Brucellar Prosthetic Infection After Total Knee Arthroplasty: A Case With Retained Prosthesis by Arthroscopic and Medical Treatment
Öz
Infection after total knee arthroplasty is a severe complication and is associated with high morbidity. We describe a case of a brucellosis infection of the knee joint, four years after cemented total knee prosthesis application. Treatment strategies of antimicrobial chemotherapy with or without initial excisional arthroplasty are recommended in the literature. After diagnostic arthroscopy and wash-out with synovectomy, we initiated doxycycline and rifampicin combination therapy without an initial excisional arthroplasty, in this case. This treatment strategy can be another option before performing a major surgery which may affect the patient's quality of life. Turkish Başlık: Total Artroplasti Uygulanan Dizde Brusella Protez Enfeksiyonu: Artroskopi ve Medikal Tedavi ile Protezi Korunan Bir Olgu Sunumu Anahtar Kelimeler: Enfeksiyon; brusella; artroskopi; total diz protezi Enfeksiyon, total diz protezi uygulamalarının önemli bir komplikasyonudur ve ciddi bir morbiditeye sahiptir. Çalışmamızda çimentolu total diz protezi uygulanmasından dört yıl sonra ortaya çıkan brusella enfeksiyonu olgusu tanımladık. Literatürde, öncesinde eksizyonel artroplasti uygulanan yada uygulanmayan durumlar için antimikrobiyal kemoterapi stratejileri belirtilmiştir. Biz ise sunulan olguda artroskopi ve debridman ile sinoviektomi sonrası eksizyonel artroplasti yapmaksızın doksisiklin ve rifampisin kombinasyonu ile tedaviye başladık. Bu tedavi planı ile hastanın yaşam kalitesini etkileyecek majör bir cerrahi uygulamadan tedavi alternatifi oluşturulabilir.
Anahtar Kelimeler
Kaynakça
- Corbel MJ. Recent advances in brucellosis. J Med Microbiol 1997;46:101-3.
- Mousa AR, Muhtaseb SA, Almudallal DS, Khodeir SM, Marafie AA. Osteoarticular complications of brucellosis: a study of 169 cases. Rev Infect Dis 1987; 9:531-43.
- Yorgancigil H, Yayli G, Oyar O. Neglected case of osteoarticular Brucella infection of the knee. Croat Med J 2003;44:761-3.
- Ariza J, Pujol M, Valverde J, Nolla JM, Rufí G, Viladrich PF, et al. Brucellar sacroiliitis: findings in 63 episodes and current relevance. Clin Infect Dis 1993; 16:761-5.
- González-Gay MA, García-Porrşa C, Ibañez D, García-País MJ. Osteoarticular complications of bru- cellosis in an Atlantic area of Spain. J Rheumatol 1999;26:141-5.
- Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella arthritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990;49:994-8.
- Zaks N, Sukenik S, Alkan M, Flusser D, Neumann L, Buskila D. Musculoskeletal manifestations of brucel- losis: a study of 90 cases in Israel. Semin Arthritis Rheum 1995;25:97-102.
- Agarwal S, Kadhi SK, Rooney RJ. Brucellosis compli- cating bilateral total knee arthroplasty. Clin Orthop Relat Res 1991;(267):179-81.
- Kasim RA, Araj GF, Afeiche NE, Tabbarah ZA. Brucella infection in total hip replacement: case report and review of the literature. Scand J Infect Dis 2004;36:65-7.
- Malizos KN, Makris CA, Soucacos PN. Total knee arthroplasties infected by Brucella melitensis: a case report. Am J Orthop 1997;26:283-5.
- Marbach F, Saiah L, Fischer JF, Huismans J, Cometta A. Infection of a total knee prosthesis with Brucella spp. Rev Med Suisse 2007;3:1007-9. [Abstract]
- Ortega-Andreu M, Rodriguez-Merchan EC, Aguera- Gavalda M. Brucellosis as a cause of septic loosening of total hip arthroplasty. J Arthroplasty 2002;17:384-7.
- Ortí A, Roig P, Alcalá R, Navarro V, Salavert M, Martín C, et al. Brucellar prosthetic arthritis in a total knee replacement. Eur J Clin Microbiol Infect Dis 1997;16:843-5.
- Weil Y, Mattan Y, Liebergall M, Rahav G. Brucella prosthetic joint infection: a report of 3 cases and a review of the literature. Clin Infect Dis 2003;36:e81-6.
- Navarro V, Solera J, Martínez-Alfaro E, Sáez L, Escribano E, Pérez-Flores JC. Brucellar osteomyeli- tis involving prosthetic extra-articular hardware. J Infect 1997;35:192-4.
