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Isolated Lactobacillus chronic prosthetic knee infection
Insights
This case report details the first known instance of a chronic prosthetic knee infection caused by Lactobacillus. This finding highlights the potential for Lactobacillus to cause subtle, persistent implant infections, especially in at-risk patients.
Area of Science:
- Microbiology
- Infectious Diseases
- Orthopedics
Background:
- Prosthetic joint infections are an increasing concern.
- Lactobacillus is a common bacterium in the gastrointestinal and female genital tracts.
- Lactobacillus is typically associated with bacteremia and endocarditis, rarely causing other infections.
Observation:
- A 58-year-old patient presented with a chronic prosthetic knee joint infection.
- The infection was caused by isolated Lactobacillus species.
- The patient had multiple comorbidities including diabetes, hepatitis, malnutrition, anemia, and liver failure.
Findings:
- This is the first reported case of chronic prosthetic knee infection with Lactobacillus.
- The case suggests Lactobacillus may be an underrecognized cause of low-virulence prosthetic joint infections.
- The organism may potentially be vancomycin-resistant.
Implications:
- Further case series are needed to confirm Lactobacillus's role in prosthetic joint infections.
- Research into the risk of prosthetic joint infections from probiotic supplements is warranted.
- This case highlights the need to consider Lactobacillus in diagnosing subtle, chronic implant infections.
Abstract:
Lactobacillus is a gram-positive rod bacteria found primarily in the gastrointestinal and female genital tracts. Prosthetic infections in implants are being increasingly reported. The authors present a case of a 58-year-old patient with Lactobacillus septic prosthetic knee joint infection. To the authors’ knowledge, this is the first reported case of chronic prosthetic knee infection with isolated Lactobacillus species. Lactobacillus has been most commonly implicated with bacteremia and endocarditis and rarely with pneumonia, meningitis, and endovascular infection, and a vast majority of the cases are reported in immunocompromised patients. In the current case, diabetes mellitus, hepatitis, malnutrition, anemia, and liver failure were comorbid conditions, placing the patient at increased risk of infection. The findings suggest that further case series are necessary to establish the significance of Lactobacillus as an etiologic agent in chronic low-virulence, and potentially vancomycin-resistant, prosthetic joint infection. The need also exists for further research aimed at the risk of prosthetic joint infection with oral intake of certain probiotic foods and supplements. The goal of this case report is to bring to light the potential of this organism to be a cause of subtle chronic prosthetic joint infection.
