A 60-year-old male, with past medical history significant for traumatic total splenectomy in 1970, osteoarthritis, presented with symptoms of fever, chills, fatigue, and bilateral knee pain and swelling of several days duration. Physical examination was significant for bilateral knee effusion, redness, warmth, and decreased range of motion of knees bilaterally.
Initial laboratory results showed leukocytosis with neutrophilia. Bilateral joint aspiration of the knees yielded a positive joint fluid for Streptococcus pneumoniae. He was placed on IV vancomycin and immunoglobulins. The patient underwent arthroscopic and mini-open arthrotomy along with irrigation and debridement.