Periprosthetic Joint Infection Caused by Providencia stuartii: A Case Report

Periprosthetic joint infection (PJI) is a rare yet serious complication following a total hip replacement, predominantly caused by gram-positive bacteria such as Staphylococcus aureus and Staphylococcus epidermidis. However, gram-negative pathogens can also be isolated. This case report presents a 22-year-old patient with a PJI caused by Providencia stuartii after total hip replacement due to a motor vehicle accident. The patient with a clinical history of total hip replacement secondary to posttraumatic arthrosis presented to our department with clinical and laboratory indications of PJI in the right hip. Microbiological samples revealed P. stuartii, a multidrug-resistant gram-negative pathogen. A two-stage revision with a double spacer exchange procedure was performed. Antibiotic treatment with prolonged meropenem infusion via an infusion pump was administered. After two years of follow-up, no signs of infection were observed. The exchange spacer procedure with prolonged antibiotic administration for the treatment of difficult-to-treat pathogens causing PJI is a high-risk procedure associated with significant mortality. Nevertheless, for young patients with robust reparative capabilities, it may be considered a viable therapeutic option.