Pneumococcal arthritis complicating gout. Case report and literature review.

The simultaneous occurrence of septic arthritis and gout is quite uncommon. We describe a patient with chronic gout who developed pneumococcal pneumonia. Twenty-four hours later, his previously involved joints became acutely inflamed and were found to contain both pneumococcal organisms and monosodium urate crystals intracellularly. The mechanisms which may confer upon a gouty joint selective resistance or susceptibility to colonization by a blood borne organism are discussed. Septic arthritis must remain a consideration in patients with chronic gouty arthritis.