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Clinical pointers in Prevotella septic arthritis of the hip:  a case report

M P Kgagudi1, M G Mogane2, M T Ramokgopa2

  • 1Division of Orthopaedic Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. dr.pkgagudi@gmail.com.

Journal of Medical Case Reports
|June 9, 2023
PubMed
Abstract

Insights

Prevotella Septic Arthritis (PSA) is a rare cause of infective arthritis, often seen in immunocompromised individuals with a history of intravenous drug abuse. Early diagnosis and treatment, including joint decompression and lavage, lead to good outcomes.

Area of Science:

  • Orthopaedic Surgery
  • Infectious Diseases
  • Microbiology

Background:

  • Infective arthritis is a critical orthopaedic surgical emergency.
  • Staphylococcus aureus is the most frequent bacterial cause of infective arthritis.
  • Prevotella species are exceptionally rare causative agents of infective arthritis.

Observation:

  • A 30-year-old African male with a history of HIV, intravenous drug abuse, and prior hip surgery presented with infective arthritis of the left hip.
  • The patient underwent hip arthrotomy, fluid lavage, and skeletal traction for treatment.
  • The rarity of Prevotella as a causative agent was noted in this case.

Findings:

  • The patient achieved pain-free mobility with crutches after treatment.
  • Early diagnosis and intervention are crucial for managing rare infective arthritis cases.
  • Successful treatment involved joint decompression, lavage, and targeted antibiotic therapy.

Implications:

  • Clinicians should maintain a high index of suspicion for Prevotella Septic Arthritis (PSA) in at-risk patients.
  • Risk factors include immunosuppression, intravenous drug abuse, and prior joint issues.
  • Prompt diagnosis and adherence to established treatment principles can ensure favorable outcomes for PSA.
Keywords:
Case reportInfective arthritisPrevotella spp.Septic arthritis

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