Pyogenic arthritis of native joints due to Bacteroides fragilis: Case report and review of the literature

Medicine (Baltimore). 2016 Jun;95(25):e3962. doi: 10.1097/MD.0000000000003962.


Pyogenic arthritis of native joints due to Bacteroides fragilis seems to be an infrequent disease. We analyzed the cases diagnosed in a tertiary hospital during a 22-year period and reviewed the literature to summarize the experience with this infectious entity.In our institution, of 308 patients with pyogenic arthritis of native joints, B fragilis was the causative organism in 2 (0.6%) cases. A MEDLINE search (1981-2015) identified 19 additional cases.Of the 21 patients available for review (13 men and 8 women, with a mean age, of 54.4 ± 17 years), 19 (90%) presented a systemic predisposing factor for infection; the most common associated illness was rheumatoid arthritis (8 patients). Bacteremia was documented in 65% (13/20) of cases. In 5 patients (24%), 1 or more concomitant infectious process was found. Metronidazole was the most frequently used antibiotic. Surgical drainage was performed in 11 cases (52%). The overall mortality rate was 5%.Pyogenic arthritis of native joints due to B fragilis is an infrequent disease that mainly affects elderly patients with underlying medical illnesses and in whom bacteremia and the presence of a concomitant infectious process are frequent conditions.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • Arthritis, Infectious / diagnosis*
  • Arthritis, Infectious / microbiology
  • Bacteroides Infections / diagnosis*
  • Bacteroides Infections / microbiology
  • Bacteroides fragilis / isolation & purification*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Young Adult