title: Lactobacillus as a rare cause of an infected total knee replacement: a case report.
abstract: BACKGROUND
  We report a rare case of an infected revision total knee replacement as a result of a Lactobacillus species infection. Lactobacillus infections have been associated with prolonged broad-spectrum antibiotic use. This can have implications in revision surgery, especially when patients have been on previous long-term suppressive antibiotic therapy.
  
  
  METHODS
  An 81-year-old British man with a previous history of complex revision knee arthroplasty for infection presented with a hot, swollen knee joint. He had previously been on long-term suppressive antibiotic therapy. Aspiration of the knee joint yielded a culture of Lactobacillus species.
  
  
  CONCLUSIONS
  In patients undergoing revision joint arthroplasty, especially for previous infection, the presence of common and uncommon bacterial species must be excluded and eradicated before further surgical intervention.
authors.forename: Navraj
authors.initials: N
authors.lastname: Atwal
authors.forename: Akintunde
authors.initials: A
authors.lastname: George
authors.forename: Ben
authors.initials: B
authors.lastname: Squires
authors.forename: Clayton H
authors.initials: CH
authors.lastname: Marsh