ABSTRACT
Granulicatella species, formerly known as nutritionally variant streptococci, cause a variety of infections, primarily endocarditis. We report the first culture-proven case of a Granulicatella species causing septic arthritis. A 68-year-old female presented with knee pain and swelling. She was initially evaluated with arthrocentesis and arthroscopy, but no organism was identified. Her pain improved after a brief course of antibiotics but recurred 3 months later. She underwent repeat arthrocentesis, with direct inoculation of synovial fluid into blood culture bottles. Granulicatella adiacens was recovered from both bottles. She was treated with cefazolin for 4 weeks combined with gentamicin for the first 2 weeks. Her knee pain and swelling resolved without evidence of recurrence. Granulicatella should be considered in cases of septic arthritis with initially negative synovial fluid cultures. Inoculation of blood cultures bottles with synovial fluid may increase the diagnostic yield for these species.
Subject(s)
Arthritis, Infectious/diagnosis , Bacteriological Techniques/methods , Knee Joint/microbiology , Streptococcal Infections/diagnosis , Streptococcus/isolation & purification , Synovial Fluid/microbiology , Aged , Anti-Bacterial Agents/therapeutic use , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Cefazolin/therapeutic use , Culture Media , Female , Gentamicins/therapeutic use , Humans , Streptococcal Infections/complications , Streptococcal Infections/drug therapy , Streptococcal Infections/microbiology , Treatment OutcomeABSTRACT
The Diesse Mini-Ves (DMV) erythrocyte sedimentation rate (ESR) analyzer was designed to improve efficiency in determining the ESR. We compared the Westergren ESR method with the 4-sample DMV ESR analyzer for performance and clinical correlation. This prospective observational study, conducted at a 450-bed tertiary medical center, evaluated 291 paired samples from subjects with various systemic inflammatory conditions. Linear regression analysis revealed a statistically significant correlation between the 2 methods. Satisfactory precision of the DMV analyzer was obtained for high and mid-range ESR values. The 4-sample DMV ESR analyzer was precise and comparable in results to the Westergren ESR method. This DMV ESR analyzer is now used at our medical center based on quality control improvements that include a faster, safer, and more standardized ESR method. Hospital or office-based clinical laboratories should consider using the 4-sample DMV ESR analyzer in place of the Westergren method.
