<i>Yersinia enterocolitica</i> Infection of a Prosthetic Knee Joint. Case Report and Review of the Literature on Deep Sited Infections Caused by <i>Y. enterocolitica</i>

Abstract

Prosthetic joint infection is a rare manifestation of Yersinia enterocolitica. We report a case of a patient presenting with fever and a purulent infection in his prosthetic knee joint caused by Y. enterocolitica. He had been operated in 1990 for arthrosis of the right knee. Re-operation was performed in 2007 for loosening of the prosthesis. Seven months later, following progressively increasing knee pain, he became acutely febrile and a purulent knee joint infection was diagnosed. Y. enterocolitica was isolated from the joint fluid. Serum antibodies against Y. enterocolitica were also positive. He was treated with debridement, replacement of the liner component of the prosthesis and a long course of intravenous antimicrobial therapy. The infection was thought to be in a chronic suppressive state. The final outcome after all therapy was good.

Yersinia enterocolitica Prosthetic Joint Septic Arthritis Successfully Treated with Ceftriaxone

“…One case was described by Hougaard et al after THA, where the prosthetic joint was replaced and broad-spectrum antibiotics were used [ 2 ]. In contrast, all other cases were successfully treated with antibiotics without the need of revision arthroplasty [ 1 , 4 – 6 ]. The usual treatment for a prosthetic joint infection that is hematogenous in origin would be debridement antibiotics and implant retention (DAIR).…”

“…Most of them had some comorbidities, with diabetes being the most common. ree of the previously reported cases were reported after total knee arthroplasty (TKA), and two were reported after total hip arthroplasty (THA) [2][3][4][5][6]. e time duration between the placement of the prosthesis and the infection ranged from 1 year to 15 years.…”

“…A comprehensive review of the literature revealed only five prior case reports of Y. enterocolitica causing prosthetic joint infection, which includes 2 cases after total hip arthroplasty (THA) and 3 cases after total knee arthroplasty (TKA) [2][3][4][5][6]. ese have been reviewed in the discussion section.…”