TITLE:
Wrist Septic Arthritis Due to Streptococcus pneumoniae Revealing a Selective Immunoglobulin G4 Subclass Deficiciency: A Case Report
AUTHORS:
Atchi Walla, Anani Abalo, Malewé Kolou
KEYWORDS:
Streptococcus pneumoniae, Septic Arthritis, Wrist, IgG4 Subclass Deficiency
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.5 No.11,
November
5,
2015
ABSTRACT: The pneumococcal septic arthritis is uncommon
in healthy adults. In most cases, it occurs in patients with
immune deficiency. Its exceptional location at the wrist can maintain doubt with rheumatic
causes which are more frequent. IgG4 deficiency found in this patient was the
only cause that could be impugned. We report the case of a young woman of 46
years without any evident cause of immunodeficiency and any particular risk
factor, managed for septic arthritis of the wrist due to Streptococcus pneumoniae. This case without any apparent risk
factors demonstrates that pneumococcal infection in a more distant
articulation of the ENT is still possible. Scan has been a very significant
contribution in confirming the positive diagnosis that leads to surgical
drainage. The approach of the systematic search for the gateway must be done.
In the study of the patient’s immune status, the realization of the protein
profile could be interesting and then guide the practitioner in the decision to
vaccinate the patient against Streptococcus
pneumoniae if he was not. We recommend looking always for a cause of
immunodeficiency including primary Ig defiencies even among adult.