Septic arthritis due to Streptococcus pneumoniae in Nottingham, United Kingdom, 1985-1998

Pneumonia and meningitis are the 2 most frequent manifestations of Streptoc occus neumoniae infection. Pneumococcal septic arthritis is considered to b e relatively uncommon, Between 1985 and 1998, 32 (8.2%) of 389 cases' of se ptic arthritis seen in the 2 hospitals in Nottingham, United Kingdom, were due to S. pneumoniae. Six of 7 children with pneumococcal septic arthritis were aged <2 years. Of the 25 adults, 20 (80%) were aged >60 years, 11 (44% ) had concomitant pneumococcal infection elsewhere, and 23 (92%) had articu lar or nonarticular diseases and/or other risk factors. In the elderly a la ck of febrile response was striking. S. pneumoniae was isolated from blood and joint cultures in >70% of cases, and grampositive diplococci were seen in the joint fluids of 90% of patients. The mean duration of antimicrobial therapy for adults was twice as long as that for children. Eight (32%) of t he adults died.