Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy

Introduction: Immunocompromised individuals, such as those undergoing Rituximab therapy, are susceptible to severe infections by these organisms. We present a rare case of polyarticular septic arthritis caused by disseminated Ureaplasma urealyticum in a Rituximab-treated patient. Presentation of cas...

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Main Authors: Michael Axenhus, Jesper Ericson, Agata Rysinska, Annelie Petterson, Desiree Friis
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:IDCases
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Online Access:http://www.sciencedirect.com/science/article/pii/S221425092400177X
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author Michael Axenhus
Jesper Ericson
Agata Rysinska
Annelie Petterson
Desiree Friis
author_facet Michael Axenhus
Jesper Ericson
Agata Rysinska
Annelie Petterson
Desiree Friis
author_sort Michael Axenhus
collection DOAJ
description Introduction: Immunocompromised individuals, such as those undergoing Rituximab therapy, are susceptible to severe infections by these organisms. We present a rare case of polyarticular septic arthritis caused by disseminated Ureaplasma urealyticum in a Rituximab-treated patient. Presentation of case: A 38-year-old male with a history of schizophrenia and multiple sclerosis presented with intense pain, swelling, and fever, along with limited joint mobility. Despite initial treatment with antibiotics and surgical intervention, the patient's condition deteriorated. PCR assays confirmed the presence of Ureaplasma urealyticum, prompting a change in antibiotic therapy. With focused antimicrobial treatment and supportive care, the patient exhibited gradual improvement, although reinfection occurred one month after discharge, necessitating additional surgical interventions and antibiotic therapy. Discussion: Septic arthritis due to Ureaplasma urealyticum is exceedingly rare but can occur in immunocompromised patients undergoing Rituximab therapy. Accurate pathogen identification using PCR assays is crucial for optimizing therapeutic outcomes in such cases. Treatment typically involves a combination of surgical debridement and tailored antimicrobial therapy with agents effective against Ureaplasma species. Close monitoring for disease recurrence and joint function is essential for long-term management. Conclusion: This case highlights the diagnostic challenges and therapeutic complexities of septic arthritis caused by Ureaplasma urealyticum in immunocompromised patients undergoing Rituximab treatment. Interdisciplinary collaboration and the use of PCR assays for accurate pathogen identification are crucial for successful outcomes in such cases. Clinicians should consider the unique susceptibility of immunocompromised individuals to rare pathogens and tailor antimicrobial therapy accordingly.
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spelling doaj-art-bd4b82a896934cec88cb1a08216afcaa2025-08-20T02:37:29ZengElsevierIDCases2214-25092024-01-0138e0210110.1016/j.idcr.2024.e02101Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapyMichael Axenhus0Jesper Ericson1Agata Rysinska2Annelie Petterson3Desiree Friis4Danderyd Hospital, Department of Orthopedic Surgery, Stockholm, Sweden; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden; Correspondence to: Danderyd Hospital, Entrevägen 2, 182 88, Danderyd, Stockholm, Sweden.Danderyd Hospital, Department of Infectious Diseases, Stockholm, SwedenDanderyd Hospital, Department of Orthopedic Surgery, Stockholm, Sweden; Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, SwedenDanderyd Hospital, Department of Orthopedic Surgery, Stockholm, SwedenDanderyd Hospital, Department of Orthopedic Surgery, Stockholm, SwedenIntroduction: Immunocompromised individuals, such as those undergoing Rituximab therapy, are susceptible to severe infections by these organisms. We present a rare case of polyarticular septic arthritis caused by disseminated Ureaplasma urealyticum in a Rituximab-treated patient. Presentation of case: A 38-year-old male with a history of schizophrenia and multiple sclerosis presented with intense pain, swelling, and fever, along with limited joint mobility. Despite initial treatment with antibiotics and surgical intervention, the patient's condition deteriorated. PCR assays confirmed the presence of Ureaplasma urealyticum, prompting a change in antibiotic therapy. With focused antimicrobial treatment and supportive care, the patient exhibited gradual improvement, although reinfection occurred one month after discharge, necessitating additional surgical interventions and antibiotic therapy. Discussion: Septic arthritis due to Ureaplasma urealyticum is exceedingly rare but can occur in immunocompromised patients undergoing Rituximab therapy. Accurate pathogen identification using PCR assays is crucial for optimizing therapeutic outcomes in such cases. Treatment typically involves a combination of surgical debridement and tailored antimicrobial therapy with agents effective against Ureaplasma species. Close monitoring for disease recurrence and joint function is essential for long-term management. Conclusion: This case highlights the diagnostic challenges and therapeutic complexities of septic arthritis caused by Ureaplasma urealyticum in immunocompromised patients undergoing Rituximab treatment. Interdisciplinary collaboration and the use of PCR assays for accurate pathogen identification are crucial for successful outcomes in such cases. Clinicians should consider the unique susceptibility of immunocompromised individuals to rare pathogens and tailor antimicrobial therapy accordingly.http://www.sciencedirect.com/science/article/pii/S221425092400177XDisseminated UreaplasmaImmunocompromised patientRituximab treatmentSeptic arthritis
spellingShingle Michael Axenhus
Jesper Ericson
Agata Rysinska
Annelie Petterson
Desiree Friis
Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
IDCases
Disseminated Ureaplasma
Immunocompromised patient
Rituximab treatment
Septic arthritis
title Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
title_full Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
title_fullStr Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
title_full_unstemmed Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
title_short Disseminated Ureaplasma infection: A case report of septic polyarthritis in a patient on Rituximab therapy
title_sort disseminated ureaplasma infection a case report of septic polyarthritis in a patient on rituximab therapy
topic Disseminated Ureaplasma
Immunocompromised patient
Rituximab treatment
Septic arthritis
url http://www.sciencedirect.com/science/article/pii/S221425092400177X
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