Late onset periprosthetic joint infection of the knee caused by Streptococcus anginosus. Case presentation and literature review

  • Giuseppe Marongiu Orthopaedic and Traumatologic Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
  • Marco Conte Casa di Cura Policlinico Città di Quartu, Quartu Sant’Elena, Italy
  • Vincenzo Verderosa Casa di Cura Policlinico Città di Quartu, Quartu Sant’Elena, Italy
  • Stefano Congia S.C. Ortopedia e Traumatologia, Azienda Ospedaliera Brotzu, Cagliari, Italy
  • Giuseppe Dessì S.C. Ortopedia e Traumatologia, Azienda Ospedaliera Brotzu, Cagliari, Italy
  • Marco Verona Orthopaedic and Traumatologic Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
  • Vittorio Mazzarello Department of Biomedical Sciences, University of Sassari, Sassari, Italy
  • Matthew Gavino Donadu Department of Chemistry and Pharmacy, University of Sassari, Sassari, Italy
Keywords: periprosthetic joint infection, total knee arthroplasty, septic revision surgery, streptococcus anginosus, Streptococcus milleri group, streptococci

Abstract

Periprosthetic joint infection (PJI) is one of the most dramatic complications of joint arthroplasty. Although streptococcal bone and joint infections are less common than staphylococcal cases, their role as causative agents of bone and joint remains significant accounting for at least 10% of PJIs. Streptococcus anginosus group (SAG) bacteria are usually found in the normal flora of the urogenital tract, intestinal tract and oropharynx and could cause pyogenic infections to affect brain, lungs and liver. SAG bacteria are uncommonly reported as a cause of osteomyelitis and the involvement of a joint represent a rare event. S. anginosus has been anecdotical related to implant devices infections such as vascular prosthesis or orthopedic implants, however, PJI of the knee has never been fully reported before. We describe the case of a late onset periprosthetic knee infection due to Streptococcus anginosus successfully treated by a two-stage revision arthroplasty and postoperative parenteral Vancomycin, (2 g per day) and Levofloxacin (750 mg per day) for 4 weeks and then oral Levofloxacin for a further 2 weeks.

Published
2021-03-31
How to Cite
1.
Marongiu G, Conte M, Verderosa V, Congia S, Dessì G, Verona M, Mazzarello V, Donadu MG (2021) Late onset periprosthetic joint infection of the knee caused by Streptococcus anginosus. Case presentation and literature review. J Infect Dev Ctries 15:436-441. doi: 10.3855/jidc.12326
Section
Case Reports