Rice Body Formation in an Enterococcus faecalis-Infected Total Hip Arthroplasty Causing Sciatic Nerve Compression.

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Rheumatology

Background:

• Periprosthetic joint infection (PJI) is a serious complication following total hip arthroplasty (THA).
• Rice body formation is typically associated with chronic inflammatory joint conditions.

Observation:

• A 73-year-old female presented with a three-month history of an enlarging, granulomatous swelling and radiating pain around a prior left THA scar.
• Hip aspirate cultures identified Enterococcus faecalis, indicating PJI.
• Intraoperative findings revealed a large, encapsulated cyst containing rice bodies within the fascia lata.

Findings:

• Histopathological examination confirmed rice bodies within the cyst, with no evidence of malignancy.
• The patient was treated with surgical cyst excision, IV, and oral antibiotics.

Implications:

• This case highlights the potential for rice body cyst formation in the context of infected THA.
• Early recognition and management of PJI are essential to prevent such unusual presentations.
• This is the first reported instance of a rice body cyst associated with an infected THA.