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01.12.2011 | Case report | Ausgabe 1/2011 Open Access

Journal of Medical Case Reports 1/2011

Abiotrophia defectiva knee prosthesis infection: A case report

Zeitschrift:
Journal of Medical Case Reports > Ausgabe 1/2011
Autoren:
Nadim Cassir, Jean-Charles Grillo, Jean-Noël Argenson, Michel Drancourt, Pierre-Yves Levy
Wichtige Hinweise

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

NC took care of the patient and wrote the manuscript. JCG took care of the patient, reviewed and corrected the manuscript. JNA took care of the patient, reviewed and corrected the manuscript. MD took care of the patient and wrote the manuscript. PYL conceived the study and wrote the manuscript. All authors read and approved the final manuscript.

Abstract

Background

Abiotrophia species have rarely been implicated in osteoarticular infections. We report one case of an A. defectiva knee prosthesis infection.

Case presentation

A 71-year-old man of Italian origin presented with pain and swelling of the knee four years after the implantation of a total knee replacement prosthesis. While standard culturing of the synovial fluid resulted in no isolation of microorganisms, the direct inoculation of the synovial fluid into a rich culture medium resulted in the identification of A. defectiva by polymerase chain reaction sequencing. Repeated attempts of culturing microorganisms from blood were negative, and echocardiograms and colonoscopies were unremarkable. High-dose amoxicillin for nine months and a two-stage replacement of the knee prosthesis led to full patient recovery by the time of the 12-month follow-up examination.

Conclusions

Because Abiotrophia spp. are fastidious microorganisms, it is likely that cases of Abiotrophia orthopedic infection are misdiagnosed as culture-negative infections. Direct inoculation of synovial fluids into rich broth medium and further polymerase chain reaction-based detection of culture-negative synovial fluids are key tests for accurate documentation and detection of these infections.

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Literatur
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