Concomitant Streptococcus Suis Septic Arthritis and Gouty Arthritis: A Case Report

Septic arthritis, when occurring together with crystal-induced arthritis such as gout, can make the diagnosis more difficult and increase the risk of complications compared with septic arthritis without concomitant gout. Streptococcus suis, a common pathogen in swine, can be transmitted from animals to humans. Human infections are rare. Patients often have a history of contact with or consumption of undercooked pork. Most patients present with meningitis, septicemia, endocarditis, and septic arthritis. A 71-year-old man presented with bilateral knee pain, swelling, and fever. Synovial fluid aspiration from the knee revealed intracellular urate crystals and Streptococcus suis on the culture. He was diagnosed with septic arthritis due to Streptococcus suis with concomitant gouty arthritis. The patient was treated with intravenous ceftriaxone and bilateral knee arthrotomy. After clinical improvement, he was switched to oral amoxicillin and completed a total of 4 months of antibiotics. At the 1-year follow-up, his function was near pre-infection levels. This is the first reported case of septic arthritis due to Streptococcus suis, an uncommon pathogen, in a patient with gouty arthritis. Concurrent septic arthritis and gouty arthritis can make the diagnosis more difficult. A high index of suspicion for septic arthritis with gouty arthritis is important for the accurate diagnosis and appropriate treatment in order to minimize complications.