[Implant infections. What must an internist know?]

Implant-associated infections are a major challenge for the primary care physician because the chance of cure depends on the time interval between infection and start of adequate surgical and antimicrobial treatment. On the other hand, rapid therapy should not prevent from correct microbiological sampling. Since long-term antibiotic therapy is required, the microorganism and its susceptibility pattern should be known. Thus, the primary care physician should know signs and symptoms of these rare infections and rapidly involve the specialist. The main task of the specialist is to confirm the diagnosis and to decide whether the implant has to be removed, or whether debridement with retention is a feasible option to eradicate infection. In this review, infections associated to vascular grafts, to pacemakers and to arthroplasties are presented.