We report 3 cases of Brucella melitensis infection of prosthetic hips and knees, and we summarize data about 4 cases reported in the literature. Six of the 7 affected patients were men. The median duration from prosthesis implantation to the onset of symptoms was 38.7 months. Five patients had only local symptoms. Preoperative joint aspirates yielded negative culture results for 3 patients, and blood culture results were negative for 6 patients. Excisional arthroplasty was the initial intervention for 3 patients. Three others responded well to medical therapy alone. One patient had relapse while receiving tetracycline and underwent total hip replacement. All patients were treated with combined antibiotic therapy for 6 weeks to 19 months. All had favorable long-term responses. The 3 patients we treated underwent a 2-staged resection arthroplasty. Antibiotics alone can be used to treat Brucella prosthetic joint infection, but loosening of the joint and clinical or microbiological failure must be treated with a 2-staged excisional arthroplasty and 3 months of treatment with doxycycline and rifampicin.Brucellosis, a zoonosis of worldwide distribution, is a systemic infection caused by Brucella species that can involve many organs and tissues [1]. Osteoarticular disease is the most common complication of brucellosis and has been described in 10%-85% of patients [2,3]. Arthritis involving large joints and the sacroiliac joints is the most prevalent and important clinical form of osteoarticular involvement; spondylitis, bursitis, tenosynovitis, and osteomyelitis have been also described [2][3][4][5][6][7][8][9][10].Prosthetic joint infection (PJI) is a serious complication of total joint arthroplasty, with coagulasenegative staphylococci and Staphylococcus aureus accounting for 150% of cases [11,12]. The infecting organism can be introduced either during surgery or through hematogenous seeding. Brucella PJI, however, is rare. Only 4 cases of PJI associated with Brucella species have been reported in the medical literature [13][14][15][16]. We describe our experience with 3 patients who had Brucella PJI and review data about 4 additional cases published in the literature. PATIENTS AND METHODSThe first case of Brucella PJI at the Hadassah University Hospital (Jerusalem, Israel) was identified in 1997, and 2 additional cases were diagnosed subsequently. By means of manual and computerized (MEDLINE database) literature searches, data regarding all published cases of Brucella PJI were collected. The laboratory testing of these cases included use of a standard tube agglutination test with Brucella abortus antigens, and blood and synovial fluid specimens were cultured using blood culture bottles (BacT/Alert; Organon Teknika). All specimens were processed using conventional bacteriological techniques and incubated for у21 days.

Aspergillus endopthalmitis may occur in patients undergoing lung transplantation despite antifungal therapy. Increased awareness of this unusual entity may be life and vision saving in these patients.

Background Increasing reports of intrauterine device (IUD)‐related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo‐ovarian abscess is identified. Purpose A 38‐year‐old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound‐guided needle aspiration. It resulted in marked improvement and avoided surgical treatment. Conclusion Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. Infect. Dis. Obstet. Gynecol. 4:298–300, 1996. © 1997 Wiley‐Liss, Inc.

Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified.

Background: Increasing reports of intrauterine device (IUD)-related abdominopelvic actinomycosis have been described recently. Surgical therapy has been the usual treatment when tubo-ovarian abscess is identified.Case: A 38-year-old woman suffering from Actinomyces pelvic abscess unresponsive to medical treatment underwent transvaginal ultrasound-guided needle aspiration. It resulted in marked improvement and avoided surgical treatment.Conclusion: Transvaginal needle aspiration of Actinomyces pelvic abscess may be an alternative to surgical therapy, thereby allowing the preservation of pelvic organs. Infect. Dis.