Group A Streptococcal Sepsis and Arthritis

In 1977, James D. Brosseau and Joseph J. Mazza reported a case of a 28-year-old woman who developed group A streptococcal septicemia and monoarticular arthritis originating from an infected intrauterine device (IUD). The infection was believed to have been transmitted during sexual foreplay from her husband, who had a streptococcal infection of the throat and cellulitis on his fingers. The patient's symptoms included fever, chills, severe pain in her right shoulder and wrist, and a persistent watery vaginal discharge. Laboratory tests confirmed the presence of group A β-hemolytic streptococci from the IUD, blood cultures, and wrist joint aspirate. After treatment with intravenous cefazolin, due to penicillin allergy, the patient's symptoms resolved, and she later gave birth to a normal child. The case highlighted the risk of IUD-related infections, which can be exacerbated by the introduction of unusual organisms through sexual practices.