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Bilateral knee periprosthetic infection with Mycobacterium fortuitum

Manny D Porat1, Matthew S Austin

  • 1Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania 19107, USA.

The Journal of Arthroplasty
|June 7, 2008
PubMed

Insights

Periprosthetic joint infections are rare but serious complications. This case highlights Mycobacterium fortuitum as a cause of bilateral knee replacement infections, emphasizing diagnostic challenges and treatment alternatives.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Microbiology

Background:

  • Periprosthetic joint infections (PJIs) are severe complications following total joint arthroplasty.
  • Gram-positive bacteria are the usual pathogens, but atypical organisms can cause PJIs.
  • Mycobacterium fortuitum is a rare cause of PJIs, known for its resistance to antibiotics.

Observation:

  • A case of bilateral periprosthetic joint infections after total knee arthroplasty is presented.
  • The infection was caused by Mycobacterium fortuitum, an uncommon pathogen in this context.
  • This represents the first reported case of bilateral M. fortuitum infection after total knee arthroplasty.

Findings:

  • Mycobacterium fortuitum infections pose diagnostic challenges due to slow growth and antimicrobial resistance.
  • Standard antibiotic regimens may be ineffective against M. fortuitum.
  • Delayed diagnosis can occur if incubation periods are insufficient for this organism.

Implications:

  • Early recognition and appropriate diagnostic methods are crucial for M. fortuitum PJIs.
  • Treatment may require prolonged antibiotic therapy tailored to susceptibility testing.
  • Long-term antibiotic suppression could be a viable management strategy for patients unsuitable for surgery.

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