Brucella infection in total knee arthroplasty. Case report and revision of the literature

Tassinari, Enrico; Motta, Daniele Di; Giardina, Federico; Traina, Francesco; Fine, Marcello De; Toni, Aldo

doi:10.1007/s12306-008-0031-x

Cited by 10 publications

(24 citation statements)

References 25 publications

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“…After removal of duplicates, 47 remained. 18 reports contained data on 23 patients with 26 Brucella -related prosthetic joint infections; only 3 were in returning travellers [4], [5], [6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17], [18], [19], [20], [21]. Table 1 summarises all 24 patients including: gender, country of exposure, type of implant and time to symptom onset.…”

Section: Resultsmentioning

confidence: 99%

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Lewis

Folb

Kalra

et al. 2016

Travel Medicine and Infectious Disease

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SummaryBackgroundBrucella spp. prosthetic joint infections are infrequently reported in the literature, particularly in returning travellers, and optimal treatment is unknown.MethodWe describe a prosthetic joint infection (PJI) caused by Brucella melitensis in a traveller returning to the UK from Thailand, which we believe to be the first detailed report of brucellosis in a traveller returning from this area. The 23 patients with Brucella-related PJI reported in the literature are summarised, together with our case.ResultsThe diagnosis of Brucella-related PJI is difficult to make; only 30% of blood cultures and 75% of joint aspiration cultures were positive in the reported cases. Culture of intraoperative samples provides the best diagnostic yield. In the absence of radiological evidence of joint loosening, combination antimicrobial therapy alone may be appropriate treatment in the first instance; this was successful in 6/7 [86%] of patients, though small numbers of patients and the likelihood of reporting bias warrant caution in drawing any firm conclusions about optimal treatment. Aerosolisation of synovial fluid during joint aspiration procedures and nosocomial infection has been described.ConclusionsBrucella-related PJI should be considered in the differential of travellers returning from endemic areas with PJI, including Thailand. Personal protective equipment including fit tested filtering face piece-3 (FFP3) mask or equivalent is recommended for personnel carrying out joint aspiration when brucellosis is suspected. Travellers can reduce the risk of brucellosis by avoiding unpasteurised dairy products and animal contact (particularly on farms and abattoirs) in endemic areas and should be counselled regarding these risks as part of their pre-travel assessment.

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Section: Resultsmentioning

confidence: 99%

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Lewis

Folb

Kalra

et al. 2016

Travel Medicine and Infectious Disease

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“…15 Of these, however, the first one is surely the most common way. 5 , 16 Dairy products, especially soft cheeses, unpasteurized milk, and ice cream, are the most frequently implicated sources. 9 It is thought that the implant is infected by hematogenous spread of the microorganism at the time of systemic infection.…”

Section: Discussionmentioning

confidence: 99%

“…Rifampin, doxycycline, and streptomycin have been considered the drugs of choice for administration in most report. 2 , 4 , 16 , 20 Selecting the appropriate antibrucella treatment requires a multiteam approach involving the treating orthopaedic surgeon, infectious disease specialists, and clinical pharmacologists. If removal of the arthroplasty is not an option (for instance due to the wishes of the patient or poor general condition), chronic suppression with antibrucella treatment could be recommended in the absence of loosening of the components of the prosthesis.…”

Section: Discussionmentioning

confidence: 99%

Brucella infection following total joint arthroplasty: A systematic review of the literature

Kim

Park

Lee

2018

Acta Orthopaedica et Traumatologica Turcica

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IntroductionThe aim of this systematic review was to analyze the results of published treatment options in Brucella infection following total joint arthroplasty (TJA).MethodsWe performed a systematic review of the literature regarding outcomes of Brucella infection after TJA (hip and knee). We searched multiple databases for articles in the area published from 1950 to 2016.ResultsA total of 18 patients (12 male and 6 female; mean age 59 years) from 14 published studies were identified. The minimum follow-up time was 6 months (range, 6–120 months). Seven patients were treated with debridement or antibrucella treatment only. Eleven patients (61%) underwent removal of the prosthesis and were treated with one or two-stage exchange arthroplasty. The mean duration of antibiotic therapy was 5.8 months. There was no relapse of infection.ConclusionsIn the absence of loosening of the components of the prosthesis, an attempt to treat Brucella infection medically might be a reasonable choice. One or two-stage exchange arthroplasty could provide successful results without relapse of infection when combined with appropriate antibiotherapy.Level of evidenceLevel III, therapeutic study.

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“…In the literature, there are six cases of total joint arthroplasty of the knee infected by Brucella spp. [6,[8][9][10][11] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

A case of brucellar monoarthritis and review of the literature

2011

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Brucellosis is a systemic infectious disease, which constitutes a public health problem in Turkey. Brucellosis has a broad spectrum of clinical manifestations. Osteoarthicular manifestations are often seen in brucellosis but most of the brucellar monoarthritis cases are reactive rather than being septic. We report a case of brucellar (septic) monoarthritis of the knee in a 74-year-old cattleman and review of the literature.

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Brucella infection in total knee arthroplasty. Case report and revision of the literature

Cited by 10 publications

References 25 publications

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Brucella melitensis prosthetic joint infection in a traveller returning to the UK from Thailand: Case report and review of the literature

Brucella infection following total joint arthroplasty: A systematic review of the literature

A case of brucellar monoarthritis and review of the literature

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