title: Late Streptococcus bovis infection of total knee replacement complicated by infective endocarditis and associated with colonic ulcers.
abstract: Streptococcus bovis is rare cause of late infections after total knee replacement (TKR). This report presents a case of confirmed late septic arthritis following TKR caused by S bovis that was further complicated with infective endocarditis resulting in aortic valve insufficiency in an immunecompetent patient. As an association between S bovis and gastrointestinal malignancies is suggested, a workup for such malignancies was performed that revealed non-malignant ulcers in patient's ascending colon. The patient is currently recovering from his aortic valve replacement surgery and is scheduled to have annual colonoscopies. His knee joint has improved; however, he developed constant pain because of underlying chronic infection in the affected joint and has difficulties mobilising. Therefore, a revision TKR is considered but postponed until he fully recovers from his heart valve surgery.
authors.affiliation: Department of Trauma and Orthopaedic Surgery, Macclesfield District General Hospital, Macclesfield, UK. dr.nagy@gmx.net
authors.forename: Mathias Thomas
authors.initials: MT
authors.lastname: Nagy
authors.forename: Sann Minn
authors.initials: SM
authors.lastname: Hla
authors.forename: Graham Watson
authors.initials: GW
authors.lastname: Keys
mesh_terms: D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D003093:Colitis, Ulcerative / Q000150:complications*; D004696:Endocarditis / Q000150:complications*; D006801:Humans; D008297:Male; D013290:Streptococcal Infections / Q000150:complications*; D016985:Streptococcus bovis / Q000302:isolation & purification*