Rare Occurrence of Acute Hematogenous Periprosthetic Joint Infection Due to Fusobacterium Nucleatum in the Background of a Dental Procedure: A Case Report

Orthop Surg. 2020 Dec;12(6):2026-2030. doi: 10.1111/os.12844. Epub 2020 Nov 4.

Abstract

Objective: Fusobacterium nucleatum is an anaerobic gram-negative bacilli that is one of the oral and other mucosal surface microbiota. It involves a wide range of human diseases and was first found in periodontal diseases, but reports of bone-related infections caused by F. nucleatum are rare, especially periprosthetic joint infections (PJI).

Methods: Here, we present the first case of acute hematogenous PJI of the hip joint caused by F. nucleatum, and debridement, antibiotics, and implant retention (DAIR) was performed.

Results: The patient was successfully treated with DAIR, identification of isolates by metagenomics next-generation sequencing was confirmed by polymerase chain reaction.

Conclusions: For stable acute hematogenous PJI after hip replacement, quick and accurate diagnosis, the identification of pathogenic microorganisms, and the use of DAIR combined with sufficient sensitive antibiotics have a certain clinical effect and can achieve the purpose of both preserving the prosthesis and infection control.

Keywords: Debridement, antibiotics, and implant retention (DAIR); Fusobacterium nucleatum; Periprosthetic joint infections.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use*
  • Arthroplasty, Replacement, Hip*
  • Debridement*
  • Female
  • Fusobacterium Infections / drug therapy*
  • Fusobacterium nucleatum
  • Hip Prosthesis
  • Humans
  • Prosthesis-Related Infections / drug therapy*
  • Prosthesis-Related Infections / microbiology*
  • Prosthesis-Related Infections / surgery*
  • Toothache / surgery

Substances

  • Anti-Bacterial Agents