Successful Debridement of a Knee Joint Prosthesis Infected with Listeria Monocytogenes. Case Report and Review of Current Literature

Abstract

According to the relevant literature, prosthetic joint infections caused by Listeria monocytogenes require two stage revision surgery or prosthesis removal for a successful outcome. We present the case of a patient who suffered such an infection after Total Knee Replacement surgery and was successfully treated with antibiotics, joint lavage, debridement and retention of the prosthesis.

Treatment of Prosthetic Joint Infection due to Listeria Monocytogenes. A Comprehensive Literature Review and a Case of Total Hip Arthroplasty Infection

“…In a recent study of 294 hips and knees, infection caused by LM was reported at a rate of 0.7%. We have found 67 cases with PJI caused by LM in English Literature (from 1987 until 2020) [ 2 , 3 , 5 , 20 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] ] ( Table 1 ). The mid-time from initial surgery to the onset of infection caused by LM in the prior literature was 6.8 years (range, 2 mo-21 y) whereas in this case was 9 years postoperatively ( Table 1 , Table 2 ).…”

“…Search results were limited to articles written in the English-language. There were 33 publications; 31 were found in PubMed and 2 in Google Scholar where 67 cases were reported (the first one was reported in 1987 and the last one was reported in 2020) ( Table 1 ) [ 2 , 3 , 5 , 20 , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] ]. The median age of the patients was 65 y (range, 29-87 y), there were ∼60% males and ∼40% females, 20 patients (30%) had TKA infection whereas 47 patients (70%) had THA infection including our case.…”

“…and Staph. E.) Two-stage revision Iv Amp for 4 days; po Amp for 3 mo Asymptomatic 2y later 26) 2012 [ 2 ] 34 [59] 34/43 (1992-2010 FNRCL) Age was 72 (range, 16–89)/61% M 79% (NS particularly for Arth/sty) 79% (NS particularly for Arth/sty) Hip 26 Knee 8 9y median time 12 one-stage revision 2two-stage revision 5 removal 13 no surgery 2 NS Primarily Amox 80% with Ami 48% for median duration 15w Asymptomatic 5 mo later 27) 2015 [ 5 ] 1 [60] 72/F Polymyalgia rheumatic Prednisone Knee 2y Debridement Iv Amp 6w; po Amox 6 mo Asymptomatic mo later 28) 2016 [ 6 ] 1 [61] 61/M DM; Cushing syndrome Prednisolonemg Fludrocortisone Knee 2y Debridement Iv Amp/ TMP/SMX 6w; po Amox/ TMP/S MX for 7 w Asymptomatic several months later 29) 2018 [ 13 ] 1 [62] 78/F Rectal cancer None Hip 21y One-stage revision with the diagnosis of aseptic loosening Van prophylaxis (Implant microbiological analysis LM) Asymptomatic 6 mo later 30) 2018 [ 3 ] 1[63] 69/M DM. Anemia, Hypertension None Knee 3w Debridement, mobile parts were replaced Iv Amox/2w folloed by TMP/SMX/10w Asymptomatic 1y later 31) 2019 [ 20 ] 1 [64] 50/M None None Hip 9 mo Debridement, mobile parts were replaced Iv Amp/Rif 13 d; po Lev/Fif for 3 mo Asymptomatic 20 mo later 32) 2...…”

“…The rate of listeriosis in Europe and in the United States is estimated to be 4.7 cases per million people [ 2 ]. Prosthetic joint infection (PJI) caused by Listeria monocytogenes (LM) is rare and affects mainly immunocompromised patients [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. In a study by Charlier et al.…”