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Two-Stage Revision Total Knee Arthroplasty for Melioidosis Prosthetic Joint Infection: A Case Report

Parvati Dadwal1,2, Samitha Samaraweera1, Jon Smith1

  • 1Department of Orthopaedics, Mackay Base Hospital, Mackay, Queensland, Australia.

JBJS Case Connector
|May 30, 2025
PubMed
Abstract

Insights

Prosthetic joint infection (PJI) caused by Burkholderia pseudomallei is rare but dangerous. Successful treatment involved a two-stage revision and extended antibiotic therapy, leading to a full recovery.

Area of Science:

  • Infectious Diseases
  • Orthopedic Surgery
  • Microbiology

Background:

  • * Burkholderia pseudomallei is a dangerous pathogen, causing severe illness and mortality in up to 40% of symptomatic individuals.
  • * Prosthetic joint infection (PJI) is an uncommon manifestation of B. pseudomallei infections.

Purpose of the Study:

  • * To report a rare case of B. pseudomallei knee PJI.
  • * To describe the successful management and long-term outcome of this challenging infection.

Main Methods:

  • * A patient with culture-confirmed B. pseudomallei knee PJI underwent a two-stage revision surgery.
  • * Treatment included 8 weeks of intravenous ceftazidime followed by 6 months of oral trimethoprim-sulfamethoxazole.

Main Results:

  • * The patient survived the infection with excellent functional recovery.
  • * Eight years post-treatment, there were no complications or signs of relapse, with a high Oxford Knee Score.

Conclusions:

  • * B. pseudomallei PJI, though rare, is a life-threatening condition.
  • * A combination of two-stage revision surgery and prolonged antibiotic treatment is recommended for successful management and cure.
Keywords:
melioidosisprosthetic joint infection

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