Case Report 


Mohammed Omer Mohammed *, Sherko A Omer **, Taha Ahmed Fathulla *** Rebar Mohammed Nori **** and Abdulla Delmany *****

*       Department of Medicine, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.

**     Department of Microbiology, School of Medicine, Faculty of Medical Sciences, University of Sulaimani. 

***   General Teaching Hospital, Sulaimani City, Iraq.

****  Department of Surgery, School of Medicine, Faculty of Medical Sciences, University of Sulaimani.

***** Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Iraq.

Submitted: 26/11/2013; Accepted: 12/2/2014; Published 1/6/2014

DOI Link: https://doi.org/10.17656/jsmc.10051 


A diabetic man with chronic liver disease developed septic arthritis of knee. The joint infection was caused by Gram positive cocci called Pediococcus pentosaceus.


Pediococcus pentosaceus, Septic Arthritis, Chronic Liver Disease, Diabetes mellitus.


1- Riebel WJ, Washington JA. Clinical and microbiologic characteristics of pediococci. Journal of clinical microbiology. 1990 Jun;28(6):1348-55. PubMed PMID: 2380362. Pubmed Central PMCID: 267931.

2- Stackebrandt E, Fowler VJ, Woese CR. A Phylogenetic Analysis of Lactobacilli, Pediococcus pentosaceus and Leuconostoc mesenteroides. Systematic and applied microbiology. 1983;4(3):326-37. PubMed PMID: 23194733.

3- Ruoff KL, Kuritzkes DR, Wolfson JS, Ferraro MJ. Vancomycin-resistant gram-positive bacteria isolated from human sources. Journal of clinical microbiology. 1988 Oct;26(10):2064-8. PubMed PMID: 3182995. Pubmed Central PMCID: 266817.

4- Barton LL, Rider ED, Coen RW. Bacteremic infection with Pediococcus: vancomycin-resistant opportunist. Pediatrics. 2001 Apr;107(4):775-6. PubMed PMID: 11335758. Epub 2001/05/23. eng.

5- Corcoran GD, Gibbons N, Mulvihill TE. Septicaemia caused by Pediococcus pentosaceus: a new opportunistic pathogen. The Journal of infection. 1991 Sep;23(2):179-82. PubMed PMID: 1753117.

6- Benlloch S, Berenguer M. Chronic viral hepatitis. In: Friedman LS, Keeffe EB, editors. Handbook of Liver Disease. Third Edition. Philadelphia: Saunders; 2011. p. 53-69.

7- Macnaughtan J, Stadlbauer V, Mookerjee RP, Jalan R. SIRS, Bacterial Infections, and Alterations of the Immune System. In: Ginès P, Kamath PS, Arroyo V, editors. Chronic Liver Failure : Mechanisms and Management. Clinical Gastroenterology. New York: Humana Press; 2011. p. 219-38.

8- Aggarwal A, Ong JP, Younossi ZM, Nelson DR, Hoffman-Hogg L, Arroliga AC. Predictors of mortality and resource utilization in cirrhotic patients admitted to the medical ICU. Chest. 2001 May;119(5):1489-97. 

PubMed PMID: 11348958.

9- Graves DT, Kayal RA. Diabetic complications and dysregulated innate immunity. Frontiers in bioscience : a journal and virtual library. 2008;13:1227-39. PubMed PMID: 17981625. Pubmed Central PMCID: 3130196. Epub 2007/11/06. eng.

10- Larkin JG, Frier BM, Ireland JT. Diabetes mellitus and infection. Postgraduate medical journal. 1985 Mar;61(713):233-7. PubMed PMID: 3885204. Pubmed Central PMCID: 2418179.

11- Ahmed I, Goldstein B. Diabetes mellitus. Clinics in dermatology. 2006 Jul-Aug;24(4):237-46. PubMed PMID: 16828404.

