Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

Abstract

Context:Brucellosis is actually considered to be the commonest zoonotic infection worldwide; conversely prosthetic infection due to brucella is extremely rare. Although diagnostic is easily achieved, management of such situations is extremely challenging.AimsTo report the case of prosthetic hip loosening due to brucellar infection, discuss management manners and to summarize data about 19 cases reported in the literature.MethodsWe report the case of a 73-year-old woman with brucellar prosthetic hip loosening treated with 2-stage exchange of the prosthesis and prolonged double antibiotherapyResultsAt two years follow up the patient is pain free with total functional recovery and no clinical and radiographic signs of prosthetic looseningConclusionsBrucella should be evocated as a cause of total joint arthroplasty infection especially in patients from endemic regions and with occupational exposure. Antibiotic treatment alone can be followed if there are no signs of implant loosening. Tow stage revision should be considered in other cases.

Periprosthetic hip infections caused by Brucella: a rare case report and literature review

“…Periprosthetic hip infection caused by Brucella is very rare, with only 12 cases reported in the literature. 5–14 The characteristics of these cases are summarized in Table 1. The patients included eight men and four women with a mean age of 61 years.…”

“…Most of these previous cases had symptoms such as hip pain, thigh pain and fever. [5][6][7][8][9][10][11][12][13][14] The current patient had none of these symptoms and only presented with a sinus tract at the original incision scar on the hip. The sinus exudate was cultured for other bacteria, suggesting the possibility of a mixed bacterial infection, which has not been previously reported.…”