scholarly journals 323. First case of Prosthetic joint infection due to Nocardia veterana-elegans

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S234-S234
Author(s):  
Tasaduq Fazili ◽  
Ekta Bansal ◽  
Dorothy C Garner ◽  
Vijendra Bajwa
Keyword(s):  
Septic Arthritis ◽  
Prosthetic Joint Infection ◽  
English Literature ◽  
Joint Infection ◽  
Nocardia Species ◽  
First Case ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
History Of ◽  
Removal Of Hardware

Abstract Background Nocardia are Gram-positive filamentous bacteria that cause Nocardiosis, a rare opportunistic infection. The most common site of infection is the lungs, with metastatic spread usually to the central nervous system. Prosthetic joint infection due to Nocardia is very rare. Methods We report the first case of prosthetic joint infection due to Nocardia veteran-elegans, and review the literature regarding Nocardia septic arthritis, with particular attention to prosthetic joint infection. Results The patient was a 35 year old male with history of Hodgkin’s Lymphoma for which he received chemotherapy previously, poorly controlled diabetes, motor vehicle accident in 2003 with right open tibial plateau fracture requiring hardware placement, who was admitted with a two week history of right knee pain and swelling. Knee aspiration revealed purulent fluid and synovial culture grew Nocardia species. He underwent right knee arthrotomy and debridement with removal of hardware. The Nocardia species was speciated as N. veterana-elegans, sensitive to trimethoprim/sulfamethoxazole, linezolid, clarithromycin, imipenem and amikacin. He was placed on oral linezolid for four weeks, which was then switched to oral trimethoprim/sulfamethoxazole, with a plan for a six month course of therapy. He has completed two months of therapy thus far and is doing well clinically. Nocardia is an uncommon cause of septic arthritis. We found only 37 cases reported in the English literature thus far. Amongst these, only six involved prosthetic joints, including our case, which is the first one to be caused by N. veterana-elegans.Three cases were caused by N. nova and one each by N. farcinica and asteroides. Septic arthritis due to Nocardia has a favorable outcome with a combination of surgical debridement and prolonged antimicrobial therapy of three to six months. For prosthetic joint infections, removal of hardware seems to carry a better prognosis. Trimethoprim/sulfamethoxazole is the preferred antimicrobial, including for bone and joint infection, although susceptibilities can vary amongst the different species. Conclusion Nocardia is an uncommon cause of septic arthritis. Prosthetic joint infection is very rare. Prognosis is fair with a combination of hardware removal and prolonged antibiotic therapy. Disclosures All Authors: No reported disclosures

scholarly journals BACTERIAL (SEPTIC) ARTHRITIS AND PROSTHETIC JOINT INFECTION

2017 ◽  
Vol 55 (2) ◽  
pp. 192-200 ◽  
Author(s):  
B. S. Belov ◽  
S. A. Makarov ◽  
E. I. Byalik
Keyword(s):  
Septic Arthritis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint

Prior hip or knee prosthetic joint infection in another joint increases risk three-fold of prosthetic joint infection after primary total knee arthroplasty

2019 ◽  
Vol 101-B (7_Supple_C) ◽  
pp. 91-97 ◽  
Author(s):  
B. P. Chalmers ◽  
J. T. Weston ◽  
D. R. Osmon ◽  
A. D. Hanssen ◽  
D. J. Berry ◽  
...  
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Primary Total Knee Arthroplasty ◽  
Study Cohort ◽  
Study Group ◽  
Prosthetic Joint ◽  
Primary Tkas ◽  
History Of ◽  
Total Knee ◽  
Primary Total Knee

