Article in Japanese

A child case of septic arthritis caused by emm type 1.0 Streptococcus pyogenes

Daisuke YOSHIDA

This study reports a 3-year-old girl who developed septic arthritis of the right ankle caused by Streptococcus pyogenes (GAS). After arthrocentesis, pus aspiration and lavage, antibiotic therapy was started with teicoplanin and cefotaxime. GAS was isolated from pus culture, before changing to penicillin G single-agent therapy. The patient received 18-day parenteral therapy, which was followed by high-dose oral amoxicillin, and a total 35-day administration of antibiotics. Her outcome was good without sequelae one year later. The GAS was typed as emm 1.0, with streptococcal-pyrogenic-exotoxin gene speA and speB, which is often observed in streptococcal toxic shock syndrome (STSS) patients. However, she did not develop STSS, even in anti-streptlysin O (ASO) elevation until 2 weeks after the onset, despite the existence of invasive streptococcal disease such as septic arthritis. Her treatment was continued until normalization of erythrocyte sedimentation rate (ESR), but in a relatively long period of time. The duration of anitibiotic therapy for septic arthritis should be individualized by the severity of symptoms, organism responsible, and clinical course. Data accumulation is needed for more appropriate antibiotic treatment of septic arthritis.

---

Department of Pediatrics, Japan Baptist Hospital

Key words
Received	April 9, 2014
Accepted	July 2, 2014

26 (3)：376─380,2014