Successful treatment of periprosthetic joint infection caused by Granulicatella para-adiacens with prosthesis retention: a case report.

Détails

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Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_88455D0F6F26
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Titre
Successful treatment of periprosthetic joint infection caused by Granulicatella para-adiacens with prosthesis retention: a case report.
Périodique
BMC musculoskeletal disorders
Auteur(s)
Renz N., Chevaux F., Borens O., Trampuz A.
ISSN
1471-2474 (Electronic)
ISSN-L
1471-2474
Statut éditorial
Publié
Date de publication
12/04/2016
Peer-reviewed
Oui
Volume
17
Pages
156
Langue
anglais
Notes
Publication types: Case Reports ; Journal Article
Publication Status: epublish
Résumé
Granulicatella and Abiotrophia spp. are difficult to detect due to their complex nutritional requirements. Infections with these organisms are associated with high treatment failure rates. We report the first implant-associated infection caused by Granulicatella para-adiacens, which was cured with anti-microbial treatment consisting of anti-biofilm-active rifampin and debridement, exchange of mobile parts and retention of the prosthesis.
Patient with a history of left hip arthroplasty presented with acute onset of fever, pain and limited range of motion of the left hip. Arthrocentesis of the affected joint yielded purulent fluid and exchange of mobile parts of the prosthesis, but retention of fixed components was performed. Granulicatella para-adiacens grew from preoperative and intraoperative cultures, including sonication fluid of the removed implant. The transesophageal echocardiography showed a vegetation on the mitral valve; the orthopantogram demonstrated a periapical dental abscess. The patient was treated with intravenous penicillin G and gentamicin for 4 weeks, followed by levofloxacin and rifampin for additional 2 months. At discharge and at follow-up 1, 2 and 5 years later, the patient was noted to have a functional, pain-free, and radiologically stable hip prosthesis and the serum C-reactive protein was normal.
Although considered a difficult-to-treat organism, we report a successful treatment of the Granulicatella hip prosthesis infection with prosthesis retention and a prolonged antibiofilm therapy including rifampin. The periapical dental abscess is considered the primary focus of hematogenously infected hip prosthesis, underlining the importance treatment of periodontitis prior to arthroplasty and of proper oral hygiene for prevention of hematogenous infection after arthroplasty.

Mots-clé
Abiotrophia, Aged, Anti-Bacterial Agents/therapeutic use, Arthroplasty, Replacement, Hip/adverse effects, Debridement/methods, Gram-Positive Bacterial Infections/diagnostic imaging, Gram-Positive Bacterial Infections/therapy, Humans, Male, Prosthesis Retention/methods, Prosthesis-Related Infections/diagnostic imaging, Prosthesis-Related Infections/therapy, Treatment Outcome
Pubmed
Open Access
Oui
Création de la notice
19/04/2016 17:15
Dernière modification de la notice
20/08/2019 14:47
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