Rare Occurrence of Prosthetic Knee Septic Arthritis Due to Streptococcus viridans in the Background of a Dental Procedure

Kansara, Tikal; Pernia, Monica; Kim, Yoojin; Saeed, Mohammad

doi:10.7759/cureus.5980

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…S. gordonii produces a complex type 1 LTA that shows abundant D-alanylation and glycosylation; this has been the understood mechanism for biofilm formation [ 10 ]. Strong bio-film production is associated with worse clinical outcome and represents up to a 5-fold increased risk for developing recurrent infection [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Prosthetic Joint Infection with Streptococcus gordonii

et al. 2022

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Patient: Female, 75-year-old Final Diagnosis: Right knee prosthetic joint infection Symptoms: Knee pain Medication:— Clinical Procedure: Revision of right total knee arthroplasty including complete revision of the femoral and tibial components Specialty: Infectious Diseases Objective: Rare coexistence of disease or pathology Background: Chronic prosthetic joint infection (PJI) is a devastating complication following total joint arthroplasty, resulting in significant morbidity and mortality. The criterion standard of treatment for chronic PJI is two-stage revision arthroplasty consisting of complete hardware removal, thorough irrigation and debridement, placement of an antibiotic spacer, prolonged intravenous antibiotics based on culture sensitivities, and revision total knee arthroplasty once the infection resolves. The most common organism implicated in chronic PJI is Staphylococcus aureus . Case Report: In this report, we have summarized the case of a 75-year-old woman who developed chronic PJI caused by an unusual organism, Streptococcus gordonii , 1 year after a right total knee arthroplasty. S. gordonii is a gram-positive organism that is an oral flora and a colonizer of human teeth. This organism is known to create biofilm on the human teeth, more commonly known as dental plaque. S. gordonii has the ability to travel to extraoral sites and cause infection. It has been found to be a cause of subacute bacterial endocarditis, but it has been rarely described in the literature as a cause of prosthetic joint infection. Treatment of S. gordonii requires a tailored approach. Conclusions: This case report highlights the clinical presentation, diagnosis, and treatment of chronic prosthetic joint infection caused by S. gordonii and identifies a rare cause of PJI that is not well documented in the literature. Streptococcal PJI portends a poorer prognosis, and identification of this organism is crucial for prompt treatment and improved outcomes for PJI.

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Section: Discussionmentioning

confidence: 99%

A Rare Case of Prosthetic Joint Infection with Streptococcus gordonii

et al. 2022

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“…The common organisms procured in the prosthetic joint infections after the dental procedure are Staphylococcus and beta-hemolytic Streptococci. [4][5][6][7] Predominantly, septic arthritis involves the weight-bearing joints of the hip and knee, which account for nearly 60% of cases. 8 Apart from the above-mentioned joints, sternoclavicular, acromioclavicular, sacroiliac, and, spondylodiscitis involvement has also been reported.…”

Section: Discussionmentioning

confidence: 99%

Septic arthritis of multiple native joints following tooth extraction

Siddegowda

Nanjundappa

Japatti

et al. 2021

Int J Otorhinolaryngol Head Neck Surg

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<p>Infection of the distant parts of the body especially the joints after a tooth extraction is uncommon, but when it occurs due to the virulence of the organism or due to the risk factors, it may cause severe joint infection with abscess formation and may limit the movements. We report a case of arthritis of the knee joint along with involvement of other joints following mandibular third molar teeth extraction one week postoperatively. The patient had swelling and limited range of motion of the involved joints, pain over other multiple joints. The patient had two episodes of postoperative septic arthritis following each mandibular third molar extraction. He was diagnosed of having septic arthritis and treated with antibiotics, analgesics, and steroids, that resolved after 3 weeks. </p>

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Prosthetic Joint Infection After Dental Work: Is the Correct Prophylaxis Being Prescribed? A Systematic Review

et al. 2021

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Background: Prosthetic joint infection (PJI) of total hip (THA) or total knee arthroplasty (TKA) after dental procedures is uncommon, and antibiotic prophylaxis remains controversial. For high-risk patients, the American Academy of Orthopedic Surgeons recommends amoxicillin prophylaxis. However, no systematic review of the literature of PJIs associated with dental procedures explores if amoxicillin is suitable for the reported organisms. Methods: A librarian-assisted search of the major databases (PubMed, Medline, Embase, Scopus) identified 954 articles. Only case reports, case series, and reviews with patient level data were included. After exclusions, 79 articles were fully reviewed. Results: Forty-four PJIs after dental procedures were identified, 22 in primary THA, 20 in primary TKA, one in revision THA, and one in a hip resurfacing procedure. Antibiotic prophylaxis was documented for 5 patients. The dental procedure was invasive in 35 (79.5%). Comorbidities were present in 17 patients (38.7%). The organisms reported were Streptococcus spp. in 44%, other aerobic gram-positives in 27%, anaerobic gram-positives in 18%, and gram-negative organisms in 11%. An estimated 46% of organisms may be resistant to amoxicillin. The outcomes of treatment were reported for 35 patients (79.5%). Twenty-seven patients (61.4%) had no clinical signs of PJI at the final follow-up visit. Conclusions: Lower extremity PJI associated with dental procedures is often caused by organisms unlikely to be prevented with amoxicillin. Additional studies are warranted to determine the choice and efficacy of antibiotic prophylaxis to prevent dental-associated PJI in the highest risk patients. Insufficient data exist to recommend the optimal treatment for patients with PJI in THA and TKA associated with dental procedures.

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Rare Occurrence of Prosthetic Knee Septic Arthritis Due to Streptococcus viridans in the Background of a Dental Procedure

Cited by 3 publications

References 17 publications

A Rare Case of Prosthetic Joint Infection with Streptococcus gordonii

A Rare Case of Prosthetic Joint Infection with Streptococcus gordonii

Septic arthritis of multiple native joints following tooth extraction

Prosthetic Joint Infection After Dental Work: Is the Correct Prophylaxis Being Prescribed? A Systematic Review

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