Hematogenous infection of a total knee arthroplasty with Klebsiella pneumoniae in association with occult adenocarcinoma of the cecum.
Acute hematogenous septic arthritis caused by the genus Klebsiella is extremely rare. This case report describes a prosthetic joint infected with Klebsiella pneumoniae via acute hematogenous spread. This is the first reported case of K pneumoniae pyogenic arthritis with a coexisting occult colonic adenocarcinoma. The patient was treated successfully with open irrigation, debridement, polyethylene spacer exchange, and chronic suppressive antibiotics. The underlying colon cancer was recognized early, and the patient responded well to surgery and adjuvant chemotherapy. This case illustrates the importance of having a high index of suspicion for underlying pathologic processes when an unusual organism presents as the cause of septic arthritis.
Chodos
Marc D
MD
Department of Orthopaedic Surgery, Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224-2780, USA.
Johnson
Carl A
CA
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001170:Arthritis, Infectious / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D019645:Arthroplasty, Replacement, Knee; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D003646:Debridement; D006801:Humans; D007710:Klebsiella Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D007711:Klebsiella pneumoniae; D007720:Knee Prosthesis / Q000382:microbiology*; D008297:Male; D008875:Middle Aged; D009382:Neoplasms, Unknown Primary / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D016459:Prosthesis-Related Infections / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000900:Anti-Bacterial Agents