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Rodríguez Duque JC, Galindo Rubín P, González Humara B, Quesada Sanz AA, Busta Vallina MB, Fernández-Sampedro M. Fusobacterium nucleatum prosthetic hip infection: Case report and review of the literature of unusual anaerobic prosthetic joint infection. Anaerobe 2018; 54:75-82. [PMID: 30118892 DOI: 10.1016/j.anaerobe.2018.08.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 07/26/2018] [Accepted: 08/12/2018] [Indexed: 12/26/2022]
Abstract
The anaerobic Gram-negative rod Fusobacterium nucleatum is an oral commensal and periodontal pathogen that has been associated with a wide variety of infections, yet it is extremely rare to be associated with prosthetic joint infection. After an exhaustive literature review, only two cases of prosthetic joint infection by F. nucleatum have been previously reported. To our knowledge, the case we report on here is the first combined with periprosthetic abscess and related with hemochromatosis. We therefore sought to provide a comprehensive literature review of case reports or series of less commonly encountered anaerobic microorganisms isolated from prosthetic joint infections.
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Affiliation(s)
- J C Rodríguez Duque
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - P Galindo Rubín
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - B González Humara
- Department of Radiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - A A Quesada Sanz
- Service of Microbiology, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M B Busta Vallina
- Department of Orthopaedic Surgery, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
| | - M Fernández-Sampedro
- Infectious Diseases Unit, Department of Medicine, Hospital Universitario Marqués de Valdecilla-IDIVAL, School of Medicine, University of Cantabria, Santander, Spain.
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Kierzkowska M, Pedzisz P, Babiak I, Janowicz J, Kulig M, Majewska A, Sawicka-Grzelak A, Mlynarczyk G. Orthopedic infections caused by obligatory anaerobic Gram-negative rods: report of two cases. Med Microbiol Immunol 2017; 206:363-366. [PMID: 28730548 DOI: 10.1007/s00430-017-0513-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 07/14/2017] [Indexed: 11/26/2022]
Abstract
Anaerobic bone and joint infections are uncommon, although the number of anaerobic infections is presumably underestimated because of difficulties with isolation and identification of obligate anaerobes. This study describes two cases of complicated Bacteroides fragilis peri-implant infection of the lumbar spine, infection of the hip and osteomyelitis. Bacteria were identified with the use of a mass spectrometer, VITEK MS system. Drug susceptibility was performed with the use of E-test. The EUCAST breakpoints were used for interpretation with B. fragilis ATCC 25285 as a control. In the two described cases clinical samples were collected for microbiological examination intraoperatively and simultaneously empirical treatment was applied. B. fragilis was isolated in monoculture or in a combination with other bacteria. The treatment was continued according to the susceptibility tests. In a case one clindamycin failure was observed and clindamycin resistance of the isolate was likely due to inadequate time of therapy. Difficulties in collecting an adequate samples and culturing anaerobic bacteria cause that not all infections are properly recognized. In a successful therapy, identification and determination of the susceptibility of the pathogen are essential as well as an appropriate surgical debridement.
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Affiliation(s)
- Marta Kierzkowska
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004, Warsaw, Poland
| | - Piotr Pedzisz
- Department of Orthopedics and Traumatology, Medical University of Warsaw, Lindleya 4 Str., 02-005, Warsaw, Poland
| | - Ireneusz Babiak
- Department of Orthopedics and Traumatology, Medical University of Warsaw, Lindleya 4 Str., 02-005, Warsaw, Poland
| | - Jakub Janowicz
- Department of Orthopedics and Traumatology, Medical University of Warsaw, Lindleya 4 Str., 02-005, Warsaw, Poland
| | - Mateusz Kulig
- Department of Orthopedics and Traumatology, Medical University of Warsaw, Lindleya 4 Str., 02-005, Warsaw, Poland
| | - Anna Majewska
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004, Warsaw, Poland.
| | - Anna Sawicka-Grzelak
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004, Warsaw, Poland
| | - Grazyna Mlynarczyk
- Chair and Department of Medical Microbiology, Medical University of Warsaw, Chalubinskiego 5 Str., 02-004, Warsaw, Poland
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Shah N, Osmon D, Tande AJ, Steckelberg J, Sierra R, Walker R, Berbari EF. Clinical and Microbiological Characteristics of Bacteroides Prosthetic Joint Infections. J Bone Jt Infect 2017; 2:122-126. [PMID: 28540148 PMCID: PMC5441143 DOI: 10.7150/jbji.17129] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Clinical and microbiological characteristics of patients with Bacteroides prosthetic joint infection (PJI) have not been well described in the literature. The aim of this retrospective cohort study was to assess the outcome of patients with Bacteroides PJI and to review risk factors associated with failure of therapy. Between 1/1969 and 12/2012, 20 episodes of Bacteroides PJI in 17 patients were identified at our institution. The mean age of the patients in this cohort at the time of diagnosis was 55.6 years; 59% (n=10) had knee involvement. Twenty four percent (n=4) had diabetes mellitus, and 24% had a history of either gastrointestinal (GI) or genitourinary (GU) pathology prior to the diagnosis of PJI. Thirty five percent (n=6) were immunosuppressed. The initial medical/surgical strategy was resection arthroplasty (n=9, 50%) or debridement and implant retention (n=5, 28%). Thirty seven percent (n=7) were treated with metronidazole. Eighty percent (n=4) of patients that failed therapy had undergone debridement and retention of their prosthesis, as compared to none of those treated with resection arthroplasty. Seventy percent (n=14) of patient episodes were infection free at their last date of follow up. In conclusion, a significant proportion of patients with Bacteroides PJI are immunosuppressed and have an underlying GI or GU tract pathology. Retention and debridement of the prosthesis is associated with a higher risk of treatment failure.
