Prosthetic Joint Infection by Streptococcus lutetiensis (Bovis) With Noncancerous Polyps and Negative Blood Cultures:...

Prosthetic joint infection (PJI), caused by Streptococcus bovis group (SBG), is uncommon and related to colorectal cancer. We present here a case of an 84-year-old male who had a past medical history of chronic obstructive pulmonary disease (COPD), congestive heart failure, pulmonary arterial hypertension, iron deficiency anemia, chronic kidney disease, diabetes mellitus, gout, hypertension, bilateral knee replacement with left knee pain and swelling. We initially suspected gout and treated him with prednisolone, but it did not relieve him. Joint aspiration revealed high WBC, predominantly neutrophils, and polymerase chain reaction (PCR)-identified Streptococcus lutetiensis. The patient underwent knee incision, drainage, poly exchange, and wound vacuum-assisted closure (VAC) placement. Sensitivity testing led us to treat him with ceftriaxone. Echocardiography revealed no endocarditis. A colonoscopy revealed multiple non-bleeding polyps and adenomas. After discharge, our patient completed six weeks of ceftriaxone via a peripherally inserted central catheter (PICC) line. At follow-up, our patient reported no complaints of fever and knee swelling.