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[Prosthetic hip joint infection caused by Listeria monocytogenes]
W Tabib1, P Guiffault, C Brocard Lemort
1Service de Chirurgie Orthopédique, Groupe hospitalier du Havre, 29-avenue, P. Mendes France, 76290 Montivilliers, France.
Abstract:
The authors report an unusual case of prosthetic hip joint infection caused by Listeria monocytogenes. The patient, an 87-year-old lady who had undergone a right total hip replacement 10 years previously, presented with pain and restriction of hip motion three weeks after an episode of abdominal pain. Aspiration of the joint yielded a dark fluid, from which Listeria Monocytogenes type 4-b was isolated. Blood cultures remained negative. After prolonged antibiotic therapy, symptoms gradually resolved. A few months later, pain recurred with radiological signs of loosening of the femoral component. One-stage revision arthroplasty was performed combined with antibiotic treatment. The patient remains asymptomatic at one year follow-up. Laboratory data and x-ray control are normal. Prosthetic hip joint infection with Listeria monocytogenes is uncommon; few cases have been reported. The literature review shows that prolonged antibiotic therapy alone may be used in patients for whom removal of the prosthesis is not desirable, although revision arthroplasty or prosthesis removal remains necessary in the other cases.
Insights
This case study details a rare prosthetic hip joint infection caused by Listeria monocytogenes. Treatment involved antibiotics and revision surgery, leading to a successful outcome for the patient.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Prosthetic joint infections (PJIs) pose significant challenges in orthopedic surgery.
- Listeria monocytogenes is an uncommon pathogen in PJIs, making such cases particularly noteworthy.
- This report focuses on a PJI in an elderly patient with a history of total hip replacement.
Observation:
- An 87-year-old female presented with hip pain and restricted motion 10 years post-right total hip replacement.
- Joint aspiration revealed dark fluid from which Listeria monocytogenes type 4-b was isolated.
- Initial symptoms resolved with prolonged antibiotic therapy, but recurrence with femoral component loosening necessitated further intervention.
Findings:
- Listeria monocytogenes type 4-b was identified as the causative agent of the prosthetic hip joint infection.
- The patient initially responded to conservative antibiotic treatment, but disease progression occurred.
- Successful management was achieved through one-stage revision arthroplasty combined with antibiotic therapy.
Implications:
- This case highlights the importance of considering Listeria monocytogenes in prosthetic joint infections, despite its rarity.
- Management strategies for Listeria PJIs may include prolonged antibiotic therapy or surgical intervention, such as revision arthroplasty.
- Early diagnosis and appropriate treatment are crucial for favorable outcomes in prosthetic hip joint infections.