Foreign-Body Osteoarticular Infection by Brucella Melitensis

Cairó, Mireia; Calbo, Esther; Gómez, Lucía; Matamala, Alfredo; Asunción, Jordi; Cuchí, Eva; Garau, Javier

doi:10.2106/00004623-200601000-00025

Cited by 7 publications

(11 citation statements)

References 9 publications

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“…Six Weeks is the duration recommended by the WHO and the Loannina Consensus. In six cases out of twenty the infection resolved with the sole use of the antibiotic therapy without having to resort to surgical revision [17,18,19,23,25,27] in this patient there was no radiographic evidence of implant loosening. A single stage prosthetic revision was done in 3 cases but only because the infection had not been suspected from the beginning [22,23,28].…”

Section: Discussionmentioning

confidence: 70%

“…Aerobic gram-negative bacilli, anaerobes and mycobacterial infection are far less frequent [15]. PJI due to Brucella is an extremely rare condition, and only 19 cases have been reported in the literature [16][17][18][19][20][21][22][23][24][25][26][27][28]. The demographic characteristics of the 19 cases and our patient are summarized in Table 1 [Table 1].…”

Section: Discussionmentioning

confidence: 99%

“…The rate of isolation of brucella in patients with osteoarticular brucellosis oscillates between 33% and 77% [3]. In the reviewed cases culture of synovial fluid sample or tissue sample recovered brucella in 17 cases (85%).In one case the germe was isolated from a sinus tract discharge [28] and from blood samples in two cases [18,23]. Laboratory culture of brucella is often unsuccessful because of the slow-growing nature of these microorganisms and the requirement for special media and high Co2 tension.…”

Section: Discussionmentioning

confidence: 99%

“…Because of the rare occurrence of PJI caused by Brucella, there is no consensus on its management. The most accepted course is antibiotic treatment with removal or retention of prosthetic components [23]. A variety of drugs have activity against brucella, however the results of in vitro susceptibility tests do not always predict clinical efficacy [32].The intracellular localization of brucella is believed to offer some protection against antimicrobials, and drugs with good penetration into cells are thought necessary for cure.…”

Section: Discussionmentioning

confidence: 99%

“…Monotherapy for brucellosis has generally been considered inadequate due to unacceptably high relapse rate. Of the 20 cases that we reviewed, 14 were treated with double antibiotic therapy [16][17][18][20][21][22][23][25][26][27][28], the most used association was Doxycylline and Rifampicine (8 cases) this association offers the advantage of an all-oral treatment and was recommended by the World Health Organization (WHO) in 1986 [33] and by Consensus " Loannina Recommendations" for Fig. 3 [34].…”

Section: Discussionmentioning

confidence: 99%

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Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

et al. 2016

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Context:Brucellosis is actually considered to be the commonest zoonotic infection worldwide; conversely prosthetic infection due to brucella is extremely rare. Although diagnostic is easily achieved, management of such situations is extremely challenging.AimsTo report the case of prosthetic hip loosening due to brucellar infection, discuss management manners and to summarize data about 19 cases reported in the literature.MethodsWe report the case of a 73-year-old woman with brucellar prosthetic hip loosening treated with 2-stage exchange of the prosthesis and prolonged double antibiotherapyResultsAt two years follow up the patient is pain free with total functional recovery and no clinical and radiographic signs of prosthetic looseningConclusionsBrucella should be evocated as a cause of total joint arthroplasty infection especially in patients from endemic regions and with occupational exposure. Antibiotic treatment alone can be followed if there are no signs of implant loosening. Tow stage revision should be considered in other cases.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

et al. 2016

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

et al. 2008

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Brucella infection in arthroplasties is a rare event. An unspecific clinical symptomatology is associated with unclear radiographic peri-prosthetic signs of bone halisteresis. Only a positive anamnesis, combined with an antibiogram of the joint liquid and a high serum antibody titre, can lead to a definitive diagnosis. We report a case of Brucella melitensis infection in a total knee arthroplasty implanted 2 years earlier. With the absence of radiological signs of prosthetic loosening and thanks to a systemic antibiotic combined therapy (rifampicin + doxycycline) extended for 8 weeks, we were able to solve the infection avoiding surgery.

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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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Foreign-Body Osteoarticular Infection by Brucella Melitensis

Cited by 7 publications

References 9 publications

Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

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

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

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