Dual Ureaplasma parvum arthritis: a case report of U. parvum septic arthritis following contralateral reactive arthritis in an immunosuppressed patient

BMC Infect Dis. 2021 Oct 29;21(1):1117. doi: 10.1186/s12879-021-06733-0.

Abstract

Background: Ureaplasma parvum is usually part of the normal genital flora. Rarely can it cause invasive infections such as genitourinary infections, septic arthritis, or meningitis.

Case presentation: Here we present the first description of chronic ureterocystitis in a 56-year-old immunocompromised patient, complicated first by reactive arthritis and secondarily by contralateral septic arthritis due to U. parvum infection. U. parvum was detected in synovial fluid and in a urine sample. Treatment consisted of double-J stenting and targeted antibiotic therapy. Evolution showed resolution of urinary symptoms and clinical improvement of arthritis despite functional sequelae.

Conclusions: Given the high prevalence of U. parvum colonisation, this diagnosis should remain a diagnosis of exclusion. However, because of the difficulty in detecting this microorganism, it should be considered in unexplained subacute urethritis or arthritis, including reactive arthritis, especially in immunosuppressed patients. Real-time PCR positivity in the absence of a differential diagnosis should not be overlooked.

Keywords: Case report; Immunosuppression; Reactive arthritis; Septic arthritis; Ureaplasma parvum.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Infectious* / diagnosis
  • Arthritis, Infectious* / drug therapy
  • Arthritis, Reactive*
  • Humans
  • Immunocompromised Host
  • Middle Aged
  • Ureaplasma
  • Ureaplasma Infections* / diagnosis
  • Ureaplasma Infections* / drug therapy