J Korean Med Sci.  2004 Aug;19(4):608-610. 10.3346/jkms.2004.19.4.608.

Klebsiella pneumoniae Septic Arthritis in a Cirrhotic Patient with Hepatocellular Carcinoma

• Park CH
• Joo YE
• Choi SK
• Rew JS
• Kim SJ

• KMID: 2157695
• DOI: http://doi.org/10.3346/jkms.2004.19.4.608

Abstract

Despite septic arthritis is increasingly being reported in elderly patients with diabetes or alcoholism, reported cases of spontaneous bacterial arthritis in cirrhotic patients are extremely rare. We present the first reported case of K. pneumoniae septic arthritis and spontaneous bacterial peritonitis in a cirrhotic patient with hepatocellular carcinoma. K. pneumoniae, one of the most common causative organisms of spontaneous bacterial peritonitis in cirrhotic patients, was isolated from both the blood and the joint fluid, which suggests that the route of infection was hematogenous. After the treatment with cefotaxime and closed tube drainage, the condition of the patient was improved, and subsequently, the joint fluid became sterile and the blood cultures were proved negative. Therefore, this case provides further evidence for the mode of infection being bacteremia in cirrhotic patients and suggests that the enteric bacteremia in cirrhotics may cause infection in different organ systems.

Keyword

Arthritis; Infectious; Liver Cirrhosis; Carcinoma; Hepatocellular; Klebsiella pneumoniae

MeSH Terms

Aged
Animals
Arthritis, Infectious/blood/*diagnosis/*microbiology
*Carcinoma, Hepatocellular/pathology
Fatal Outcome
Female
Humans
Joints/chemistry/microbiology
Klebsiella pneumoniae/*metabolism
Liver Cirrhosis/*microbiology
*Liver Neoplasms/pathology
*Peritonitis/blood/microbiology/physiopathology

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