Stumpner T, Kuhn R, Hochreiter J, Ortmaier R. Periprosthetic knee joint infection caused by Brucella melitensis which was first -osteoarticular brucellosis or osteoarthrosis: A case report. World J Clin Cases 2023; 11(3): 677-683 [PMID: 36793627 DOI: 10.12998/wjcc.v11.i3.677]
Corresponding Author of This Article
Thomas Stumpner, MD, Doctor, Staff Physician, Department of Orthopaedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Seilerstätte 4, Linz 4010, Austria. thomas.stumpner@ordensklinikum.at
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 26, 2023; 11(3): 677-683 Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.677
Periprosthetic knee joint infection caused by Brucella melitensis which was first -osteoarticular brucellosis or osteoarthrosis: A case report
Thomas Stumpner, Regina Kuhn, Josef Hochreiter, Reinhold Ortmaier
Thomas Stumpner, Regina Kuhn, Josef Hochreiter, Reinhold Ortmaier, Department of Orthopaedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Linz 4010, Austria
Author contributions: Stumpner T performed the follow-up examinations and wrote the manuscript with the support of Kuhn R and Ortmaier R; Kuhn R managed the case and coordinated the involved disciplines; Hochreiter J and Ortmaier R supervised the case; all authors contributed to, read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: All authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Thomas Stumpner, MD, Doctor, Staff Physician, Department of Orthopaedic Surgery, Ordensklinikum Linz Barmherzige Schwestern, Seilerstätte 4, Linz 4010, Austria. thomas.stumpner@ordensklinikum.at
Received: November 24, 2022 Peer-review started: November 24, 2022 First decision: December 13, 2022 Revised: December 26, 2022 Accepted: January 5, 2023 Article in press: January 5, 2023 Published online: January 26, 2023
Abstract
BACKGROUND
Brucellosis is the most common zoonosis worldwide and is endemic in the Middle East, Africa, Asia, and Latin America. However, it is uncommon in Central Europe, and periprosthetic infections caused by Brucella are therefore rare. Due to the low prevalence and nonspecific clinical presentation of the disease, accurate diagnosis can be challenging; no gold standard currently exists for treating brucellosis.
CASE SUMMARY
Here, we present a 68-year-old Afghan woman living in Austria with a periprosthetic knee infection caused by Brucella melitensis. The interval from total knee arthroplasty to septic loosening was five years. A profound medical history and examinations suggested that the patient had been suffering from unrecognized chronic osteoarticular brucellosis prior to total knee arthroplasty. She was successfully treated by two-stage revision surgery and combined antibiotic therapy over three months.
CONCLUSION
Clinicians should consider brucellosis as a possible cause of chronic arthralgia and periprosthetic infection in patients originating from countries with a high brucellosis burden.
Core Tip: Periprosthetic infections caused by Brucella species are rare, difficult to diagnose, and challenging to treat. We present here our experience in treating a 68-year-old Afghan woman with a periprosthetic knee joint infection caused by Brucella melitensis. In conclusion we recommend clinicians to consider Brucellosis as a possible cause for chronic arthralgia and periprosthetic infection in patients originating from countries with a high brucellosis burden.
