Brucella melitensis infection in total knee arthroplasty: a case report

Erdoğan, Haluk; Çakmak, Gökhan; Erdogan, Askin; Arslan, Hande

doi:10.1007/s00167-010-1048-x

Cited by 12 publications

(19 citation statements)

References 6 publications

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“…After removal of duplicates, 47 remained. 18 reports contained data on 23 patients with 26 Brucella -related prosthetic joint infections; only 3 were in returning travellers [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. Table 1 summarises all 24 patients including: gender, country of exposure, type of implant and time to symptom onset.…”

Section: Resultsmentioning

confidence: 99%

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Lewis

Folb

Kalra

et al. 2016

Travel Medicine and Infectious Disease

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SummaryBackgroundBrucella spp. prosthetic joint infections are infrequently reported in the literature, particularly in returning travellers, and optimal treatment is unknown.MethodWe describe a prosthetic joint infection (PJI) caused by Brucella melitensis in a traveller returning to the UK from Thailand, which we believe to be the first detailed report of brucellosis in a traveller returning from this area. The 23 patients with Brucella-related PJI reported in the literature are summarised, together with our case.ResultsThe diagnosis of Brucella-related PJI is difficult to make; only 30% of blood cultures and 75% of joint aspiration cultures were positive in the reported cases. Culture of intraoperative samples provides the best diagnostic yield. In the absence of radiological evidence of joint loosening, combination antimicrobial therapy alone may be appropriate treatment in the first instance; this was successful in 6/7 [86%] of patients, though small numbers of patients and the likelihood of reporting bias warrant caution in drawing any firm conclusions about optimal treatment. Aerosolisation of synovial fluid during joint aspiration procedures and nosocomial infection has been described.ConclusionsBrucella-related PJI should be considered in the differential of travellers returning from endemic areas with PJI, including Thailand. Personal protective equipment including fit tested filtering face piece-3 (FFP3) mask or equivalent is recommended for personnel carrying out joint aspiration when brucellosis is suspected. Travellers can reduce the risk of brucellosis by avoiding unpasteurised dairy products and animal contact (particularly on farms and abattoirs) in endemic areas and should be counselled regarding these risks as part of their pre-travel assessment.

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Section: Resultsmentioning

confidence: 99%

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Lewis

Folb

Kalra

et al. 2016

Travel Medicine and Infectious Disease

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“…All patients who had been checked were strongly positive for Brucella specific serum tests. Nevertheless, this infection is very unusual in periprosthetic joint infection of the knee and only nine cases were reported in the literature (2,3,5,(17)(18)(19). In this case, if the authors had been aware of this infection, the serum indicators of brucellosis could have tested and the cultures incubated in a longer time period to detect the Brucella spp.…”

Section: Discussionmentioning

confidence: 95%

“…Knee prosthesis infection due to Brucella spp. is very rare with the first case reported in 1991 (2) and the ninth case reported in 2010 (5). Prosthetic infection may be local (the surgical site) or systemic (hematogenous).…”

Section: Introductionmentioning

confidence: 99%

Infected Total Knee Arthroplasty by Brucella melitensis: A Rare Case Report

2016

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Introduction: Brucellosis is a zoonotic infectious disease with worldwide distribution, especially in the south and central American countries, the Middle-East and the Mediterranean areas. Knee prosthesis infection due to Brucella spp. is very rare with the first case reported in 1991 and the ninth case reported in 2010. Case Presentation: Here is reported a case of a 68-year-old female patient, referring to Shafa Orthopedic hospital, Tehran, Iran, complaining about a discharge from right total knee arthroplasty. All of the knee joint aspirations and laboratory tests were negative for infection. Initially, no clear reason was found for this painful operated knee and it was decided to revise it; however, intraoperative samples were positive for Brucella melitensis. Unfortunately, serum indicators of Brucellosis (Wright, Coombs Wright and 2-mercaptoethanol (2ME) tests) had not been checked in the preoperative evaluations. After six months of antibiotic therapy for brucellosis, a second stage revision surgery was performed successfully. Conclusions: Prosthetic infection by Brucella species is very uncommon, this is the tenth case of total knee prosthesis infection with Brucella spp. reported in the literature but all orthopedic surgeons, especially those who work in the endemic areas, should evaluate a suspected joint for brucellosis.

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“…It is caused by a variety of microorganisms from the Brucella genus and can be transmitted by inoculation through the conjunctivae and through cuts and abrasions in the skin, or by ingestion of unpasteurized milk or infected dairy products. Brucellosis is a systemic infection with nonspecific symptoms such as sweating, anorexia, fatigue, weight loss, fever, lymphadenopathy, and hepatosplenomegaly [7]. Brucellosis is a disease with protean manifestations, which can be either acute or chronic.…”

Section: Discussionmentioning

confidence: 99%

Total Knee Arthroplasty Infected by Brucella melitensis: Septic Loosening and Long-Term Results of Two-Stage Revision Knee Arthroplasty

Ayvaz¹

2014

Surgery

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Brucella melitensis infection in total knee arthroplasty: a case report

Cited by 12 publications

References 6 publications

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Infected Total Knee Arthroplasty by Brucella melitensis: A Rare Case Report

Total Knee Arthroplasty Infected by Brucella melitensis: Septic Loosening and Long-Term Results of Two-Stage Revision Knee Arthroplasty

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