title: Arthroplasty infection by Priopionibacterium granulosum treated with reimplantation despite ongoing purulent-appearing fluid collection.
abstract: We present the first case of infection in a native or prosthetic joint by Propionibacterium granulosum in which a patient developed symptoms of prosthetic hip infection 5 years after primary surgery. The patient required multiple operative debridements to eradicate the infection and was successfully reimplanted despite an ongoing purulent-appearing, although sterile, fluid collection at the time of reimplantation. There is no clinical or laboratory evidence of infection at 3 years post-reimplantation, and the patient has a well-functioning total hip arthroplasty. P granulosum is a low-virulence but highly-inflammatory organism. It seems to produce a large fluid collection that may require multiple debridements. To our knowledge, there are no reported cases of native or prosthetic joint infection from P granulosum. We present the first case here.
authors.affiliation: Department of Orthopaedics & Rehabilitation, University of Iowa Hospitals & Clinics, Iowa City, Iowa 52242, USA.
authors.forename: Lukas M
authors.initials: LM
authors.lastname: Nystrom
authors.forename: Casi M
authors.initials: CM
authors.lastname: Wyatt
authors.forename: Nicolas O
authors.initials: NO
authors.lastname: Noiseux
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip; D016908:Gram-Positive Bacterial Infections / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D011424:Propionibacterium; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000628:therapy*; D012086:Reoperation