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Prosthetic Knee Joint Infection by Brucella melitensis
Vasileios Athanasiou1, Spyridon Papagiannis1, George Sinos1
1Orthopaedics and Traumatology, Patras University Hospital, Patras, GRC.
Abstract:
Prosthetic joint infection following arthroplasty is a serious complication associated with high morbidity and prolonged hospitalization. Treatment consists of a combination of surgical intervention and long-acting antibiotic therapy targeted to the responsible microorganism(s). Brucella species-related prosthetic joint infections are uncommon. Diagnosis can be challenging, especially in non-endemic countries, and is confirmed by serological studies and joint aspiration results. We present a rare case of a 78-year-old man with Brucella melitensis infection in a prosthetic right knee joint, seven years after the primary procedure. The patient was treated with a two-stage surgical intervention and a four-month period of antibiotic therapy. After a follow-up period of 12 months, no clinical or laboratory findings of infection were present and the patient was able to return to his everyday activities.
Insights
This case study details a rare Brucella melitensis prosthetic knee joint infection diagnosed seven years post-surgery. Successful treatment involved surgery and antibiotics, with full recovery after 12 months.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Prosthetic joint infections (PJIs) are severe complications of arthroplasty, requiring extensive treatment.
- Brucella species are an uncommon cause of PJIs, posing diagnostic challenges, especially in non-endemic regions.
- Early and accurate diagnosis is crucial for effective management and improved patient outcomes.
Observation:
- A rare case of Brucella melitensis infection in a prosthetic right knee is presented.
- The infection was diagnosed seven years after the initial knee arthroplasty procedure in a 78-year-old male patient.
- Diagnosis was confirmed via serological studies and joint aspiration, highlighting diagnostic challenges in non-endemic areas.
Findings:
- The patient underwent a two-stage surgical intervention to address the prosthetic joint infection.
- A four-month course of targeted antibiotic therapy was administered.
- Post-treatment follow-up of 12 months showed no recurrence of infection, with the patient resuming daily activities.
Implications:
- This case underscores the importance of considering Brucella species in the differential diagnosis of prosthetic joint infections, even years after surgery.
- Successful management involves a combination of surgical debridement and prolonged antibiotic treatment.
- Effective treatment can lead to favorable outcomes, restoring function and quality of life for patients with rare PJIs.
