Infection after Total Knee Arthroplasty by M. Catarrhalis Associated with Rheumatoid Arthritis and DMARDs Therapy

Area of Science:

• Rheumatology
• Infectious Diseases
• Orthopedic Surgery

Background:

• Rheumatoid arthritis (RA) is an autoimmune disease often treated with biologic therapies.
• Antitumor necrosis factor (anti-TNF) agents like certolizumab are used in RA management.
• Prosthetic joint infection (PJI) is a serious complication following joint replacement surgery.

Observation:

• A patient with rheumatoid arthritis was undergoing treatment with certolizumab.
• The patient subsequently underwent a total knee replacement procedure.
• The patient developed a prosthetic joint infection post-surgery.

Findings:

• The prosthetic joint infection was caused by Moraxella catarrhalis.
• Moraxella catarrhalis is an uncommon pathogen in prosthetic joint infections.
• This represents the first reported case of PJI caused by Moraxella catarrhalis in a patient on anti-TNF therapy.

Implications:

• This case expands the known spectrum of pathogens causing PJI.
• Clinicians should consider a broader range of microorganisms in immunocompromised patients with PJI.
• Further research may be needed to understand the specific risks associated with anti-TNF therapy and PJI.
• Early recognition and appropriate antibiotic treatment are crucial for managing PJI.