not receive an injection of steroid into his joint, he probably should not be included in the population of people to whom those data may apply. With regard to diagnostic arthrocentesis, I am unaware of any reports of iatrogenic septic arthritis following this procedure. The absence of any such report makes its occurrence in this case unlikely.


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REFERENCES 
 
    1
  1. Scholle, D. 2007. A spontaneous joint infection with Corynebacterium striatum. J. Clin. Microbiol. 45:656-658.[Abstract/Free Full Text]
    2. 2
  2. von Essen, R., and H. A. Savolainen. 1989. Bacterial infection following intra-articular injection: a brief review. Scand. J. Rheumatol. 18:7-12.[Medline]
David Scholle
Department of Infectious Disease
Peter Morton Medical Building
200 UCLA Medical Plaza, Suite 365-C1
Los Angeles, California 90095-1688
Phone: (310) 206-7663
E-mail: dscholle{at}fastmail.fm

Journal of Clinical Microbiology, June 2007, p. 2097, Vol. 45, No. 6
0095-1137/07/$08.00+0     doi:10.1128/JCM.00298-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.




This Article
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
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Right arrow Similar articles in this journal
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Right arrow Copyright Information
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Right arrow Articles by Scholle, D.

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