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Logo of bmjcrInstructions for authorsCurrent ToCBMJ Case Reports
BMJ Case Rep. 2010; 2010: bcr0120102638.
Published online Oct 18, 2010. doi:  10.1136/bcr.01.2010.2638
PMCID: PMC3029820
Unusual presentation of more common disease/injury
An atypical pneumococcal arthritis
Pascal Rossi,1 Brigitte Granel,1 Philippe Mouly,1 Anne-Laurence Demoux,1 Fanny Le Mée,1 Fanny Bernard,2 Gerard Faugère,1 and Yves Francès1
1Department of Internal Medicine, Hopital Nord, Marseille, France
2Hopital Nord, Marseille, France
Correspondence to Pascal Rossi, pascalmaurice.rossi/at/
Bone and joint infections due to Streptococcus pneumoniae usually occur in patients who are immunocompromised, and involve one site. The unique case of a 49-year-old immunocompetent man, with an unremarkable medical history, with septicaemia and polyarticular septic arthritis involving the shoulder and knee and with cervical spondylodiscitis due to S pneumoniae, is described. In this case, S pneumoniae probably originated from the gingiva, which is commonly colonised in children and adults. S pneumoniae should be considered routinely when facing bone and joint infections, and multiple locations should be carefully sought owing to the possible lack of symptoms.
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