title: Prosthetic hip infection due to Brucella melitensis: case report and literature review.
abstract: Prosthetic joint infection (PJI) due to Brucella spp. is extremely rare. We report the case of a prosthetic hip infection due to Brucella melitensis in a 51-year-old male patient. The initial presentation was a gluteal abscess. There was radiographic evidence of implant loosening. The patient was cured after prolonged treatment with streptomycin, rifampicin, and doxycycline, followed by 2-stage exchange of the prosthesis. Brucella spp. should be considered in the differential diagnosis of PJI in countries where brucellosis is endemic. The review of all cases previously reported shows that a conservative approach using antibiotics alone can be followed in patients without signs of implant loosening. In contrast, prolonged antibiotic treatment and prosthetic joint revision should be considered in patients with evidence of implant loosening.
authors.affiliation: Section of Microbiology, Service of Traumatology and Orthopaedic Surgery, University Hospital of Guadalajara, 19003 Guadalajara, Spain. danielt@sescam.jccm.es
authors.forename: Daniel
authors.initials: D
authors.lastname: Tena
authors.forename: Oscar
authors.initials: O
authors.lastname: Romanillos
authors.forename: Manuel
authors.initials: M
authors.lastname: Rodríguez-Zapata
authors.forename: Basilio
authors.initials: B
authors.lastname: de la Torre
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Pérez-Pomata
authors.forename: Ramón
authors.initials: R
authors.lastname: Viana
authors.forename: José María
authors.initials: JM
authors.lastname: Chaves
authors.forename: Julia
authors.initials: J
authors.lastname: Bisquert
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D017347:Brucella melitensis / Q000302:isolation & purification*; D002006:Brucellosis / Q000175:diagnosis / Q000382:microbiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents