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Native join Propionibacterium septic arthritis

Thomas Taylor1,2, Marcus Coe3,4, Ana Mata-Fink5

  • 1Department of Medicine, Geisel Medical School at Dartmouth, Hanover, NH.

Infectious Disease Reports
|October 27, 2017
PubMed

Insights

Propionibacterium septic arthritis in native joints often mimics osteoarthritis and presents with subtle signs, leading to delayed diagnosis. Early consideration of this infection is crucial for timely treatment and improved patient outcomes.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • Propionibacterium species, normal skin flora, are increasingly implicated in septic arthritis.
  • Septic arthritis caused by Propionibacterium in native joints often presents atypically, mimicking osteoarthritis.
  • Delayed diagnosis is common due to subtle infection signs and slow bacterial growth.

Purpose of the Study:

  • To identify and describe cases of Propionibacterium septic arthritis in native joints.
  • To review the literature on Propionibacterium septic arthritis, focusing on clinical course, diagnosis, and treatment.
  • To emphasize the importance of considering Propionibacterium in atypical joint infections.

Main Methods:

  • Case series of three patients with Propionibacterium septic arthritis in native joints.
  • Comprehensive literature review of previously reported Propionibacterium septic arthritis cases.
  • Analysis of clinical presentation, diagnostic challenges, treatment strategies, and patient outcomes.

Main Results:

  • Fourteen cases exhibited few acute infection signs, slow culture growth, and delayed diagnosis.
  • Three initial cultures were mistakenly dismissed as contaminants.
  • Fifteen cases were successfully treated with antibiotics, with five requiring additional surgery.

Conclusions:

  • Propionibacterium septic arthritis in native joints often presents insidiously, mimicking osteoarthritis.
  • Delayed diagnosis due to subtle signs and potential for missed anaerobic cultures leads to poorer outcomes.
  • Consider Propionibacterium infection in native joint arthritis, especially when presenting atypically, before considering arthroplasty.
Keywords:
Propionibacteriumanaerobe infectionosteoarthritisseptic arthritis

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