- Solera J, Martínez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs 1997;53:245-56.
- Solera J, Rodríguez-Zapata M, Geijo P, Largo J, Paulino J, Sáez L, et al. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. Antimicrob Agents Chemother 1995;39:2061-7.
Total Artroplasti Uygulanan Dizde Brusella Protez Enfeksiyonu: Artroskopi ve Medikal Tedavi ile Protezi Korunan Bir Olgu Sunumu
Öz
Enfeksiyon, total diz protezi uygulamalarının önemli bir komplikasyonudur ve ciddi bir morbiditeye sahiptir. Çalışmamızda çimentolu total diz protezi uygulanmasından dört yıl sonra ortaya çıkan brusella enfeksiyonu olgusu tanımladık. Literatürde, öncesinde eksizyonel artroplasti uygulanan yada uygulanmayan durumlar için antimikrobiyal kemoterapi stratejileri belirtilmiştir. Biz ise sunulan olguda artroskopi ve debridman ile sinoviektomi sonrası eksizyonel artroplasti yapmaksızın doksisiklin ve rifampisin kombinasyonu ile tedaviye başladık. Bu tedavi planı ile hastanın yaşam kalitesini etkileyecek majör bir cerrahi uygulamadan tedavi alternatifi oluşturulabilir.
Anahtar Kelimeler
Kaynakça
- Corbel MJ. Recent advances in brucellosis. J Med Microbiol 1997;46:101-3.
- Mousa AR, Muhtaseb SA, Almudallal DS, Khodeir SM, Marafie AA. Osteoarticular complications of brucellosis: a study of 169 cases. Rev Infect Dis 1987; 9:531-43.
- Yorgancigil H, Yayli G, Oyar O. Neglected case of osteoarticular Brucella infection of the knee. Croat Med J 2003;44:761-3.
- Ariza J, Pujol M, Valverde J, Nolla JM, Rufí G, Viladrich PF, et al. Brucellar sacroiliitis: findings in 63 episodes and current relevance. Clin Infect Dis 1993; 16:761-5.
- González-Gay MA, García-Porrşa C, Ibañez D, García-País MJ. Osteoarticular complications of bru- cellosis in an Atlantic area of Spain. J Rheumatol 1999;26:141-5.
- Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella arthritis: a study of 96 cases in Kuwait. Ann Rheum Dis 1990;49:994-8.
- Zaks N, Sukenik S, Alkan M, Flusser D, Neumann L, Buskila D. Musculoskeletal manifestations of brucel- losis: a study of 90 cases in Israel. Semin Arthritis Rheum 1995;25:97-102.
- Agarwal S, Kadhi SK, Rooney RJ. Brucellosis compli- cating bilateral total knee arthroplasty. Clin Orthop Relat Res 1991;(267):179-81.
- Kasim RA, Araj GF, Afeiche NE, Tabbarah ZA. Brucella infection in total hip replacement: case report and review of the literature. Scand J Infect Dis 2004;36:65-7.
- Malizos KN, Makris CA, Soucacos PN. Total knee arthroplasties infected by Brucella melitensis: a case report. Am J Orthop 1997;26:283-5.
- Marbach F, Saiah L, Fischer JF, Huismans J, Cometta A. Infection of a total knee prosthesis with Brucella spp. Rev Med Suisse 2007;3:1007-9. [Abstract]
- Ortega-Andreu M, Rodriguez-Merchan EC, Aguera- Gavalda M. Brucellosis as a cause of septic loosening of total hip arthroplasty. J Arthroplasty 2002;17:384-7.
- Ortí A, Roig P, Alcalá R, Navarro V, Salavert M, Martín C, et al. Brucellar prosthetic arthritis in a total knee replacement. Eur J Clin Microbiol Infect Dis 1997;16:843-5.
- Weil Y, Mattan Y, Liebergall M, Rahav G. Brucella prosthetic joint infection: a report of 3 cases and a review of the literature. Clin Infect Dis 2003;36:e81-6.
- Navarro V, Solera J, Martínez-Alfaro E, Sáez L, Escribano E, Pérez-Flores JC. Brucellar osteomyeli- tis involving prosthetic extra-articular hardware. J Infect 1997;35:192-4.
- Solera J, Martínez-Alfaro E, Espinosa A. Recognition and optimum treatment of brucellosis. Drugs 1997;53:245-56.
- Solera J, Rodríguez-Zapata M, Geijo P, Largo J, Paulino J, Sáez L, et al. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. Antimicrob Agents Chemother 1995;39:2061-7.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Mart 2008 |
| Yayımlandığı Sayı | Yıl 2008 Cilt: 2008 Sayı: 3 |