An uncommon case of acute rheumatic fever with migratory polyarthritis, caused by Shewanella putrefaciens: A case report

Shewanella putrefaciens is a gram-negative, halophilic opportunistic pathogen. Infections are uncommon but have been reported, particularly in warmer climates. This case highlights a rare instance of Acute Rheumatic Fever (ARF) with migratory polyarthritis caused by S. putrefaciens, emphasizing the importance of considering rare pathogens. A 31-year-old male presented with fever, chills, myalgia, and joint pain. Initial treatment with piperacillin-tazobactam provided temporary relief, but an idiosyncratic reaction necessitated a switch to amoxicillin and clavulanate potassium. The addition of steroids significantly reduced symptoms. Joint fluid culture revealed S. putrefaciens, leading to a diagnosis of ARF with migratory polyarthritis, carditis, and acute kidney injury. This case documents a novel association of S. putrefaciens with ARF and migratory polyarthritis. Successful management with targeted antibiotics and steroids underscores the importance of early detection and appropriate treatment for rare infections. It highlights the need for stringent infection control practices to prevent nosocomial infections caused by opportunistic pathogens like S. putrefaciens.