A recurrent prosthetic joint infection caused by : case report and literature review.

Prosthetic knee joint infection caused by is uncommon and only one case of recurrent infection has previously been described. Here, we describe the case of a 77-year-old male patient who was admitted to the teaching hospital of Rennes (France) with bilateral and nocturnal gonalgia evolving for 1 month. He had bilateral knee prosthesis 10 years ago, and a history of large B-cell lymphoma in remission. A diagnosis of infective endocarditis, with prosthetic knee infection, was made, with positive cultures of synovial fluids and blood; colonies of were identified by MALDI-TOF MS. Initial treatment involved debridement, implant retention surgery and intravenous amoxicillin (12 g day) for 6 weeks with gentamicin 3 mg kg day added for the first 4 days. One year later, a second episode of infection occurred, suggesting a recurrence or reinfection due to the same bacterial species. The patient was finally cured after a two-stage exchange with a cemented articulated spacer and a 3 month course of amoxicillin (12 g day, iv). Different characteristics of infection were discussed, with a review of all cases of prosthetic joint infections caused by species. This case highlights the need for a long-term survey of patients, and a good knowledge of their environment to avoid any risk of reinfection.