The pneumococcal septic arthritis is uncommon in healthy adults. In most cases, it occurs in patients\nwith immune deficiency. Its exceptional location at the wrist can maintain doubt with\nrheumatic causes which are more frequent. IgG4 deficiency found in this patient was the only\ncause that could be impugned. We report the case of a young woman of 46 years without any\nevident cause of immunodeficiency and any particular risk factor, managed for septic arthritis of\nthe wrist due to Streptococcus pneumoniae. This case without any apparent risk factors demonstrates\nthat pneumococcal infection in a more distant articulation of the ENT is still possible. Scan\nhas been a very significant contribution in confirming the positive diagnosis that leads to surgical\ndrainage. The approach of the systematic search for the gateway must be done. In the study of the\npatient�s immune status, the realization of the protein profile could be interesting and then guide\nthe practitioner in the decision to vaccinate the patient against Streptococcus pneumoniae if he\nwas not. We recommend looking always for a cause of immunodeficiency including primary Ig\ndefiencies even among adult.
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