• Joan M Nolla, Oscar Murillo, Javier Narvaez, Carmen Gómez Vaquero, Jaime Lora-Tamayo, Salvador Pedrero, Javier Cabo, and Javier Ariza.
• Rheumatology Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain Infectious Diseases Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain Orthopedic Surgery Department, IDIBELL-Hospital Universitari de Bellvitge, Barcelona, Spain.
• Medicine (Baltimore). 2016 Jun 1; 95 (25): e3962e3962.

AbstractPyogenic 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.

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