scholarly journals Isolated Septic Arthritis of the Hip Due to Fusobacterium nucleatum in An Immunocompetent Adult: A Case Report and Review of the Literature

2021 ◽  
Vol 11 (4) ◽  
Author(s):  
Masanori Nishi ◽  
Yasushi Yoshikawa ◽  
Yasutaka Kaji ◽  
Satoshi Okamoto ◽  
Katsunori Inagaki
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Joint Infection ◽  
Hip Osteoarthritis ◽  
Fusobacterium Nucleatum ◽  
Etiologic Agent ◽  
Perthes Disease ◽  
Two Stage ◽  
Immunocompetent Adult ◽  
History Of

Introduction: Hip septic arthritis is more common in children than in adults. Staphylococcus aureus and Streptococcus spp. are commonly found in association with septic joints. In contrast, Fusobacterium nucleatum septic arthritis in adults is extremely rare. To the best of our knowledge, only five cases have been reported in the literature in English, and three of them were cases of periprosthetic joint infection. We report a rare case of hip septic arthritis due to F. nucleatum in an immunocompetent adult. Case Presentation: A 56-year-old Asian man with a history of bilateral Perthes’ disease and mild alcoholic liver disease presented to our hospital complaining of worsening right hip pain and difficulty in walking for the previous 3 weeks. On presentation, his temperature was 38.7°C, and laboratory results showed a white blood cell count of 19 200 cells/µL and a C-reactive protein level of 43.56 mg/dL. Hip movements were limited due to pain. Contrast-enhanced computed tomography and magnetic resonance imaging showed fluid retention, suggesting infection. F. nucleatum was detected in the culture test from joint aspirate. Surgical drainage was performed 3 times in combination with antibiotherapy. Finally, we performed two-stage total hip arthroplasty, and the post-operative course was uneventful without implant loosening or infection relapse. Conclusion: The patient had a history of Perthes’ disease and had hip osteoarthritis, which may have contributed to the development of hip septic arthritis. We treated this rare case of hip septic arthritis due to F. nucleatum with two-stage revision surgery and antibiotherapy. Clinicians should be aware that F. nucleatum could be the etiologic agent of hip septic arthritis in an immunocompetent patient. Keywords: Septic Arthritis, Hip joint, Fusobacterium nucleatum, Adult

A Case of Periprosthetic Joint Infection Because of Rothia Mucilaginosa

2021 ◽  
Author(s):  
Janse T Schermerhorn ◽  
Donald F Colantonio ◽  
Derek T Larson ◽  
Robert J McGill
Keyword(s):  
Knee Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Joint Infection ◽  
Diagnostic Delay ◽  
Infectious Agent ◽  
Two Stage ◽  
Treatment Regimens ◽  
History Of ◽  
Rothia Mucilaginosa ◽  
One Year

ABSTRACT Periprosthetic joint infection (PJI) is a rare but devastating complication of total joint arthroplasty. Identifying the offending infectious agent is essential to appropriate treatment, and uncommon pathogens often lead to a diagnostic delay. This case describes the first known instance of a total knee arthroplasty (TKA) with Rothia mucilaginosa, a typical respiratory tract organism. This report aims to provide insight into the treatment of this atypical PJI, as there are only six previously published cases of Rothia species PJI septic arthritis. The patient is a 64-year-old diabetic male who underwent a right TKA and left TKA ∼6 months later. Approximately 3 weeks status post-left TKA, he showed evidence of left PJI. One year after treatment and recovery from his left PJI, he presented with several months of right knee pain and fatigue. Subsequent labs and imaging revealed right PJI. No recent history of dental disease or work was observed. He then underwent two-stage revision right knee arthroplasty and microbial cultures yielded Rothia mucilaginosa. After initial empiric treatment, antibiotic therapy was narrowed to 6 weeks of vancomycin. Following negative aspiration cultures the patient underwent reimplantation of right TKA components. One year following treatment, the patient was fully recovered with no evidence of infection. This case emphasizes the possibility of microbial persistence despite various antibiotic treatment regimens for the patient’s contralateral knee arthroplasty and PJI. Additionally, this case demonstrates the importance of two-stage revision in patients with PJI, and the viability of treating Rothia species PJIs with vancomycin.

scholarly journals Spontaneous Bilateral Sternoclavicular Joint Septic Arthritis and Lumbar Discitis: An Unusual Case in a Healthy Adult

