AI Article Synopsis

  • * Ureaplasma parvum was identified as a rare pathogenic cause of his condition through advanced genetic testing, despite the absence of typical responses to treatment and normal liver function tests.
  • * The findings suggest that Ureaplasma parvum should be considered as a potential cause of septic arthritis, particularly in patients with atypical presentations and symptoms of hyperammonemia.

Article Abstract

Background: Septic arthritis requires prompt diagnosis and treatments. Rare pathogens should be considered when patients respond poorly to the initial antibiotic treatments. Ureaplasma parvum is an opportunistic pathogen that commonly resides in the human urogenital tract. Its infection commonly causes hyperammonemia. Hyperammonemia from Ureaplasma parvum septic arthritis has never been reported previously.

Case Presentation: A 65-year-old male presented with fever and left lower leg pain and swelling for more than ten days. Septic arthritis and sepsis were considered after laboratory tests and arthrocentesis. However, he responded poorly to the antibiotic treatments, including cefoperazone-sulbactam, imipenem-cilastatin, and linezolid. His mental status deteriorated rapidly with elevated blood ammonia levels with unremarkable liver function test and sonogram examination results. Despite the treatments with lactulose, L-ornithine L-aspartate, mannitol, and hemodialysis therapy to lower his ammonia level, his blood ammonia level remained persistently high. Finally, metagenomic sequencing of the left knee synovial fluid reported Ureaplasma parvum, which was considered to contribute to his hyperammonemia.

Conclusion: Ureaplasma parvum could cause septic arthritis with hyperammonemia. Genetic tests, such as polymerase chain reaction and next-generation sequencing techniques, could provide a sensitive and fast diagnosis of Ureaplasma parvum.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9783457PMC
http://dx.doi.org/10.1186/s12879-022-07953-8DOI Listing

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