Bilateral periprosthetic joint infection with Ureaplasma urealyticum in an immunocompromised patient

Abstract

This case study discusses how we diagnosed and treated a patient with a late haematogenous bilateral periprosthetic joint infection (PJI) after total knee arthroplasties caused by Ureaplasma urealyticum. This has never been reported before. We will discuss how we used a PET-CT, synovial fluid cell count, and synovial fluid analysis by 16S rRNA gene sequencing to diagnose this PJI. We will also discuss how we treated this patient to obtain full recovery.

The difference between native septic arthritis and prosthetic joint infections: A review of literature

“…19,24 Although bilateral PJIs have been described in case reports, the incidence of polyarticular PJIs is unknown. 29,30…”

“…19,24 Although bilateral PJIs have been described in case reports, the incidence of polyarticular PJIs is unknown. 29,30 Underlying joint diseases, such as rheumatoid arthritis and other forms of inflammatory arthropathies, are predisposing factors for developing both SA and PJIs. 1,4,28,31,32 Patients receiving immunosuppressive therapy, such as classic disease modifying antirheumatic drugs, anti-Tumor-Necrosis-Factor (TNF) therapy, or intra-articular corticosteroid injections, are also at higher risk of both SA and PJI.…”

Clostridium difficile septic arthritis and periprosthetic joint infection in a patient with acute lymphoblastic leukaemia, T-/B-lymphocytopenia and hypogammaglobulinemia – a case report and review of the literature

“…Hypogammaglobulinemia in the context of PJI has rarely been described () [13–16]. All cases that we were able to identify were associated with a type of lymphoma.…”

“…Given short follow-ups and heterogenous outcome characteristics, a final evaluation of existing cases is challenging. The largest study of Abad et al reported that 5 out of 6 patients died during the follow-up[13], while Roerdink et al reported of an infection free and mobile patient[15].…”

Clinical implications of the genus Mycoplasma

“…U. urealyticum . Lo más habitual es aislarlo como un patógeno oportunista en pacientes inmunocomprometidos en casos de poliartritis y artritis séptica [ 238 - 241 ]; absceso perifrénico [ 242 ], abscesos cerebrales [ 243 ], osteomielitis [ 244 , 245 ], uretritis [ 246 ], pielonefritis [ 247 ], meningitis postrasplante [ 248 ] e infección periprotésica posquirúrgica [ 249 ]. También asociado a embarazos de riesgo y complicaciones neonatales [ 250 ]; corioamnionitis, enfermedad pélvica inflamatoria, enfermedad pulmonar crónica en pretérminos [ 251 - 253 ], infertilidad [ 254 - 256 ], prostatitis [ 257 ] y vaginosis bacteriana [ 232 ], bronquiolitis en niños [ 258 ], poliartritis séptica en paciente con leucemia linfoblástica aguda [ 259 ], empiema pleural en paciente con linfoma B difuso de célula grande [ 260 ], artritis séptica en paciente con LES [ 261 ], diabetes insípida [ 262 ], bacteriemia postquirúrgica [ 263 ], coinfección junto a Chlamydia trachomatis en el síndrome de Reiter [ 264 , 265 ] y piuria estéril [ 266 ].…”