Aims There is little information regarding the risk of a patient developing prosthetic joint infection (PJI) after primary total knee arthroplasty (TKA) when the patient has previously experienced PJI of a TKA or total hip arthroplasty (THA) in another joint. The goal of this study was to compare the risk of PJI of primary TKA in this patient population against matched controls. Patients and Methods We retrospectively reviewed 95 patients (102 primary TKAs) treated between 2000 and 2014 with a history of PJI in another TKA or THA. A total of 50 patients (53%) were female. Mean age was 69 years (45 to 88) with a mean body mass index (BMI) of 36 kg/m2 (22 to 59). In total, 27% of patients were on chronic antibiotic suppression. Mean follow-up was six years (2 to 16). We 1:3 matched these (for age, sex, BMI, and surgical year) to 306 primary TKAs performed in 306 patients with a THA or TKA of another joint without a subsequent PJI. Competing risk with death was used for statistical analysis. Multivariate analysis was followed to evaluate risk factors for PJI in the study cohort. Results The cumulative incidence of PJI in the study cohort (6.1%) was significantly higher than the matched cohort (2.6%) at ten years (hazard ratio (HR) 3.3; 95% confidence interval 1.18 to 8.97; p = 0.02). Host grade in the study group was not a significant risk factor for PJI. Patients on chronic suppression had a higher rate of PJI (HR 15; p = 0.002), with six of the seven patients developing PJI in the study group being on chronic suppression. The new infecting microorganism was the same as the previous in only two of seven patients. Conclusion In this matched cohort study, patients undergoing a clean primary TKA with a history of TKA or THA PJI in another joint had a three-fold higher risk of PJI compared with matched controls with ten-year cumulative incidence of 6.1%. The risk of PJI was 15-fold higher in patients on chronic antibiotic suppression; further investigation into reasons for this and mitigation strategies are recommended. Cite this article: Bone Joint J 2019;101-B(7 Supple C):91–97

scholarly journals Mycobacterium bovis prosthetic joint infection following intravesical instillation of BCG for bladder cancer

2019 ◽  
Vol 12 (12) ◽  
pp. e231830 ◽  
Author(s):  
Ashka Patel ◽  
Joel Elzweig
Keyword(s):  
Bladder Cancer ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Fluid Collection ◽  
Acid Fast Bacillus ◽  
Intravesical Instillation ◽  
Susceptibility Data ◽  
Prosthetic Joint ◽  
Bcg Therapy ◽  
History Of

A 91-year-old man with a history of intravesicular BCG therapy for recurrent bladder cancer and bilateral total hip arthroplasty (THA) presented with left hip pain. He was noted to have a fluid collection over the left lateral hip and hip X-ray showed loosening of the prosthetic hip stem indicative of a prosthetic joint infection (PJI). He subsequently underwent removal of the THA and insertion of an antibiotic spacer. He was discharged on intravenous ceftriaxone for presumed culture negative PJI. Intraoperative acid fast bacillus culture later grew Mycobacterium tuberculosis complex, which was then differentiated to M. bovis. The M. bovis infection was thought to be a complication of the patient’s prior BCG therapy. He was initially started on isoniazid, rifampin, pyrazinamide and ethambutol pending cultures and sensitivities; pyrazinamide was discontinued after M. bovis was isolated on culture and susceptibility data confirmed the expected inherent resistance of M. bovis to pyrazinamide. The patient underwent successful THA revision and remains symptom-free at 1 year.

scholarly journals Periprosthetic Joint Infections: Clinical and Bench Research

2013 ◽  
Vol 2013 ◽  
pp. 1-17 ◽  
Author(s):  
Laurence Legout ◽  
Eric Senneville
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Diagnostic Methods ◽  
High Morbidity ◽  
Substantial Cost ◽  
Prosthetic Infection ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Definition Of

Prosthetic joint infection is a devastating complication with high morbidity and substantial cost. The incidence is low but probably underestimated. Despite a significant basic and clinical research in this field, many questions concerning the definition of prosthetic infection as well the diagnosis and the management of these infections remained unanswered. We review the current literature about the new diagnostic methods, the management and the prevention of prosthetic joint infections.

scholarly journals Improved Diagnosis of Prosthetic Joint Infection by Culturing Periprosthetic Tissue Specimens in Blood Culture Bottles

mBio ◽  
2016 ◽  
Vol 7 (1) ◽  
Author(s):  
Trisha N. Peel ◽  
Brenda L. Dylla ◽  
John G. Hughes ◽  
David T. Lynch ◽  
Kerryl E. Greenwood-Quaintance ◽  
...  
Keyword(s):  
Blood Culture ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Revision Arthroplasty ◽  
Broth Culture ◽  
Periprosthetic Tissue ◽  
Tissue Samples ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Tissue Specimens

