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Septic arthritis caused by Mycoplasma hominis in a patient with systemic lupus erythematosus
  1. Ryan Malcolm Hum1,2,
  2. Hajira Iftikhar1,
  3. Elaine Tang1 and
  4. Pauline Ho1,2
  1. 1The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
  2. 2Centre for Musculoskeletal Research, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Ryan Malcolm Hum; ryan.hum{at}doctors.org.uk

Abstract

Mycoplasma hominis is one of the most common commensal organisms of the genitourinary tract. Immunocompromised patients are susceptible to developing severe infections secondary to M. hominis, and rarely, septic arthritis. This case report describes the occurrence of septic arthritis secondary to M. hominis in a 27-year-old woman with systemic lupus erythematosus (SLE), who presented with a 2-week history of left elbow swelling and tenderness, elevated inflammatory markers and joint aspiration findings consistent with infection. Serial blood cultures were negative. She was treated with flucloxacillin; however, failed to respond and so doxycycline was added to cover for atypical organisms. Subsequently, PCR analysis from the joint aspirate found M. hominis on day 16. Fortunately, doxycycline was an effective treatment for this atypical organism. This case outlines the importance of considering atypical organisms such as M. hominis as a cause of septic arthritis in immunosuppressed patients especially those with SLE.

  • rheumatology
  • connective tissue disease
  • systemic lupus erythematosus
  • sexual transmitted infections (bacterial)

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Footnotes

  • Twitter @DrRyanHum

  • Contributors RMH and HI oversaw the writing of the manuscript, literature review, citations and images. ET and PH were directly involved in the care of the patient, and in reviewing manuscripts and providing supervision. All authors contributed to the final draft of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.