Acute haematogenous periprosthetic joint infection due to Streptococcus sanguinis along with coexistent crystalline arthropathy after total knee arthroplasty: a rare combination.
| Autor: | Malkus JB; Departmeny of Surgery, Isala Hospitals, Zwolle, The Netherlands j.malkus@gmail.com.; Department of Orthopaedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands., Goedhart LM; Department of Orthopaedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands.; Department of Orthopaedic Surgery, University Medical Centre Groningen, Groningen, The Netherlands., Verra WC; Department of Orthopaedic Surgery, Medisch Spectrum Twente, Enschede, The Netherlands. |
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| Jazyk: | angličtina |
| Zdroj: | BMJ case reports [BMJ Case Rep] 2022 May 06; Vol. 15 (5). Date of Electronic Publication: 2022 May 06. |
| DOI: | 10.1136/bcr-2022-249154 |
| Abstrakt: | A man in his 60s, with a medical history of gout, underwent total knee arthroplasty of his right knee followed by expeditious rehabilitation. Seven months after surgery, he was referred to the emergency ward with sudden onset of pain and swelling of his right knee accompanied with fever. Further inquiry revealed no trauma, infection or skin lesions besides a tongue bite several weeks earlier. An impaired range motion of the knee was seen on physical examination along with a tachycardia. Laboratory studies showed a C reactive protein of 345 mg/L, after which a debridement, antibiotics and implant retention procedure was performed. Intraoperatively obtained synovial fluid showed monosodium urate crystals consistent with crystalline arthropathy (ie, gout). However, unexpectedly, Streptococcus sanguinis was identified in all microbiological cultures too, confirming a coexistent periprosthetic joint infection. After comprehensive antibiotic treatment and gout flare therapy, this patient made a full recovery with retention of the implant. Competing Interests: Competing interests: None declared. (© BMJ Publishing Group Limited 2022. No commercial re-use. See rights and permissions. Published by BMJ.) |
| Databáze: | MEDLINE |
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