<it>Abiotrophia defectiva </it>knee prosthesis infection: A case report

• Main Authors: Levy Pierre-Yves, Drancourt Michel, Grillo Jean-Charles, Argenson Jean-Noël, Cassir Nadim
• Format: Article
• Language: English
• Published: BMC 2011-09-01
• Series: Journal of Medical Case Reports
• Online Access: http://www.jmedicalcasereports.com/content/5/1/438

<p>Abstract</p> <p>Background</p> <p><it>Abiotrophia </it>species have rarely been implicated in osteoarticular infections. We report one case of an <it>A. defectiva </it>knee prosthesis infection.</p> <p>Case presentation</p> <p>A 71-year-old man of Italian origin presented with pain and swelling of the knee four years after the implantation of a total knee replacement prosthesis. While standard culturing of the synovial fluid resulted in no isolation of microorganisms, the direct inoculation of the synovial fluid into a rich culture medium resulted in the identification of <it>A. defectiva </it>by polymerase chain reaction sequencing. Repeated attempts of culturing microorganisms from blood were negative, and echocardiograms and colonoscopies were unremarkable. High-dose amoxicillin for nine months and a two-stage replacement of the knee prosthesis led to full patient recovery by the time of the 12-month follow-up examination.</p> <p>Conclusions</p> <p>Because <it>Abiotrophia </it>spp. are fastidious microorganisms, it is likely that cases of <it>Abiotrophia </it>orthopedic infection are misdiagnosed as culture-negative infections. Direct inoculation of synovial fluids into rich broth medium and further polymerase chain reaction-based detection of culture-negative synovial fluids are key tests for accurate documentation and detection of these infections.</p>