Mycobacterium tuberculosis prosthetic joint infections: A case series and literature review

Uhel, Fabrice; Corvaisier, Grégory; Poinsignon, Yves; Chirouze, Catherine; Béraud, Guillaume; Grossi, Olivier; Varache, N.; Arvieux, Cédric; Berre, Rozenn Le; Tattevin, Pierre; Centre-Ouest, Groupe d’Epidémiologie et Recherche en Infectiologie Clinique

doi:10.1016/j.jinf.2018.08.008

Cited by 25 publications

(13 citation statements)

References 38 publications

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“…A retrospective medical record review of prosthetic joints infected with M. tuberculosis found that an extended course of antibiotics (18 months) was effective and did not require removal of the joint. 15 We believe that the best option for our patient is an extended course of antituberculous therapy (18 months), which we hope will eliminate the M. bovis infection and forego the need for major open aortic surgery (graft explant and revascularization).…”

Section: Discussionmentioning

confidence: 96%

Successful endovascular treatment of abdominal aortic rupture secondary to bacillus Calmette-Guérin vaccine

Liechty

Pacifico

Brant-Zawadzki

2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Discussionmentioning

confidence: 96%

Successful endovascular treatment of abdominal aortic rupture secondary to bacillus Calmette-Guérin vaccine

Liechty

Pacifico

Brant-Zawadzki

2022

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…PJI is essentially a surgical disease and the majority of the cases require some form of surgical intervention. The DAIR remains a key element in the management of PJI, especially when the usual pathogens are involved, such as Enterococcus, Staphylococcus, and Streptococcus [13]. For acute PJIs caused by gram-negative bacteria and managed with the DAIR procedure, the prognosis is relatively good.…”

Section: Discussionmentioning

confidence: 99%

Acute Periprosthetic Hip Joint Infection Caused by Multidrug-Resistant Acinetobacter Baumannii: Is Debridement, Antibiotics, Irrigation, and Implant Retention a Viable Treatment Option?

Vasiliadis

Poutoglidou

Chatziravdeli

et al. 2021

Cureus

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In this study, we aimed to investigate the effectiveness of debridement, antibiotics, irrigation, and implant retention (DAIR) in periprosthetic hip joint infection caused by multidrug-resistant (MDR) Acinetobacter baumannii (A. baumannii) . From July 2019 to June 2020, we retrospectively reviewed all patients treated for periprosthetic hip joint infections caused by MDR A. baumannii at our institution. The diagnosis of periprosthetic joint infection (PJI) was established based on the Musculoskeletal Infection Society (MSIS) 2018 criteria. The Charlson Comorbidity Index (CCI) was used to estimate the risk of mortality. The patients were followed up for over a year, until their death, or loss to follow-up. Four patients (three females and one male), with a mean age of 68 years, were included in the study. A. baumannii exhibited resistance to fluoroquinolones in all cases. All patients were treated with the DAIR procedure followed by intravenous tigecycline and colistin combination treatment. Prosthesis retention with good functional results was achieved in two patients. One patient required resection arthroplasty and one patient died two months after the initial surgical treatment, yielding a success rate of 50% for the DAIR procedure. Periprosthetic hip joint infection caused by MDR A. baumannii is one of the most demanding and challenging complications in orthopaedic practice. This case series suggests that the outcome of the DAIR is affected by a number of factors that are in a complex interplay. Our results indicate a limited success rate for the DAIR procedure in the treatment of a periprosthetic hip joint infection caused by MDR A. baumannii .

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“…The initial database queries produced 191 reports; 162 articles were excluded, including those that were duplicates (43), reviews or meta‐analyses (24), descriptions of general periprosthetic joint infections (25), descriptions of hip replacements (14), descriptions of non‐tuberculous mycobacterium infections (all case reports, 14), articles on knee joint tuberculosis replacements (23), and non‐English reports (19) 13–41 . We identified 44 cases of TBPJI described in the 29 selected articles.…”

Section: Methodsmentioning

confidence: 99%

Total Knee Arthroplasty in Patients with Unsuspected Tuberculosis of the Joint: A Report of Four Cases and a Systematic Review of the Literature

Wei

Sun²,

Zhang

et al. 2020

Orthopaedic Surgery

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Objectives: To provide a case series and systematic review that explores the clinical manifestations, treatments, and methods for defining tuberculosis diagnoses in patients who have undergone total knee arthroplasty (TKA). Methods: Four patients (three women, one man; average age, 59.5 ± 8.89 years; range, 48-69 years) underwent TKA and were subsequently treated for previously unsuspected knee tuberculosis between January 2013 and December 2019. We also reviewed published cases of tuberculous periprosthetic joint infections (TBPJIs) following TKA through databases of MEDLINE/PubMed, the Cochrane Library, and EMBASE. We reviewed studies that were published between January 1980 and December 2019. Results: In our four cases, the preoperative diagnoses were osteoarthritis (n = 2), rheumatoid arthritis (one case), and Charcot's arthropathy (one case). The main clinical manifestations were knee swelling and pain, without fever, weakness, or weight loss. Comorbidities included multiple joints with rheumatoid arthritis or Charcot's arthropathy, diabetes mellitus, and uremia. One patient had a history of lumbar tuberculosis treated with debridement and intervertebral fusion. Preoperative elevated erythrocyte sedimentation rates (ESRs) were detected in all cases, and elevated C-reactive protein (CRP) levels were observed in three cases. The tuberculosis diagnoses were confirmed via histopathologic analysis (three cases) and second-generation sequencing (one case). Three patients received antituberculosis therapy for 1 year, without surgical intervention. Two-stage exchange arthroplasty was performed in one patient because of prosthesis loosening. Within an average follow-up period of 24.75 months, tuberculosis reactivation was not observed and overall functional improvement was demonstrated. Forty-four TBPJI cases were reported in the literature between January 1980 and December 2019. Most (59.09%) occurred within the first year after the index arthroplasty, and the diagnoses were confirmed by culturing Mycobacterium tuberculosis in 88.64% of cases. Favorable outcomes were achieved in 90.91% of the patients who did not undergo surgery, 71.43% of those treated with debridement, 93.33% undergoing revision arthroplasty, and in 90.91% of those undergoing resection and arthrodesis. Conclusions: Clinical manifestations of knee tuberculosis and TBPJI are atypical. Thus, attention should be paid to finding the causes of increased ESRs and CRP levels, particularly in patients with weakened immune functioning, before performing TKA. Pathological examination is an effective method for diagnosing tuberculosis, although sending multiple specimens for pathological examination is necessary.

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Mycobacterium tuberculosis prosthetic joint infections: A case series and literature review

Abstract: M. tuberculosis PJI can be controlled with prolonged antituberculosis treatment in most cases, with or without surgical treatment.

Cited by 25 publications

References 38 publications

Successful endovascular treatment of abdominal aortic rupture secondary to bacillus Calmette-Guérin vaccine

Successful endovascular treatment of abdominal aortic rupture secondary to bacillus Calmette-Guérin vaccine

Acute Periprosthetic Hip Joint Infection Caused by Multidrug-Resistant Acinetobacter Baumannii: Is Debridement, Antibiotics, Irrigation, and Implant Retention a Viable Treatment Option?

Total Knee Arthroplasty in Patients with Unsuspected Tuberculosis of the Joint: A Report of Four Cases and a Systematic Review of the Literature

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