Early prosthetic joint infection due to Ureaplasma urealyticum: Benefit of 16S rRNA gene sequence analysis for diagnosis

Rouard, Caroline; Pereyre, Sabine; Abgrall, Sophie; Guillet-Caruba, Christelle; Diviné, Pierre; Bourgeois-Nicolaos, Nadège; Roy, S.; d’Ouince, Véronique Mangin; Bebear, Cécile; Bégué, Thierry; Doucet‐Populaire, Florence

doi:10.1016/j.jmii.2017.07.017

Cited by 8 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sequencing of the 16s rRNA gene, which is ubiquitously present in bacteria, is a critical tool for identifying di cult-to-culture organisms [10]. There have been several reports on Ureaplasma detection using 16S rRNA gene analysis [15,17,18]. Given that only a limited number of medical facilities can perform the 16s rRNA gene analysis, it is crucial to collect and preserve specimens from the infection site before initiating empiric therapy.…”

Section: Discussionmentioning

confidence: 99%

Disseminated Septic Arthritis caused by Ureaplasma urealyticum in an Immunocompromised Patient with Hypogammaglobulinemia after Rituximab Therapy

Oguni,

Fukushima,

Otsuka

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose Ureaplasma urealyticum is a rare pathogen associated with septic arthritis that predominantly affects patients with hypogammaglobulinemia. Bacterial identification of fastidious organisms is challenging because they are undetectable by routine culture testing. To the best of our knowledge, this is the first report of septic arthritis induced by U. urealyticum infection in Japan. Case description We describe the case of a 23-year-old Japanese female with secondary hypogammaglobulinemia (serum immunoglobulin level <500 mg/dL), identified 8 years after treatment with rituximab. The patient presented with persistent fever and polyarthritis that were unresponsive to ceftriaxone and prednisolone. Contrast-enhanced computed tomography and gallium-67 scintigraphy revealed effusion and inflammation in the left sternoclavicular, hip, wrist, knee, and ankle joints. Although Gram staining and bacterial culture of the drainage fluid from the left hip joint were negative, the condition exhibited characteristics of purulent bacterial infection. The patient underwent empirical treatment with doxycycline, and her symptoms promptly resolved. Subsequent 16S ribosomal RNA (rRNA) gene sequencing of the joint fluid confirmed the presence of U. urealyticum, leading to the diagnosis of septic arthritis. Combination therapy with doxycycline and azithromycin yielded a favorable recovery from the inflammatory status and severe arthritic pain. Conclusion This case highlights U. urealyticum as a potential causative agent of disseminated septic arthritis, particularly in patients with hypogammaglobulinaemia. The 16S rRNA gene analysis proved beneficial for identifying pathogens in culture-negative specimens, such as synovial fluid, in suspected bacterial infections.

show abstract

Section: Discussionmentioning

confidence: 99%

Disseminated Septic Arthritis caused by Ureaplasma urealyticum in an Immunocompromised Patient with Hypogammaglobulinemia after Rituximab Therapy

Oguni,

Fukushima,

Otsuka

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…This combination of factors is hypothesized to facilitate the dissemination of these organisms inside neutrophils to areas of active neutrophil recruitment, such as traumatic joints [4] . Rarely, Ureaplasma species can cause septic arthritis in immunocompetent patients, however, the infection seems to predominantly affect older patients with prosthetic joints [9] , [13] , [14] , [15] .…”

Section: Discussionmentioning

confidence: 99%