Erysipelothrix rhusiopathiae infection of a total knee arthroplasty an occupational hazard

Area of Science:

• Infectious Diseases
• Microbiology
• Orthopedic Surgery

Background:

• Rheumatoid arthritis and lupus nephritis patients on immunosuppressants are susceptible to infections.
• Total knee arthroplasty (TKA) can be complicated by periprosthetic joint infections.
• Erysipelothrix rhusiopathiae is a zoonotic bacterium typically associated with animal handlers.

Observation:

• A 76-year-old male with a history of rheumatoid arthritis, lupus nephritis, and steroid therapy underwent revision TKA.
• The patient presented with a deep infection of the arthroplasty.
• Cultures revealed Erysipelothrix rhusiopathiae, a pathogen rarely implicated in human septic arthritis.

Findings:

• The infected arthroplasty was diagnosed with Erysipelothrix rhusiopathiae.
• The patient had a history of potential occupational exposure to the organism.
• Literature review identified only three prior cases of E. rhusiopathiae septic arthritis in humans.

Implications:

• This case underscores the pathogenicity of Erysipelothrix rhusiopathiae in human joint infections.
• It highlights the importance of considering zoonotic pathogens in prosthetic joint infections, especially with relevant exposure history.
• Further research may be warranted to understand the full spectrum of E. rhusiopathiae infections in immunocompromised individuals.