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Affiliation(s)
- Neel Shah
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Douglas Osmon
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Aaron J Tande
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - James Steckelberg
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Rafael Sierra
- Department of Orthopedic Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Randall Walker
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
| | - Elie F Berbari
- Division of Infectious Disease, Mayo Clinic College of Medicine, Rochester, Minnesota, USA
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Cho Y, Minami K, Kasai M, Kubota N, Higuchi T. Infective endocarditis due to multiple species of anaerobes following tricuspid valve replacement. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2016; 50:733-734. [PMID: 27553447 DOI: 10.1016/j.jmii.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 06/13/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Yoshiaki Cho
- Department of General Pediatrics, Nagano Children's Hospital, Azumino-shi, Nagano, Japan; Department of Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Musashidai, Fuchu-shi, Tokyo, Japan.
| | - Kisei Minami
- Department of General Pediatrics, Nagano Children's Hospital, Azumino-shi, Nagano, Japan
| | - Masashi Kasai
- Department of Pediatric Intensive Care, Nagano Children's Hospital, Azumino-shi, Nagano, Japan
| | - Noriko Kubota
- Department of Laboratory Medicine, Nagano Children's Hospital, Azumino-shi, Nagano, Japan
| | - Tsukasa Higuchi
- Department of General Pediatrics, Nagano Children's Hospital, Azumino-shi, Nagano, Japan
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Shah NB, Tande AJ, Patel R, Berbari EF. Anaerobic prosthetic joint infection. Anaerobe 2015; 36:1-8. [DOI: 10.1016/j.anaerobe.2015.08.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 12/01/2022]
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Abstract
Radical and definitive surgical treatment is indicated in approximately one out of ten patients with hemorrhoidal disease. The Milligan and Morgan hemorrhoidectomy technique is the most widely performed in France: the technique is well-codified and results are satisfactory and durable if the indications and the post-operative follow-up are appropriately respected. Post-operative pain can be adequately controlled.
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Affiliation(s)
- H Pillant-Le Moult
- Institut de proctologie Léopold-Bellan, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France.
| | - M Aubert
- Institut de proctologie Léopold-Bellan, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
| | - V De Parades
- Institut de proctologie Léopold-Bellan, hôpital Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France
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Berkel AEM, Witte ME, Koop R, Hendrix MGR, Klaase JM. Brain abscess after transanal hemorrhoidal dearterialization: a case report. Case Rep Gastroenterol 2013; 7:208-13. [PMID: 23741208 PMCID: PMC3670629 DOI: 10.1159/000351817] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
A relatively new therapy in the treatment of hemorrhoids is transanal hemorrhoidal dearterialization (THD). We report a case of brain abscess caused by Streptococcus milleri following THD. Although a brain abscess after drainage of a perianal abscess has been described in the literature, no report exists of a brain abscess following treatment of hemorrhoids. A healthy 51-year-old man with hemorrhoids underwent THD. Two weeks later he presented with a headache, bradyphrenia, flattened behavior and a left hemiplegia. No perianal complaint and/or perianal abscess was present. A contrast CT scan of the cerebrum showed a right temporoparieto-occipital abscess, with edema and compression of the surrounding tissue and lateral ventricles. MRI showed an abscess with leakage in the right lateral ventricle. Treatment with dexamethasone and intravenous antibiotics was started. Because of progression of symptoms, 3 weeks later ventriculoscopy was performed and the abscess was drained. Culture of the punctuate showed S. milleri. Because of developing hydrocephalus 3 days after ventriculoscopy, first an external ventricle drain and later a ventriculoperitoneal drain was placed. Hereafter the hemiplegia and cognitive disorders improved. This case report describes a severe complication following treatment of hemorrhoids with THD which until now, to our knowledge, has never been described in the literature.
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Affiliation(s)
- A E M Berkel
- Department of Surgery, Medisch Spectrum Twente, Enschede, The Netherlands
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Abstract
BACKGROUND Recent reports of serious sepsis following stapled haemorrhoidectomy have raised concerns about the appropriate treatment of haemorrhoidal disease. METHODS A Medline search was undertaken for reports of sepsis following the commonly practised conservative and surgical treatments of haemorrhoids. RESULTS Published accounts of significant septic complications after injection sclerotherapy, rubber-band ligation, cryotherapy, open and closed haemorrhoidectomy, and stapled haemorrhoidectomy are discussed. This is supplemented by the authors' own experiences of stapled haemorrhoidectomy. CONCLUSION Septic complications following both conservative and surgical treatment of haemorrhoids are rare but may be catastrophic. Immunological compromise poses an additional risk for many treatment modalities. The technique of stapled haemorrhoidectomy should be learned diligently to avoid septic complications.
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Affiliation(s)
- R J Guy
- Department of Colorectal Surgery, Outram Road, Singapore 169608.
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Deacon JM, Pagliaro AJ, Zelicof SB, Horowitz HW. Prophylactic use of antibiotics for procedures after total joint replacement. J Bone Joint Surg Am 1996; 78:1755-70. [PMID: 8934495 DOI: 10.2106/00004623-199611000-00020] [Citation(s) in RCA: 86] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- J M Deacon
- Department of Orthopaedic Surgery, New York Medical College, Valhalla 10595, USA
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