[Septic arthritis as an initial manifestation of bacterial endocarditis caused by Staphylococcus aureus]. / Artritis séptica como manifestación inicial de endocarditis bacteriana por Staphylococcus aureus.

We describe a case of Staphylococcus aureus mitral valve endocarditis, in a 80-year-old man who presented with abrupt onset of septic arthritis of the glenohumeral joint, without cardiac symptomatology. Fever and articular infection recovery after articular drainage and antimicrobial therapy, but worsening caused by heart failure made valve replacement surgery urgent. He died suddenly before surgery could be done. Until August 2005, in medical literature (Index Medicus, Medline, Embase, Excerpta Medica), we have found 26 cases of bacterial endocarditis with articular infection, as initial manifestation, but none with septic arthritis and only one in the glenohumeral joint. This report highlights that unexplained arthritis should alert us to the possibility of bacterial endocarditis because of its influence on the clinical management and prognostic implications.

Artritis séptica como manifestación inicial de endocarditis bacteriana por Staphylococcus aureus / Septic arthritis as an initial manifestation of bacterial endocarditis caused by Staphylococcus aureus

Comunicamos un caso de endocarditis bacteriana por Staphylococcusaureus, sobre válvula mitral nativa, en un varón de 80 años, que debutó con una monoartritis séptica, de la articulación glenohumeral, sin manifestaciones cardiológicas iniciales. La respuesta clínica inicial tras drenaje articular y tratamiento antibiótico fue apropiada, pero la aparición de insuficiencia cardiaca recomendó el recambio quirúrgico de la válvula mitral. El paciente falleció súbitamente, el día previo a la intervención. En la literatura médica (Index Medicus, Medline, Embase, Excerpta Medica hasta 08/2005) están descritos 26 casos, de endocarditis bacteriana con afectación articular inicial, ninguno de ellos séptica, y solamente uno en la articulación glenohumeral. Queremos incidir en la necesidad de investigar la existencia de endocarditis bacteriana en toda artritis séptica, sin factores de riesgo evidentes,dadas las implicaciones pronosticas y terapéuticas

We describe a case of Staphylococcus aureus mitral valve endocarditis, in a 80-year-old man who presented with abrupt onset of septic arthritis of the glenohumeral joint, whithout cardiac sintomatology. Fever and articular infection recovery after articular drainage and antimicrobial therapy, but worsening caused by heart failure made valve replacement surgery urgent. He died sudendly before surgery could be done, Until august 2005, in medical literature (Index Medicus, Medline, Embase, Excerpta Medica), we have found 26 cases of bacterial endocarditis with articular infection, as initial manifestation, but none whith septic arthritis and only one in the glenohumeral joint. This report highligths that unexplained arthritis should alert us to the possibility of bacterial endocarditis because their influence on the clinical management and pronostic implications