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Georgios Mamarelis ◽  
Mohammad Zain Sohail ◽  
Athanasios Mamarelis ◽  
Hassan Fawi ◽  
Jehangir Mahaluxmivala
Keyword(s):  
Septic Arthritis ◽  
Healthy Adult ◽  
Joint Infection ◽  
Good Condition ◽  
Rare Condition ◽  
Sternoclavicular Joint ◽  
Intravenous Antibiotics ◽  
History Of ◽  
Image Investigation ◽  
Ct And Mri

Introduction. Septic arthritis of the sternoclavicular (SC) joint is a rare condition. Typically, it presents in patients with risk of infection and is usually unilateral. In this report, we describe a case of spontaneous bilateral sternoclavicular joint infection of an otherwise healthy adult. Case Presentation. A 67-year-old man presented in our hospital complaining of 2-week history of neck and chest pain which was radiating to his shoulders bilaterally. Clinical examination revealed erythema and swelling of the sternoclavicular area. Inflammatory markers were raised. Image investigation with CT and MRI was undertaken and verified the presence of bilateral sternoclavicular joint infection. The patient received prolonged course of intravenous antibiotics since his admission. The patient was discharged in a good condition and followed up in clinic. Conclusion. High index of clinical suspicion of SC joint infection is important for early diagnosis to avoid further complications.

scholarly journals Prosthetic Joint Infection due to Actinomyces species: A case series and review of literature

2019 ◽  
Vol 4 (4) ◽  
pp. 174-180 ◽  
Author(s):  
Ramez Dagher ◽  
Talha Riaz ◽  
Aaron J. Tande ◽  
Douglas R. Osmon ◽  
Anil Jagtiani ◽  
...  
Keyword(s):  
Median Duration ◽  
Joint Infection ◽  
Late Complication ◽  
Case Series ◽  
Additional Risk Factor ◽  
Beta Lactam ◽  
Two Stage ◽  
Prosthetic Joint ◽  
Prosthetic Joint Infections ◽  
History Of

Abstract. Background: Actinomyces prosthetic joint infections (APJIs) are rare and optimal medical and surgical treatment strategies are unknown. The purpose of our study was to characterize the demographics, risk factors, management and outcomes of patients with PJIs due to Actinomyces spp.Methods: Using a retrospective cohort study design, the medical records of all patients with Actinomyces spp. total hip or knee arthroplasty infection (APJI) seen at a single institution between January 1, 1969 and December 31, 2016 were reviewed. We abstracted information including patient demographics, co-morbidities, joint age, surgical history, microbiology, management and outcomes. A simultaneous literature search via PubMed was performed to identify cases of APJI published in literature and a descriptive analysis was performed.Results: Eleven cases were identified over a 47 year study period at our institution. Seven patients (64%) were female. The median age at the time of diagnosis of infection was 71 years (range, 57-89). The knee was involved in six cases (55%) followed by the hip in 5 (45 %) cases. Three cases had dentures, broken teeth, or poor dentition. Actinomyces odonotlyticus was the most commonly found subspecies at our institution. Median ESR and CRP values were 61mm/hr and 64 mg/L respectively. Eight (72%) patients were managed with 2 stage exchange. Most patients received a course of beta-lactam therapy for 6 weeks. Ten cases (91%) were free of failure after a median duration of follow-up of 2 years (range, 0.67 - 5 years). The median duration from joint arthroplasty to the onset of symptoms was 162 days, range (20-3318). Six (54%) had a history of prior PJI with a different microorganism at the same joint site and 4 patients had history of prior 2 stage exchange (36%). In the literature group, we identified 12 cases and the most common subspecies was Actinomyces israelii; most patients underwent two stage exchange and were treated with 6 weeks of beta lactam antibiotics.Conclusions: Based on our observational study, Actinomyces PJI presents as a late complication of TJR, may be associated with prior PJI at the index joint and antecedent dental manipulation may portend as an additional risk factor. Treatment includes two stage exchange and beta- lactam therapy for 6weeks. These results will help clinicians in improved understanding and management of APJIs which although are rare but warrant special attention as population with implanted joint arthroplasties continues to rise.

scholarly journals Treatment Failure Among Infected Periprosthetic Total Hip Arthroplasty Patients

2014 ◽  
Vol 8 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Ran Schwarzkopf ◽  
Bassem Mikhael ◽  
Elizabeth Wright ◽  
Daniel M Estok ◽  
Jeffrey N Katz
Keyword(s):  
Joint Infection ◽  
Deep Infection ◽  
Prior History ◽  
Two Stage ◽  
Reactive Protein ◽  
Prosthetic Joint ◽  
History Of ◽  
Eradication Of Infection ◽  
One Year

