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[Streptococcus equisimilis associated septic arthritis/prosthetic joint infection]

Oğuz Reşat Sipahi1, Sebnem Ozkören Calik, Hüsnü Pullukçu

  • 1Ege Universitesi Tip Fakültesi, Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Izmir. oguz.resat.sipahi@ege.edu.tr

Mikrobiyoloji Bulteni
|October 1, 2008
PubMed

Insights

This case report details a rare instance of Streptococcus equisimilis prosthetic joint infection in a 71-year-old male. Successful treatment with teicoplanin highlights its efficacy in managing this challenging infection.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Orthopedic Surgery

Background:

  • Group C streptococci, including Streptococcus equisimilis, are typically commensal flora but can cause invasive infections.
  • Prosthetic joint infections (PJIs) pose significant challenges in orthopedic surgery, often requiring complex management.
  • Arthritis caused by S. equisimilis is uncommon, and PJIs specifically linked to this pathogen are exceedingly rare.

Observation:

  • A 71-year-old male presented with symptoms of erythema, swelling, and tenderness in a right knee with a total knee prosthesis.
  • Synovial fluid analysis revealed a high leukocyte count, indicative of infection.
  • Empirical ampicillin-sulbactam therapy was initiated, followed by a switch to teicoplanin due to symptom recurrence.

Findings:

  • Synovial fluid culture identified Streptococcus equisimilis as the causative agent.
  • The S. equisimilis isolate demonstrated susceptibility to penicillin, erythromycin, and teicoplanin, but resistance to chloramphenicol and tetracycline.
  • Recurrence of symptoms after initial improvement was attributed to antibiotic tolerance, necessitating a change in treatment.

Implications:

  • This case represents the first reported instance of S. equisimilis arthritis in Turkey.
  • It is also the first documented case of a prosthetic joint infection caused by S. equisimilis.
  • The successful management with teicoplanin underscores its potential role in treating resistant or recurrent S. equisimilis PJIs.

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