Prosthetic Joint Infection Caused by Streptococcus pneumoniae Serotype 15F: A Rare Manifestation of an Emerging...

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Microbiology

Background:

• Prosthetic joint infection (PJI) is a serious complication of joint replacement surgery.
• Infection by Streptococcus pneumoniae is an uncommon cause of PJI, particularly without concurrent bacteremia.
• Follicular lymphoma and prior bilateral total hip arthroplasty are relevant patient comorbidities.

Purpose of the Study:

• To report a rare case of PJI caused by Streptococcus pneumoniae.
• To describe an atypical presentation of pneumococcal PJI in a patient without bacteremia or typical symptoms.
• To highlight the emergence of non-vaccine serotypes (NVTs) and potential antibiotic resistance in PJI.

Main Methods:

• Case report detailing a patient's clinical presentation and diagnostic workup.
• Identification of the causative pathogen, Streptococcus pneumoniae, and its serotype.
• Review of relevant literature on pneumococcal PJI and serotype replacement.

Main Results:

• A 69-year-old female with a history of follicular lymphoma and bilateral total hip arthroplasty developed a right periprosthetic abscess.
• The abscess was caused by Streptococcus pneumoniae serotype 15F, a non-vaccine serotype (NVT).
• The patient presented atypically, without bacteremia, respiratory, or neurological symptoms.

Conclusions:

• Streptococcus pneumoniae can cause prosthetic joint infections, even in the absence of bacteremia.
• Non-vaccine serotypes, such as 15F, are emerging pathogens in PJI due to serotype replacement following vaccination.
• Atypical presentations and potential antibiotic resistance necessitate vigilance in diagnosing and managing pneumococcal PJI.