Manifestations ostéo-articulaires secondaires à une piqûre, griffure, morsure ou à germes inhabituels ou émergents

Osteoarticular manifestations after a sting, a bite or a scratch are rare but the diagnosis should not be neglected. Targeted antibiotic therapy is mandatory. Surgery might help the diagnosis with adequate biopsy and is sometimes essential for recovery. A detective work is needed to identify a history of wound. Pantoea agglomerans (P. agglomerans) and nocardiosis are seen after a telluric wound, Capnocytophaga canimorsus (C. canimorsus) and Pasteurella multocida (P. multocida) after a dog bite, Bartonella henselae (B. henselae) and P. multocida after a cat scratch, Erysipelothrix rhusopathiae (E. rhusopathiae) when the wound is caused by a pig bone or a fishbone. A contact with water soiled with rat urine during work or leisure activity could indicate infection with Streptobacillus moniliformis (S. moniliformis) Spirillum minus (S. minus), Leptospira interrogans (L. interrogans). Bacteriological documentation might be difficult but is often mandatory to ascertain diagnosis and to adapt antibiotics. A sting can be responsible for a non-infectious arthritis. Inflammation is directly mediated by foreign body and is called “thorn arthritis”. Foreign body is often not seen on conventional radiography, hardly seen in ultrasonography, and surgery is needed to extract it and sometimes to perform synovectomy. Atypical mycobacteria are seen in patients with immunodepression but not only. Contact with fish or fishing material brings Mycobacterium marinum (M. marinum) to mind and a history of joint injection evoke Mycobacterium kansasii (M. kansasii). Surgery is frequently needed for diagnosis and treatment of tenosynovitis or arthritis caused by atypical mycobacteria. Tick-borne arthritis are mainly caused by Borrelia burgdorferi but can also involve Babesia divergens or Rickettsia conorii. Among arthropod-borne viruses, chikungunya provides a model of infection-triggered inflammatory joint disease.