Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection

We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosth...

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Main Authors: Trevor J. Shelton, Alton W. Skaggs, Gavin C. Pereira
Format: Article
Language:English
Published: Hindawi Limited 2018-01-01
Series:Case Reports in Orthopedics
Online Access:http://dx.doi.org/10.1155/2018/8657562
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spelling doaj-ae180722027f4c82b5e4cb083a49b9cd2020-11-24T22:31:05ZengHindawi LimitedCase Reports in Orthopedics2090-67492090-67572018-01-01201810.1155/2018/86575628657562Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip InfectionTrevor J. Shelton0Alton W. Skaggs1Gavin C. Pereira2Department of Orthopaedics, University of California, Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817, USASchool of Medicine, University of California, Davis, Sacramento, CA 95817, USADepartment of Orthopaedics, University of California, Davis, 4860 Y Street, Suite 3800, Sacramento, CA 95817, USAWe report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup. The authors have not identified literature describing a similar resolution of draining sinus tracts from around a prosthetic joint after discontinuing AST. Despite the resolution of this patient’s sinus tract, the authors do not advocate for discontinuing AST in patients with a draining sinus tract. However, in spite of the fact that the MSIS consensus statement suggests that a draining sinus is a sure sign of PJI and that the assumption is that the infection will not go away until explant, this case was different.http://dx.doi.org/10.1155/2018/8657562
collection DOAJ
language English
format Article
sources DOAJ
author Trevor J. Shelton
Alton W. Skaggs
Gavin C. Pereira
spellingShingle Trevor J. Shelton
Alton W. Skaggs
Gavin C. Pereira
Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
Case Reports in Orthopedics
author_facet Trevor J. Shelton
Alton W. Skaggs
Gavin C. Pereira
author_sort Trevor J. Shelton
title Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
title_short Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
title_full Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
title_fullStr Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
title_full_unstemmed Self-Resolution of a Draining Sinus Tract in a Patient with Chronic Periprosthetic Hip Infection
title_sort self-resolution of a draining sinus tract in a patient with chronic periprosthetic hip infection
publisher Hindawi Limited
series Case Reports in Orthopedics
issn 2090-6749
2090-6757
publishDate 2018-01-01
description We report a novel case of a patient who had a draining sinus soon after a total hip arthroplasty that spontaneously resolved. The patient voluntarily discontinued antibiotic suppressive therapy (AST) after 10 years of treatment and paradoxically experienced full resolution of signs of chronic prosthetic joint infection (PJI), including recovery of his left-sided draining sinus tract. Now 8 years after discontinuing AST, the patient has no pain, good function, and no major or minor criteria of joint infection according to the Musculoskeletal Infection Society (MSIS) workgroup. The authors have not identified literature describing a similar resolution of draining sinus tracts from around a prosthetic joint after discontinuing AST. Despite the resolution of this patient’s sinus tract, the authors do not advocate for discontinuing AST in patients with a draining sinus tract. However, in spite of the fact that the MSIS consensus statement suggests that a draining sinus is a sure sign of PJI and that the assumption is that the infection will not go away until explant, this case was different.
url http://dx.doi.org/10.1155/2018/8657562
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