Streptococcus pneumoniae Septic Arthritis in a Vaccinated Host: Case Report
DOI:
https://doi.org/10.46570/utjms-2026-1993Keywords:
Streptococcus pneumoniae, Septic Arthritis, VaccineAbstract
Streptococcus pneumoniae septic arthritis is an uncommon infection, rarely encountered in the US since the introduction of pneumococcal vaccination. We present a case of S. pneumoniae septic arthritis in a patient with HIV from a serotype not covered by pneumococcal vaccines: the patient had previously received PPV-23 and PCV-13 pneumococcal vaccination in addition to PCV-20 pneumococcal vaccination a year before presentation. This case highlights the importance of S. pneumoniae as a pathogen in people with HIV regardless of vaccination status, and the potential for pneumococcal disease from serotypes not covered in the currently available vaccines (serotype replacement).
References
Boger WP. Pneumococcic Arthritis: Report of a Case of So-called Primary Pneumococcic Arthritis. JAMA. 1944;126(17):1062–1065. doi:10.1001/jama.1944.02850520004003
Esteban J, Salar-Vidal L, Schmitt BH, Waggoner A, Laurent F, Abad L, Bauer TW, Mazariegos I, Balada-Llasat J-M, Horn J, Wolk DM, Jefferis A, Hermans M, Verhoofstad I, Butler-Wu SM, Umali-Wilcox M, Murphy C, Cabrera B, Craft D, von Bredow B, Leber A, Everhart K, Dien Bard J, Flores II, Daly J, Barr R, Holmberg K, Graue C, Kensinger B. Multicenter evaluation of the BIOFIRE Joint Infection Panel for the detection of bacteria, yeast, and AMR genes in synovial fluid samples. J Clin Microbiol. 2023 Nov 21;61(11):e0035723. doi: 10.1128/jcm.00357-23. Epub 2023 Oct 25. PMID: 37877730; PMCID: PMC10662359.
Putnam NE, Charles DW, Doub JB, Johnson JK. Broad-range polymerase chain reaction and sequencing for the diagnosis of infectious diseases. Microbiol Spectr. 2025 Apr;13(4):e0250524. doi: 10.1128/spectrum.02505-24. Epub 2025 Mar 5. PMID: 40042284; PMCID: PMC11960090.
Hyams C, Amin-Chowdhury Z, Fry NK, North P, Finn A, Judge A, Ladhani SN, Williams OM. Streptococcus Pneumoniae septic arthritis in adults in Bristol and Bath, United Kingdom, 2006-2018: a 13-year retrospective observational cohort study. Emerg Microbes Infect. 2021 Dec;10(1):1369-1377. doi: 10.1080/22221751.2021.1945955. PMID: 34151740; PMCID: PMC8259820.
Baraboutis I, Skoutelis A. Streptococcus pneumoniae septic arthritis in adults. Clin Microbiol Infect. 2004 Dec;10(12):1037-9. doi: 10.1111/j.1469-0691.2004.00968.x. PMID: 15606629.
Torres J, Rathbun HK, Greenough WB 3rd. Pneumococcal arthritis: report of a case and review of the literature. Johns Hopkins Med J. 1973 Apr;132(4):234-41. PMID: 4144608.
Ispahani P, Weston VC, Turner DP, Donald FE. Septic arthritis due to Streptococcus pneumoniae in Nottingham, United Kingdom, 1985-1998. Clin Infect Dis. 1999 Dec;29(6):1450-4. doi: 10.1086/313526. PMID: 10585794.
Daniels CC, Rogers PD, Shelton CM. A Review of Pneumococcal Vaccines: Current Polysaccharide Vaccine Recommendations and Future Protein Antigens. J Pediatr Pharmacol Ther. 2016 Jan-Feb;21(1):27-35. doi: 10.5863/1551-6776-21.1.27. PMID: 26997927; PMCID: PMC4778694.
Arrizabalaga M, Borjas Y, Peñaranda M, Garau M, Ruíz de Gopegui E, Payeras A. Osteoarticular infections caused by Streptococcus pneumoniae since authorization of conjugate vaccines. Reumatol Clin (Engl Ed). 2019 Sep-Oct;15(5):e62-e65. English, Spanish. doi: 10.1016/j.reuma.2017.05.003. Epub 2017 Jun 7. PMID: 28599870.
Hamdad F, El Bayeh N, Auger G, Peuchant O, Wallet F, Ruimy R, Reibel F, Martin C, Ploy MC, Robin F, Laurens C, Lanotte P, Kempf M, Tetu J, Revillet H, Patry I, Cailloux P, Azouaou M, Varon E, Duhaut P, Lozniewski A, Cattoir V. Pneumococcal Septic Arthritis among Adults, France, 2010-2018. Emerg Infect Dis. 2025 Jan;31(1):8–17. doi: 10.3201/eid3101.240321. PMID: 39714309; PMCID: PMC11682792.
Weinberger DM, Malley R, Lipsitch M. Serotype replacement in disease after pneumococcal vaccination. Lancet. 2011 Dec 3;378(9807):1962-73. doi: 10.1016/S0140-6736(10)62225-8. Epub 2011 Apr 12. PMID: 21492929; PMCID: PMC3256741.
Frankel RE, Virata M, Hardalo C, Altice FL, Friedland G. Invasive pneumococcal disease: clinical features, serotypes, and antimicrobial resistance patterns in cases involving patients with and without human immunodeficiency virus infection. Clin Infect Dis. 1996 Sep;23(3):577-84. doi: 10.1093/clinids/23.3.577. PMID: 8879783.
Medina P, de Lazzari E, Espasa M, de la Mora L, Martínez-Rebollar M, González-Cordón A, Laguno M, Inciarte A, Ambrosioni J, Calvo J, Foncillas A, Sempere A, Chivite I, Berrocal L, Blanco JL, Martínez E, Miró JM, Mallolas J, Torres B. Incidence, Clinical Features and Vaccination Coverage of Pneumococcal Disease in People Living with HIV: A Retrospective Cohort Study (2015-2024). Vaccines (Basel). 2025 Dec 13;13(12):1240. doi: 10.3390/vaccines13121240. PMID: 41441706; PMCID: PMC12737652.
Kobayashi M, Matanock A, Xing W, Adih WK, Li J, Gierke R, Almendares O, Reingold A, Alden N, Petit S, Farley MM, Harrison LH, Holtzman C, Baumbach J, Thomas A, Schaffner W, McGee L, Pilishvili T. Impact of 13-Valent Pneumococcal Conjugate Vaccine on Invasive Pneumococcal Disease Among Adults With HIV-United States, 2008-2018. J Acquir Immune Defic Syndr. 2022 May 1;90(1):6-14. doi: 10.1097/QAI.0000000000002916. PMID: 35384920; PMCID: PMC9009407.
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Copyright (c) 2026 Joan Duggan, Branavan Ragunanthan, Savanna King, Nicole Hubbard, Claudiu Georgescu (Author)

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