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A rare case of Prosthetic Joint Infection associated with Coxiella burnetii

Rachel Chenouard1, Emmanuel Hoppé2, Carole Lemarié1

  • 1Laboratoire de Bactériologie, Institut de Biologie en Santé, Centre Hospitalier Universitaire d'Angers, Angers, France.

International Journal of Infectious Diseases : IJID : Official Publication of the International Society for Infectious Diseases
|August 3, 2019
PubMed

Insights

This case report details a prosthetic joint infection caused by Coxiella burnetii in a hip replacement patient. Early diagnosis using 16S rDNA sequencing and qPCR identified this rare Q fever complication.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Orthopedic Surgery

Background:

  • Prosthetic Joint Infections (PJI) are serious complications following joint replacement surgery.
  • Coxiella burnetii is an intracellular bacterium known to cause Q fever, a zoonotic illness.
  • Q fever is rarely associated with PJI, often presenting with chronic symptoms and requiring multiple surgeries.

Observation:

  • A 62-year-old male patient with a revised total hip arthroplasty presented with a suspected prosthetic joint infection.
  • Diagnostic analysis of hip fluid aspirate was performed.
  • The patient had no previously known risk factors for Q fever.

Findings:

  • 16S rDNA sequencing of the hip fluid aspirate initially identified the presence of Coxiella burnetii.
  • Subsequent specific quantitative polymerase chain reaction (qPCR) confirmed the diagnosis.
  • This confirmed a rare case of Q fever manifesting as a prosthetic joint infection.

Implications:

  • This case highlights the importance of considering Coxiella burnetii in the differential diagnosis of prosthetic joint infections, even in patients without typical risk factors.
  • The findings underscore the utility of molecular diagnostic techniques like 16S rDNA sequencing and qPCR in identifying uncommon pathogens in PJI.
  • Early and accurate diagnosis is crucial for effective management of Q fever-associated PJI, potentially influencing treatment strategies and patient outcomes.
Keywords:
16s rDNA sequencingCoxiella burnetiiPCRPersistent infectionProsthetic Joint Infection

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