Capnocytophaga canimorsus - An underestimated cause of periprosthetic joint infection?

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Periprosthetic joint infection (PJI) is a significant complication in orthopedic surgery.
• Capnocytophaga canimorsus (C. canimorsus) is an uncommon bacterium rarely implicated in PJI, particularly in immunocompetent individuals.
• Previous literature suggests C. canimorsus primarily affects immunocompromised patients.

Purpose of the Study:

• To report a case of PJI caused by C. canimorsus in an immunocompetent patient.
• To increase awareness of C. canimorsus as a potential pathogen in orthopedic joint arthroplasty infections.
• To emphasize the importance of considering C. canimorsus in cases of PJI, irrespective of the patient's immune status.

Main Methods:

• A case of a 54-year-old immunocompetent patient with late PJI after total knee arthroplasty is presented.
• The patient underwent a two-stage revision procedure, including prosthesis explantation and antibiotic-impregnated spacer insertion.
• Treatment involved a four-week course of intravenous cefuroxime followed by two weeks of oral ciprofloxacin, culminating in secondary revision total knee arthroplasty.

Main Results:

• Successful treatment of C. canimorsus periprosthetic joint infection in an immunocompetent patient was demonstrated.
• The implemented treatment regimen effectively resolved the infection and allowed for successful secondary revision surgery.

Conclusions:

• Capnocytophaga canimorsus should be considered a potential pathogen in periprosthetic joint infections, even in immunocompetent patients.
• The diagnostic challenge and unusual nature of C. canimorsus necessitate heightened clinical suspicion.
• Successful management is achievable with appropriate antimicrobial therapy and surgical intervention, regardless of the patient's immunological status.