Septic arthritis of the hip caused by Streptococcus pyogenes bloodstream infection in a previously healthy adult: a case report
- 1Department of Laboratory Medicine, Guang’anmen Hospital (Baoding), No. 2699 Yuhua East Road, Lianchi, Baoding, Hebei 071000 China
- 2Department of General Practice, Guang’anmen Hospital (Baoding), Baoding, Hebei 071000 China
- 3Department of Orthopedics I, Guang’anmen Hospital (Baoding), Baoding, Hebei 071000 China
Abstract
Background: Pyogenic arthritis of the hip joint is a rare but serious complication of invasive Streptococcus pyogenes (group A Streptococcus [GAS]) infection that may rapidly lead to joint destruction and is often difficult to diagnose early. This report describes the case of a previously healthy adult who developed GAS bloodstream infection complicated by unilateral pyogenic arthritis of the hip, temporally following an episode of sore throat.
Case presentation: A 37-year-old man presented with right hip swelling, pain, and restricted mobility after a sore throat and high fever. The patient met the Sepsis-3 criteria at presentation. Magnetic resonance imaging, blood culture, and joint fluid culture results confirmed GAS bloodstream infection complicated by unilateral pyogenic arthritis of the hip. Owing to a history of skin allergic reactions to intravenous penicillin and cephalosporins, the patient was treated with intravenous meropenem, combined with ultrasound-guided joint aspiration–lavage. The patient's clinical condition improved progressively, and no recurrence was reported during 10 months of follow-up.
Conclusions: GAS bloodstream infection should be considered in the differential diagnosis of previously healthy adults presenting with recurrent fever and new-onset hip pain following pharyngitis. Recurrence of fever after initial defervescence may warrant evaluation for invasive bacterial infection. In patients with β-lactam allergy and documented susceptibility, meropenem may represent an option after individualized assessment. Early image-guided joint drainage, combined with appropriate systemic antimicrobial therapy such as intra-articular infusion, may contribute to infection control and preservation of joint function.
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BibTeX
@article{min2026septic,
title = {{Septic arthritis of the hip caused by Streptococcus pyogenes bloodstream infection in a previously healthy adult: a case report}},
author = {Juan Min and Ying Zhao and Shuxing Guo and Chongbo Zhu and Zhiling Zhang},
journal = {BMC Musculoskeletal Disorders},
year = {2026},
month = aug,
doi = {10.1186/s12891-026-10323-z},
url = {https://doi.org/10.1186/s12891-026-10323-z},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Septic arthritis of the hip caused by Streptococcus pyogenes bloodstream infection in a previously healthy adult: a case report
AU - Juan Min
AU - Ying Zhao
AU - Shuxing Guo
AU - Chongbo Zhu
AU - Zhiling Zhang
PY - 2026
DA - 2026/08/07
JO - BMC Musculoskeletal Disorders
DO - 10.1186/s12891-026-10323-z
UR - https://doi.org/10.1186/s12891-026-10323-z
AB - Background: Pyogenic arthritis of the hip joint is a rare but serious complication of invasive Streptococcus pyogenes (group A Streptococcus [GAS]) infection that may rapidly lead to joint destruction and is often difficult to diagnose early. This report describes the case of a previously healthy adult who developed GAS bloodstream infection complicated by unilateral pyogenic arthritis of the hip, temporally following an episode of sore throat. Case presentation: A 37-year-old man presented with right hip swelling, pain, and restricted mobility after a sore throat and high fever. The patient met the Sepsis-3 criteria at presentation. Magnetic resonance imaging, blood culture, and joint fluid culture results confirmed GAS bloodstream infection complicated by unilateral pyogenic arthritis of the hip. Owing to a history of skin allergic reactions to intravenous penicillin and cephalosporins, the patient was treated with intravenous meropenem, combined with ultrasound-guided joint aspiration–lavage. The patient's clinical condition improved progressively, and no recurrence was reported during 10 months of follow-up. Conclusions: GAS bloodstream infection should be considered in the differential diagnosis of previously healthy adults presenting with recurrent fever and new-onset hip pain following pharyngitis. Recurrence of fever after initial defervescence may warrant evaluation for invasive bacterial infection. In patients with β-lactam allergy and documented susceptibility, meropenem may represent an option after individualized assessment. Early image-guided joint drainage, combined with appropriate systemic antimicrobial therapy such as intra-articular infusion, may contribute to infection control and preservation of joint function.
SN - 1471-2474
ER -