Artrite séptica com acometimento poliarticular por Escherichia Coli em paciente com anemia falciforme: relato de caso

Abstract

Objectives: Report the case of a patient with sickle cell anemia who developed multiple joint septic arthritis after urinary tract infection (UTI) by Escherichia coli. Methodology: Review of medical records and literature revision. Results: M.A.C.S, female, 32 years old, with sickle cell anemia, presented lancinating pain in the lumbar region, which progressed to large joints, in an asymmetrical and additive manner. After 5 days, high fever, edema, flushing and joint heat appeared, and there was no ambulation. Initial laboratory tests suggested systemic bacterial infection, and empirical antibiotic therapy for UTI was initiated. Blood cultures were positive for multisensitive Escherichia coli. The left elbow arthrocentesis was initially performed and, in the absence of initial improvement with antibiotic therapy, arthrotomy of both elbows with drainage of purulent secretion was performed. Synovial fluid culture revealed multisensitive Escherichia coli that was treated with Ciprofloxacin. After 21 days of antibiotic therapy, the patient was discharged with recovery of the functionality. Conclusions: Gram-negative enteric bacilli are one of the most common agents of septic arthritis in crisis.