A recurrent prosthetic joint infection caused by Erysipelothrix rhusiopathiae: case report and literature review

Abstract

Prosthetic knee joint infection caused by Erysipelothrix rhusiopathiae is uncommon and only one case of recurrent infection has previously been described. Here, we describe the case of a 77-year-old male patient who was admitted to the teaching hospital of Rennes (France) with bilateral and nocturnal gonalgia evolving for 1 month. He had bilateral knee prosthesis 10 years ago, and a history of large B-cell lymphoma in remission. A diagnosis of infective endocarditis, with prosthetic knee infection, was made, with positive cultures of synovial fluids and blood; colonies of E. rhusiopathiae were identified by MALDI-TOF MS. Initial treatment involved debridement, implant retention surgery and intravenous amoxicillin (12 g day–1) for 6 weeks with gentamicin 3 mg kg–1 day–1 added for the first 4 days. One year later, a second episode of E. rhusiopathiae infection occurred, suggesting a recurrence or reinfection due to the same bacterial species. The patient was finally cured after a two-stage exchange with a cemented articulated spacer and a 3 month course of amoxicillin (12 g day–1, iv). Different characteristics of E. rhusiopathiae infection were discussed, with a review of all cases of prosthetic joint infections caused by Erysipelothrix species. This case highlights the need for a long-term survey of patients, and a good knowledge of their environment to avoid any risk of reinfection.

Disseminated Erysipelothrix rhusiopathiae with Secondary Prosthetic Hip Joint Infection

“…All reported cases had complete symptomatic and biochemical resolution of their infection. 7,8,[14][15][16][17][18] This case highlights the importance of considering disseminated zoonotic infections in the setting of prosthetic joint infection in at-risk populations. It also highlights the difficulty in diagnosing some of these zoonotic infections.…”

“…All reported cases had complete symptomatic and biochemical resolution of their infection. 7,8,14-18…”

“…In the 7 reported cases of prosthetic joint infection secondary to E. rhusiopathiae, 5 involved knee prostheses and the other 2 were hip prostheses 7,8,[14][15][16][17][18] . There were no reported precipitants such as abrasion injuries.…”

Erysipeloid and Erysipelothrix rhusiopathiae Bacteremia Secondary to a Crab Stab Wound: A Case Report and Literature Review

“…This may be attributed to the advancements in culture technology enabling early detection and timely treatment of bacteremia. Moreover, E. rhusiopathiae can also cause brain abscesses, endophthalmitis, meningitis, peritonitis, osteomyelitis and septic arthritis 7,8 . Patients who have underlying conditions such as malignant tumors, chronic liver diseases and tuberculosis, as well as those taking corticosteroids or cytotoxic drugs, are at higher risk for severe E. rhusiopathiae infection 9 …”

“…Moreover, E. rhusiopathiae can also cause brain abscesses, endophthalmitis, meningitis, peritonitis, osteomyelitis and septic arthritis. 7,8 Patients who have underlying conditions such as malignant tumors, chronic liver diseases and tuberculosis, as well as those taking corticosteroids or cytotoxic drugs, are at higher risk for severe E. rhusiopathiae infection. 9 The treatment of both erysipeloid and E. rhusiopathiae bacteremia is highly dependent on effective antibiotics.…”