Multiple Pyogenic Arthritis Caused by Bacteremia: A Case Report and Literature Review.

Infection with , a Gram-negative rod found in freshwater and seawater, is typically associated with the ingestion of raw fish and commonly causes enteritis, liver abscess, cholangitis, and cholecystitis in humans. However, multiple pyogenic arthritis, which have not been previously reported, are considered exceedingly rare. Herein, we report a case of bacteremia that resulted in multiple pyogenic arthritis and septic shock, which was successfully treated with intensive care. An 84-year-old man with a history of prostate cancer, diabetes mellitus, and chronic kidney disease was transferred to our hospital for swelling and pain in the left shoulder, following initial treatment for pyogenic arthritis of the left hip at a previous hospital. Imaging revealed the formation of abscesses in the shoulders and hips. He underwent emergent debridement of the left shoulder abscess and was admitted to the ICU. was identified from blood cultures on Day 3 of hospitalization. The patient developed septic shock and required vasopressor support. Intensive care, including the administration of appropriate antibiotics and surgical debridement, yielded clinical improvement. The patient was discharged from the ICU on Day 8. Cases of multiple pyogenic arthritis caused by bacteremia have the potential for rapid clinical deterioration. Our patient had multiple risk factors, including cancer, diabetes, and hypertension, which might have predisposed him to a severe disease course. Early diagnosis, appropriate antibiotic therapy, surgical debridement, and intensive care are crucial for patient survival, and early transfer to a tertiary center may improve outcomes. Even rare infections, such as , should be considered in the differential diagnosis of immunocompromised patients.