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Streptococcus bovis-infected total hip arthroplasty
M E Emerton1, D W Crook, P H Cooke
1Nuffield Orthopaedic Centre, Headington, Oxford.
The Journal of Arthroplasty
|August 1, 1995
Summary
A rare Streptococcus bovis type 1 infection in a hip prosthesis, following fracture surgery, was linked to an undiagnosed colon polyp. This case highlights the importance of considering gastrointestinal issues in patients with S. bovis joint infections.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Gastroenterology
Background:
- Total hip arthroplasty is a common procedure for hip fractures.
- Subcapital femoral neck fractures can be challenging to treat, with potential complications like infection.
- Streptococcus bovis (now Streptococcus gallolyticus) is known for its association with colonic neoplasia and endocarditis.
Observation:
- A 51-year-old man developed a Streptococcus bovis type 1 infection in his total hip prosthesis after initial fixation failure.
- The patient experienced a febrile illness preceding the prosthesis infection.
- An occult premalignant polyp was discovered in the proximal colon during further investigations.
Findings:
- Streptococcus bovis type 1, a rare cause of joint prosthesis infection, was identified.
- The presence of S. bovis bacteremia in this context strongly suggested an underlying gastrointestinal pathology.
- An occult premalignant colonic polyp was found to be the likely source of bacteremia.
Implications:
- This case underscores the critical need to investigate for gastrointestinal lesions in patients presenting with Streptococcus bovis joint prosthesis infections.
- Early detection of colonic neoplasia associated with S. bovis bacteremia can improve patient outcomes.
- Clinicians should maintain a high index of suspicion for gastrointestinal pathology when encountering S. bovis in orthopedic infections.