12- Chin CY, Monack DM, Nathan S. Delayed activation of host innate immune pathways in streptozotocin-induced diabetic hosts leads to more severe disease during infection with Burkholderia pseudomallei. Immunology. 2012 Apr;135(4):312-32. PubMed PMID: 22136109. Pubmed Central PMCID: 3372747. Epub 2011/12/06. eng.

13- Savin JA. Bacterial infections in diabetes mellitus. The British journal of dermatology. 1974 Oct;91(4):481-4. PubMed PMID: 4609453.

14- Meurer M, Stumvoll M, Szeimies RM. Skin changes in diabetes mellitus. Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete. 2004 May;55(5):428-35. PubMed PMID: 15083279. Hautveranderungen bei Diabetes mellitus.

15- George I. Varghese, Ellen S. Marmur, Varghese MC. Dermatological Complications of Diabetes Mellitus; Allergy to Insulin and Oral Agents. In: Poretsky L, editor. Principles of Diabetes Mellitus , Second Editioned. New Yor: Springer; 2006. p. 454-71.

16- OHL CA. Infectious Arthritis of Native Joints. In: Mandell GL, Bennett JE, Dolin R, editors. Mandell, Douglas, and Bennett's principles and practice of infectious diseases. 2. 7 ed. Edinburg: Churchill Livingstone; 2010. p. 1443-56.

17- Kaandorp CJ, Dinant HJ, van de Laar MA, Moens HJ, Prins AP, Dijkmans BA. Incidence and sources of native and prosthetic joint infection: a community based prospective survey. Annals of the rheumatic diseases. 1997 Aug;56(8):470-5. PubMed PMID: 9306869. Pubmed Central PMCID: 1752430.

18- Sapico FL, Liquete JA, Sarma RJ. Bone and joint infections in patients with infective endocarditis: review of a 4-year experience. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 1996 May;22(5):783-7. PubMed PMID: 8722931.

19- Ross JJ, Saltzman CL, Carling P, Shapiro DS. Pneumococcal septic arthritis: review of 190 cases. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America. 2003 Feb 1;36(3):319-27. PubMed PMID: 12539074.

20- Reuter G. Present and future of probiotics in Germany and in Central Europe. Biosci Microflora. 1997;16:43-51.

21- Holzapfel WH, Franz CMAP, Ludwig W, Dicks LMT. Genus III. Pediococcus. In: Vos PD, Garrity GM, Jones D, Krieg NR, Ludwig W, Rainey FA, et al., editors. Bergey's Manual of Systematic Bacteriology. 3 The Firmicute. London: Springer; 2009. p. 513-32.

22- Tankovic J, Leclercq R, Duval J. Antimicrobial susceptibility of Pediococcus spp. and genetic basis of macrolide resistance in Pediococcus acidilactici HM3020. Antimicrob Agents Chemother. 1993;37(4):789 - 92.

23- Atkins JT, Tillman J, Tan TQ, Demmler GJ. Pediococcus pentosaceus catheter-associated infection in an infant with gastroschisis. The Pediatric infectious disease journal. 1994 Jan;13(1):75-6. PubMed PMID: 8170738. Epub 1994/01/01. eng.

24- Michalopoulos N, Arampatzi S, Papavramidis TS, Kotidis E, Laskou S, Papavramidis ST. Necrotizing cellulitis of the abdominal wall, caused by Pediococcus sp., due to rupture of a retroperitoneal stromal cell tumor. International journal of surgery case reports. 2013;4(3):286-9. PubMed PMID: 23357010. Pubmed Central PMCID: 3604670.

25- Yu KH, Luo SF, Liou LB, Wu YJ, Tsai WP, Chen JY, et al. Concomitant septic and gouty arthritis--an analysis of 30 cases. Rheumatology. 2003 Sep;42(9):1062-6. PubMed PMID: 12730521.

Full Text 

 © The Authors, published by University of Sulaimani, College of Medicine

This work is licensed under a Creative Commons Attribution 4.0 International License.