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Successful treatment of periprosthetic joint infection caused by Granulicatella para-adiacens with prosthesis retention: a case report

Overview of attention for article published in BMC Musculoskeletal Disorders, April 2016
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Title
Successful treatment of periprosthetic joint infection caused by Granulicatella para-adiacens with prosthesis retention: a case report
Published in
BMC Musculoskeletal Disorders, April 2016
DOI 10.1186/s12891-016-1008-9
Pubmed ID
Authors

Nora Renz, Fabienne Chevaux, Olivier Borens, Andrej Trampuz

Abstract

Granulicatella and Abiotrophia spp. are difficult to detect due to their complex nutritional requirements. Infections with these organisms are associated with high treatment failure rates. We report the first implant-associated infection caused by Granulicatella para-adiacens, which was cured with anti-microbial treatment consisting of anti-biofilm-active rifampin and debridement, exchange of mobile parts and retention of the prosthesis. Patient with a history of left hip arthroplasty presented with acute onset of fever, pain and limited range of motion of the left hip. Arthrocentesis of the affected joint yielded purulent fluid and exchange of mobile parts of the prosthesis, but retention of fixed components was performed. Granulicatella para-adiacens grew from preoperative and intraoperative cultures, including sonication fluid of the removed implant. The transesophageal echocardiography showed a vegetation on the mitral valve; the orthopantogram demonstrated a periapical dental abscess. The patient was treated with intravenous penicillin G and gentamicin for 4 weeks, followed by levofloxacin and rifampin for additional 2 months. At discharge and at follow-up 1, 2 and 5 years later, the patient was noted to have a functional, pain-free, and radiologically stable hip prosthesis and the serum C-reactive protein was normal. Although considered a difficult-to-treat organism, we report a successful treatment of the Granulicatella hip prosthesis infection with prosthesis retention and a prolonged antibiofilm therapy including rifampin. The periapical dental abscess is considered the primary focus of hematogenously infected hip prosthesis, underlining the importance treatment of periodontitis prior to arthroplasty and of proper oral hygiene for prevention of hematogenous infection after arthroplasty.

Twitter Demographics

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Mendeley readers

The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 50 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 8 16%
Student > Master 6 12%
Student > Postgraduate 6 12%
Student > Ph. D. Student 6 12%
Other 4 8%
Other 7 14%
Unknown 13 26%
Readers by discipline Count As %
Medicine and Dentistry 24 48%
Biochemistry, Genetics and Molecular Biology 2 4%
Nursing and Health Professions 2 4%
Immunology and Microbiology 2 4%
Linguistics 1 2%
Other 2 4%
Unknown 17 34%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 April 2016.
All research outputs
#6,540,472
of 7,551,260 outputs
Outputs from BMC Musculoskeletal Disorders
#1,821
of 1,989 outputs
Outputs of similar age
#227,458
of 269,823 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#72
of 82 outputs
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We're also able to compare this research output to 82 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.