ABSTRACTDespite known low sensitivity, culture of periprosthetic tissue specimens on agars and in broths is routine. Culture of periprosthetic tissue samples in blood culture bottles (BCBs) is potentially more convenient, but it has been evaluated in a limited way and has not been widely adopted. The aim of this study was to compare the sensitivity and specificity of inoculation of periprosthetic tissue specimens into blood culture bottles with standard agar and thioglycolate broth culture, applying Bayesian latent class modeling (LCM) in addition to applying the Infectious Diseases Society of America (IDSA) criteria for prosthetic joint infection. This prospective cohort study was conducted over a 9-month period (August 2013 to April 2014) at the Mayo Clinic, Rochester, MN, and included all consecutive patients undergoing revision arthroplasty. Overall, 369 subjects were studied; 117 (32%) met IDSA criteria for prosthetic joint infection, and 82% had late chronic infection. Applying LCM, inoculation of tissues into BCBs was associated with a 47% improvement in sensitivity compared to the sensitivity of conventional agar and broth cultures (92.1 versus 62.6%, respectively); this magnitude of change was similar when IDSA criteria were applied (60.7 versus 44.4%, respectively;P= 0.003). The time to microorganism detection was shorter with BCBs than with standard media (P< 0.0001), with aerobic and anaerobic BCBs yielding positive results within a median of 21 and 23 h, respectively. Results of our study demonstrate that the semiautomated method of periprosthetic tissue culture in blood culture bottles is more sensitive than and as specific as agar and thioglycolate broth cultures and yields results faster.IMPORTANCEProsthetic joint infections are a devastating complication of arthroplasty surgery. Despite this, current microbiological techniques to detect and diagnose infections are imperfect. This study examined a new approach to diagnosing infections, through the inoculation of tissue samples from around the prosthetic joint into blood culture bottles. This study demonstrated that, compared to current laboratory practices, this new technique increased the detection of infection. These findings are important for patient care to allow timely and accurate diagnosis of infection.

scholarly journals Prosthetic Joint Infection Due to Histoplasma capsulatum Complicating a Total Knee Arthroplasty

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Cima Nowbakht ◽  
Katherine Garrity ◽  
Nicholas Webber ◽  
Jairo Eraso ◽  
Luis Ostrosky-Zeichner
Keyword(s):  
Total Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Histoplasma Capsulatum ◽  
Joint Infection ◽  
Stage Management ◽  
Joint Infections ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
Oral Itraconazole ◽  
Total Knee

Abstract Histoplasmosis is a common pathogen but rarely reported in prosthetic joint infections. We present a case of Histoplasmosis capsulatum prosthetic joint infection along with a literature review revealing no guidelines or consensus on surgical and antifungal management. We chose the 2-stage management with an antifungal spacer and systemic oral itraconazole.

scholarly journals Bacterial (septic) arthritis and prosthetic joint infection

2016 ◽  
Vol 18 (12) ◽  
pp. 110-116 ◽  
Author(s):  
B.S. Belov ◽  
◽  
S.A. Makarov ◽  
E.I. Bialik ◽  
◽  
...  
Keyword(s):  
Septic Arthritis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Prosthetic Joint

scholarly journals Gonococcal Prosthetic Joint Infection

2017 ◽  
Vol 2 (3) ◽  
pp. 160-162 ◽  
Author(s):  
Ian Gassiep ◽  
Bradley Gilpin ◽  
Joel Douglas ◽  
David Siebert
Keyword(s):  
Septic Arthritis ◽  
Antimicrobial Therapy ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Age Groups ◽  
Gonococcal Infection ◽  
Transmitted Infection ◽  
Sexually Transmitted ◽  
Neisseria Gonorrhoea ◽  
Prosthetic Joint

Abstract. Neisseria gonorrhoea is a common sexually transmitted infection worldwide. Disseminated gonococcal infection is an infrequent presentation and rarely can be associated with septic arthritis. Incidence of this infection is rising, both internationally and in older age groups. We present the first documented case of N. gonorrhoea prosthetic joint infection which was successfully treated with laparoscopic debridement and antimicrobial therapy.

scholarly journals A Case Of Recurrent Helicobacter cinaedi Prosthetic Joint Infection In An HIV-Infected Man

2018 ◽  
Vol 3 (4) ◽  
pp. 230-233 ◽  
Author(s):  
Joanna Kedra ◽  
Valérie Zeller ◽  
Beate Heym ◽  
Philippe Lehours ◽  
Vanina Meyssonnier ◽  
...  
Keyword(s):  
Successful Treatment ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Helicobacter Cinaedi ◽  
First Case ◽  
Prosthetic Joint

Abstract. We describe the case of an HIV-infected man who developed twice a Helicobacter cinaedi prosthetic joint infection. In our knowledge, it is the first case to date. Furthermore, it illustrates the fact that this bacterium is difficult to isolate and that recurrences can occur even after apparently successful treatment.

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