Late prosthetic joint infection due to Rothia mucilaginosa

We report a chronic hip arthroplasty infection with Rothia mucilaginosa, a Gram-positive germ belonging to the normal flora of the human oral cavity. Successful treatment was achieved by a two-stage hip arthroplasty revision and intravenous administration of vancomycin. This case report illustrates the potential virulence of R. mucilaginosa in patients with a joint prosthesis. We propose to routinely perform specific staining and prolonged culturing techniques for unusual germs such as Rothia mucilaginosa when the clinical history, physical examination or intra-operative findings suggest an implant infection. This paper reviews current antibiotic prophylaxis guidelines for infection prevention of joint arthroplasties during dental procedures.