Septic arthritis of the ankle due to Moraxella osloensis

• Published in: Foot and ankle surgery Vol. 13; no. 4; pp. 189 - 191
• Main Authors: Banks, L.N, Kurdy, N.M, Hassan, I, Aster, A.S
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ltd 2007; Elsevier
• Subjects: Ankle; Bacterial arthritis and osteitis; Bacterial diseases; Biological and medical sciences; Diseases of the osteoarticular system; Human bacterial diseases; Infectious diseases; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Moraxella osloensis; Orthopedic surgery; Orthopedics; Septic arthritis; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Ankle; Moraxella osloensis; Septic arthritis; Intravenous administration; Neisseriaceae; Diseases of the osteoarticular system; Arthritis; Moraxella; Hyperuricemia; Ankle joint; Pain; Rifampicin; Penicillin; Bacteria; Micrococcales; Antituberculous agent; Human; Effusion; Metabolic diseases; Uric acid; Fever; Infection; Antibiotic; Treatment; Purine; Antibacterial agent; Microcrystal
• ISSN: 1268-7731; 1460-9584
• DOI: 10.1016/j.fas.2007.03.002

Abstract We present an unusual case of septic arthritis of the ankle due to Moraxella osloensis . The implications of a diplococcus culture are discussed, including notification of the disease, the suggestion of sexual impropriety and drug-induced side effects for the treating doctors and other contacts. The case is of a 56-year-old man presenting with a past medical history of gout (great hallux) and increasing pain in his ankle. Systemic examination revealed a low-grade pyrexia and lateral malleolar swelling with evidence of an effusion. Initial gram stain revealed a raised WBC. Laboratory evaluation showed a raised CRP, ESR and urate. The patient was commenced on intravenous antibiotics. Initial blood cultures suggested a possibility of Neisseria meningitidis and primary contacts were commenced on rifampicin. The cultures were later confirmed as the rather unusual penicillin sensitive, gram-negative, aerobic Moraxella oseloensis . Antibiotics were discontinued at 6 weeks and the patient discharged at 3 months. The recognition of septic arthritis, obtaining systemic blood cultures, joint aspirates followed by prompt treatment with a suitable antibiotic regime will reduce morbidity and mortality. Recognition of any potential pathogens that may be harmful to health professionals or other close contacts is also of vital importance.