Streptococcus pyogenes induced septic arthritis of the wrist secondary to a temporal abscess and trapezoid fracture - A case report.

Septic arthritis (SA) of the wrist is a rare and challenging condition that requires rapid treatment to prevent irreversible joint damage. We present a unique case of a hematogenously spread SA of the wrist caused by Streptococcus pyogenes, secondary to a temporal abscess. The patient, a previously healthy 36-year-old man without known risk factors aside from occasional alcohol consumption, exhibited wrist pain without fever or overt signs of infection. One week prior, he had suffered a temporal laceration and a non-displaced trapezoid fractur following a minor fall on his head and hand. In the following days, the patient developed fever, signs of infection around the temporal wound, and increasing wrist pain, ultimately leading to the diagnosis of a temporal abscess and SA of the wrist. Multiple surgical debridements were necessary alongside targeted intravenous antibiotic therapy, to successfully eradicate the wrist infection. Despite appropriate treatment, the patient experienced persistent pain and functional limitations of the wrist five months later. This case underscores the importance of early diagnosis and treatment of SA in cases of joint pain in combination with a potential infection elsewhere in the body. The case emphasizes the critical role of timely surgical intervention in managing SA of the wrist.