Capnocytophaga canimorsus Periprosthetic Joint Infection in an Immunocompetent Patient: A Case Report
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Published on: February 2, 2024
Blane C Kelly1, David S Constantinescu1, William Foster1
1Virginia Commonwealth University Health System, Richmond, VA, USA.
Introduction:
A periprosthetic joint infection (PJI) is a potentially devastating complication following an arthroplasty procedure. There are many organisms that commonly cause this complication; in this case report, we will discuss a PJI caused by an unusual bacteria found in the mouths of domestic pets.
Objective:
To present a case report of a patient with a periprosthetic hip infection from Capnocytophaga canimorsus and review the literature.
Methods:
We present a case of C canimorsus PJI in an immunocompetent woman who had undergone a total hip arthroplasty. The patient was doing well postoperatively for many years until she was bitten on the foot by a domestic canine. Patient diagnosed using Musculoskeletal Infection Society criteria, then treated with explant of the hip prosthesis, irrigation and debridement, placement of an antibiotic cement spacer, and a 6-week course of intravenous antibiotics.
Results:
Unfortunately, while awaiting replant, this patient had a massive myocardial infarction and died.
Discussion:
Current literature suggests treating canine bites with amoxicillinas well as a discussion with patients pre-/postoperatively from a lower extremity arthroplasty specialist.
Conclusion:
Capnocytophaga canimorsus is a rare cause of infection, even more unusual in an immunocompetent patient. This study highlights the importance of considering C canimorsus as a cause of PJI, regardless of the immunologic status of the patient.
Insights
A periprosthetic joint infection (PJI) caused by Capnocytophaga canimorsus, a bacteria from domestic pets, is rare in immunocompetent patients. This case highlights the need to consider this pathogen in PJI, even without immune compromise.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Periprosthetic joint infection (PJI) is a serious complication after arthroplasty.
- Common causative organisms are well-established, but unusual pathogens can occur.
- Domestic pets can harbor bacteria capable of causing severe infections.
Purpose of the Study:
- To report a case of PJI caused by Capnocytophaga canimorsus.
- To review the literature on Capnocytophaga canimorsus as a cause of PJI.
- To emphasize the importance of considering this pathogen in PJI diagnosis.
Main Methods:
- Case report of an immunocompetent woman with a total hip arthroplasty.
- Infection occurred after a domestic canine bite.
- Diagnosis followed Musculoskeletal Infection Society criteria.
- Treatment involved prosthesis explant, debridement, antibiotic spacer, and IV antibiotics.
Main Results:
- The patient developed a periprosthetic hip infection due to Capnocytophaga canimorsus.
- Despite treatment, the patient experienced a fatal myocardial infarction while awaiting prosthesis reimplantation.
Conclusions:
- Capnocytophaga canimorsus is an uncommon cause of PJI, particularly in immunocompetent individuals.
- This case underscores the necessity of considering Capnocytophaga canimorsus in PJI etiology, irrespective of the patient's immune status.
- Prophylactic antibiotic treatment for canine bites and pre/postoperative patient counseling are recommended.
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