Concomitant Septic Arthritis on Gouty Arthropathy: A Case Report

We’re reporting the case of an arthritis to banal germ occurred in concomitance with an advanced polyarticular of gout. It was about a patient of 59 years with alcoholic and gouty chronicle more than 10 years, but without specialized medical follow-up. He has been admitted in hospitalization for a big inflammatory and stiff right knee, letting rising the pus through two cutaneous fistulas in a context of non-febrile change of his peripheral polyarthritis of the big and small articulations. Gout was at distal predominance, bilateral, distorting, tophaceous and active. Inflammatory syndrome was important (ESR = 50 mm in the 1st hour and CRP = 28 mg/l) and uricemia was high, at 84 mg/l. The glycaemia, the hepatic, the viral, renal and serological evaluation (HIV and B, C hepatitis) were normal. The bacteriological analysis of the pus collected after puncture of the knee and cleaning identified a negative gram bacillus, Morganella morganii, multi-resistant, but sensitive to the Imipeneme and to the aminosides. The evolution was lethal in a picture of multivisceral failing in spite of a bi-antibiotherapy and under hypo-uricemia treatment prescription.