Bilateral Septic Arthritis of the Knees in an Immunocompetent Elderly Female: A Rare Case Report and Literature Review

Abstract

Septic arthritis (SA) is a medical emergency requiring early recognition and prompt intervention to avoid irreversible joint damage and systemic complications. While monoarticular SA is most common, bilateral knee involvement is rare, particularly in immunocompetent individuals. This case report presents a 64-year-old woman with bilateral knee SA in the absence of traditional risk factors and negative synovial fluid cultures. Diagnosis was guided by clinical presentation and elevated inflammatory markers and elevated ASLO. Surgical management via mini-arthrotomy combined with empirical antibiotics led to a full recovery. This report highlights the need for a high index of suspicion in atypical presentations and reviews relevant literature, including the role of the Kocher criteria for SA of knee joint.