ABSTRACT
SARS-CoV-2 has certainly been at the forefront of medical discussion and research for the past 3 years. While many are adjusting back to "normal," thanks to the rapid advancements in prevention and treatment, high-risk groups, such as adults with systemic autoimmune rheumatic diseases (SARDs), still require careful monitoring and care.
ABSTRACT
A 68-year-old woman presented for left shoulder pain, decreased range of motion (ROM) and fever 7 days following COVID-19 vaccination. Investigations showed a tender left deltoid mass, decreased shoulder ROM and elevated inflammatory markers. MRI demonstrated a large glenohumeral effusion with synovitis, and arthrocentesis confirmed septic arthritis (SA). She required subtotal bursectomy. Intraoperative joint cultures grew Streptococcus gordonii She completed 6 weeks of antibiotics and is undergoing physical therapy for post-infectious adhesive capsulitis. SA is most commonly due to Staphylococcus aureus and ß-haemolytic streptococci, and rarely due to viridans group streptococci including S.â¯gordonii To avoid inadvertent injection into the glenohumeral joint, vaccination should be performed posteriorly and inferiorly into the deltoid musculature. Progressive pain, fever or decreased passive ROM following vaccination should raise concern for SA. Given its rarity, however, concern for secondary SA should not affect the general population's consideration for vaccination.