Demonstrating antibiotic stewardship while diagnosing and treating bilateral pseudoseptic arthritis: a case report. 

 -  2024 
<br/><br/>Available online through MWHC library: 2007 - present 
<br/><br/> CASE PRESENTATION: In this case report, we present a 61-year-old African American female patient who presented with bilateral knee pseudoseptic arthritis in the setting of viscosupplementation. She presented 3 days after bilateral viscosupplementation injections with bilateral knee swelling, discomfort, and pain with micromotion. Her white blood cell count (WBC) was 12.83 (4.5-11 normal), her C-reactive protein (CRP) level was 159 mg/L (0-10 normal), and her erythrocyte sedimentation rate (ESR) was 79 mm/hour (0-40 normal). Her left knee aspirate yielded 38,580 WBC with a negative gram stain and negative cultures. Her right knee aspirate yielded 29,670 WBC with a negative gram stain and negative cultures. Through the utilization of careful clinical monitoring, ice therapy, and non-steroidal inflammatory medication, we were able to successfully treat this patient while maintaining proper antibiotic stewardship.  CONCLUSION: Pseudoseptic arthritis in the setting of viscosupplementation can be adequately treated and monitored without the use of antibiotics. Copyright © 2024. The Author(s).  INTRODUCTION: Although viscosupplementation is a commonly used treatment for osteoarthritis and is widely regarded as a safe treatment option, it is associated with the rare complication of pseudoseptic arthritis. Most existing case reports that cite this rare complication employed the use of early broad-spectrum antibiotics. 
<br/><br/><br/>English 
<br/><br/><label>ISSN: </label>1752-1947 
<br/><br/><label>Standard No.: </label>10.1186/s13256-024-04568-2 [pii] PMC11084000 [pmc] 
<br/><br/><label>Subjects--Topical Terms: </label><br/>*Anti-Bacterial Agents<br/>*Antimicrobial Stewardship<br/>Anti-Bacterial Agents/tu [Therapeutic Use]<br/>Anti-Inflammatory Agents, Non-Steroidal/tu [Therapeutic Use]<br/>C-Reactive Protein/an [Analysis]<br/>Female<br/>Humans<br/>Knee Joint<br/>Middle Aged<br/>Osteoarthritis, Knee/dt [Drug Therapy]<br/>Treatment Outcome<br/>Viscosupplementation--Curated
<br/><br/><label>Subjects--Geographic Terms: </label><br/>MedStar Union Memorial Hospital
<br/><br/><label>Index Terms--Occupation: </label><br/>Orthopaedic Surgery<br/>Orthopaedic Surgery Residency
<br/><br/><label>Index Terms--Function: </label><br/>Case Reports<br/>Journal Article