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periprosthetic joint infections diagnosed with growth in cultures


Chrdle, Aleš; Trnka, Tomáš; Musil, David; Fucentese, Sandro F; Bode, Peter; Keller, Peter M; Achermann, Yvonne (2019). periprosthetic joint infections diagnosed with growth in cultures. Journal of Clinical Microbiology, 57(8):Epub ahead of print.

Abstract

Tularemia caused by is a zoonotic infection of the Northern Hemisphere that mainly affects skin, lymph nodes, bloodstream and lungs. Other manifestations of tularemia are very rare, especially with musculoskeletal involvement. Presenting in 2016, we diagnosed two cases of periprosthetic knee joint infections (PJI) caused by in Europe (one in Switzerland, one in Czech Republic). We only found two other PJI cases in literature, another knee PJI diagnosed 1999 in Ontario, Canada, and one hip PJI in Illinois, USA 2017. Diagnosis was made in all cases by positive microbiological cultures after 3, 4, 7, and 12 days. All were successfully treated, two cases with exchange of the prosthesis, one with debridement and retention, and one with repeated aspiration of the synovial fluid only. Antibiotic treatment was given between 3 weeks and 12 months wither either ciprofloxacin/rifampin or with doxycycline alone or doxycycline in combination with gentamicin.Zoonotic infections should be considered in periprosthetic infections in particular in culture negative PJIs with a positive histology or highly elevated leucocytes in synovial aspiration. Here we recommend to prolong cultivation time up to 14 days, perform specific PCR tests, and/or do epidemiologically appropriate serological tests for zoonotic infections including that for .

Abstract

Tularemia caused by is a zoonotic infection of the Northern Hemisphere that mainly affects skin, lymph nodes, bloodstream and lungs. Other manifestations of tularemia are very rare, especially with musculoskeletal involvement. Presenting in 2016, we diagnosed two cases of periprosthetic knee joint infections (PJI) caused by in Europe (one in Switzerland, one in Czech Republic). We only found two other PJI cases in literature, another knee PJI diagnosed 1999 in Ontario, Canada, and one hip PJI in Illinois, USA 2017. Diagnosis was made in all cases by positive microbiological cultures after 3, 4, 7, and 12 days. All were successfully treated, two cases with exchange of the prosthesis, one with debridement and retention, and one with repeated aspiration of the synovial fluid only. Antibiotic treatment was given between 3 weeks and 12 months wither either ciprofloxacin/rifampin or with doxycycline alone or doxycycline in combination with gentamicin.Zoonotic infections should be considered in periprosthetic infections in particular in culture negative PJIs with a positive histology or highly elevated leucocytes in synovial aspiration. Here we recommend to prolong cultivation time up to 14 days, perform specific PCR tests, and/or do epidemiologically appropriate serological tests for zoonotic infections including that for .

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Institute of Pathology and Molecular Pathology
04 Faculty of Medicine > University Hospital Zurich > Clinic for Infectious Diseases
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:12 June 2019
Deposited On:25 Jul 2019 10:31
Last Modified:25 Sep 2019 00:37
Publisher:American Society for Microbiology
ISSN:0095-1137
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1128/JCM.00339-19
PubMed ID:31189580

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Embargo till: 2019-12-12