title: Helicobacter cinaedi knee infection after arthroscopy in an immunocompetent patient.
abstract: An otherwise healthy 36-year-old man was hospitalised due to a traumatic tear of the meniscus in the left knee. An arthroscopy was performed and his meniscus was partially resected. Thirty days later, he was rehospitalised with arthritis in the left knee and cellulitis on the left tibia. Helicobacter cinaedi was isolated from the synovial fluid, which was incubated in a BACTEC Paediatric bottle. The patient was treated with oral rifampicin and moxifloxacin for 6 weeks with good clinical response without relapse. The source of the infection was not found. The case emphasises the importance of incubating the synovial fluid in a rich medium such as a BACTEC Peds Plus/F bottle. Physicians and microbiologists should be aware of H. cinaedi as a human pathogen causing a range of disease manifestations, including infective arthritis and cellulitis, particularly if symptoms evolve in the weeks following a surgical procedure.
authors.affiliation: Department of Clinical Microbiology, Aalborg University Hospital, Aalborg, Denmark Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Hans Linde
authors.initials: HL
authors.lastname: Nielsen
authors.affiliation: Department of Clinical Microbiology, Viborg Hospital, Viborg, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Prag
authors.affiliation: Department of Microbiology and Infection Control, Statens Serum Institut, Copenhagen, Denmark.
authors.forename: Karen Angeliki
authors.initials: KA
authors.lastname: Krogfelt
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001182:Arthroscopy / Q000009:adverse effects*; D005334:Fever; D024841:Fluoroquinolones / Q000008:administration & dosage; D016998:Helicobacter / Q000302:isolation & purification*; D016481:Helicobacter Infections / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D000077266:Moxifloxacin; D012293:Rifampin / Q000008:administration & dosage; D013045:Species Specificity; D013582:Synovial Fluid / Q000382:microbiology*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D000077266:Moxifloxacin; D012293:Rifampin