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Lumbar osteomyelitis and knee septic arthritis caused by Streptococcus agalactiae bacteraemia
  1. Lauren Gaffaney,
  2. Maxwell McKee-Proctor and
  3. Ho-Man Yeung
  1. Department of Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania, USA
  1. Correspondence to Dr Ho-Man Yeung; Ho-Man.Yeung{at}


A man in his late 70s presented to the emergency department endorsing a week of malaise. He was recently hospitalised for 2 days for new back pain and was discharged with non-opioid pain medications but continued to seek care as he felt unwell. On presentation, he was afebrile with a leukocytosis. Physical examination revealed a painful left knee with no evidence of trauma. Arthrocentesis revealed purulent fluid with elevated white blood cell consistent with septic arthritis. He was started on broad-spectrum antibiotics and underwent irrigation and synovectomy of the left knee. Aspirate and blood cultures grew Streptococcus agalactiae. Transthoracic echocardiogram showed no vegetations; however, an MRI of lumbar spine showed L2–L3 and L4–L5 osteomyelitis. He was treated with intravenous ceftriaxone for 3 weeks and then oral levofloxacin for 3 weeks, for a total 6 week course of antibiotics.

  • Orthopaedics
  • Bone and joint infections

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  • Contributors All authors provided direct patient care. LG and MM-P wrote the manuscript and obtained the images. H-MY consented the patient and revised the manuscript. All authors approved the final version of the manuscript submitted.

  • 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.