Two-stage revision has been shown to be the most successful treatment in eradicating deep infection following total hiparthroplasty. We identified 62 patients treated by a two-stage revision. We defined “successful revision” as negative intraoperative cultures and no further infection-related procedure. We defined “eradication of infection” on the basis of negative cultures and clinical diagnosis at least one year after 2ndstage procedure. After a mean follow up of 2.7 years, eradication of the infection was documented in 91.1%, and a successful two-stage revision in 85.7% of patients. We observed no association between higher pre-reimplantation levels of ESR and C-reactive protein and lower likelihood of successful two-stage revision. We found an association between a history of another previous infected prosthetic joint and a failed 2ndstage procedure. Failure to achieve eradication of infection and successful two-stage revision occurs infrequently. Patients with prior history of a previous prosthetic joint infection are at higher risk of failure.

scholarly journals Salmonella sp. as the Cause of Periprosthetic Joint Infection of the Hip: Report of a Rare Case and Review of Past 10-year Literatures

2020 ◽  
Vol 8 (C) ◽  
pp. 117-120
Author(s):  
Asep Santoso ◽  
Pamudji Utomo ◽  
Iwan Budiwan Anwar ◽  
Tangkas Sibarani ◽  
Bintang Soetjahjo ◽  
...  
Keyword(s):  
Case Report ◽  
Total Hip Arthroplasty ◽  
Literature Review ◽  
Hip Arthroplasty ◽  
Periprosthetic Joint Infection ◽  
Rare Case ◽  
Joint Infection ◽  
Cement Spacer ◽  
Two Stage ◽  
Revision Procedure

BACKGROUND: Periprosthetic joint infection (PJI) due to Salmonella sp. is rare. It is sometimes difficult to treat and need prolonged antibiotic treatment. CASE REPORT: We reported a case of PJI of the hip in a 67-year-old female who received prior left total hip arthroplasty. Two-stage revision surgery with antibiotic-loaded cement spacer had been performed to the patient and successfully control the infection. CONCLUSION: Although literature review showed that there has been no consensus for the treatment of Salmonella PJI, a two-stage revision procedure has been more commonly performed to control the infection by previous authors and might be the safest way to control Salmonella PJI recently.

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 Concurrent fusobacterial pyogenic liver abscess and empyema

2019 ◽  
Vol 12 (10) ◽  
pp. e231994
Author(s):  
Ahmed Gohar ◽  
Fady Jamous ◽  
Mohamed Abdallah
Keyword(s):  
Septic Shock ◽  
Pleural Effusion ◽  
Liver Abscess ◽  
Rare Case ◽  
Fusobacterium Nucleatum ◽  
Pyogenic Liver Abscess ◽  
Abdominal Discomfort ◽  
History Of ◽  
Fusobacterium Varium

We present a very rare case of concurrent empyema and liver abscess caused by Fusobacterium. Our patient presented with 3-month history of subtle abdominal discomfort and cough leading to eventually presenting with marked chest pain, dyspnoea and septic shock. CT revealed a liver abscess and large right-sided pleural effusion. Drainage of the pleural effusion yielded gross pus with the growth of Fusobacterium varium, while drainage of the liver abscess yielded Fusobacterium nucleatum. The patient responded to drainage and antibiotic therapy with resolution of symptoms and decrease in the size of empyema and abscess on follow-up imaging. We also include a review if literature of related fusobacterial infections.

scholarly journals Kingella kingaeCausing Septic Arthritis of the Knee in anImmunocompetentAdult

2015 ◽  
Vol 2015 ◽  
pp. 1-3 ◽  
Author(s):  
J. Ricketts ◽  
N. N. T. Rehmatullah ◽  
P. Sutton
Keyword(s):  
Septic Arthritis ◽  
Rare Case ◽  
Emerging Pathogen ◽  
Kingella Kingae ◽  
Immunocompetent Adult ◽  
Gram Negative ◽  
Delay In Diagnosis ◽  
Joint Infections ◽  
Isolation Techniques ◽  
Osteoarticular Infections

The bacteriumKingella kingaeis a species of Gram-negative coccobacillus usually found in the oropharynx. This is an emerging pathogen reported to cause bacteraemia, endocarditis, and osteoarticular infections in children and endocarditis in the immunocompromised adult. However, there are few cases of isolated joint infections reported in the immunocompetent adult. Due to specific isolation techniques required, delay in diagnosis can compromise patient outcome. We report a rare case of septic arthritis of the knee in an immunocompetent adult caused byK. kingae.

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