Cheong Teddy, Moo Ing How
Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore.
Department of Orthopaedic Surgery, Changi General Hospital, 2 Simei St 3, 529889, Singapore.
Int J Surg Case Rep. 2025 Apr 25;131:111380. doi: 10.1016/j.ijscr.2025.111380.
Haemophilus parainfluenzae is a common commensal of the upper respiratory tract and is an extremely rare cause of periprosthetic joint infections (PJI).
A 92-year-old male presented with five days of right knee pain, reduced knee range of motion and raised inflammatory markers. He was diagnosed with a right total knee arthroplasty (TKA) PJI caused by Haemophilus parainfluenzae via knee aspiration fluid culture and was treated with debridement, antibiotics and implant retention (DAIR). Surgery was uneventful and he was treated with a six-week course of intravenous antibiotics followed by six months of suppression via oral antibiotics. At the one-year post-operative mark, there was no recurrence of infection.
There are only five reported cases of Haemophilus parainfluenzae PJI, of which only one case had no immunocompromised state or prior dental work. Our case is the second case in existing literature that involves PJI from this bacterium in a healthy individual with no identifiable risk factors. Though Haemophilus parainfluenzae is a rare cause of PJI, principles of surgical intervention and treatment in PJI still apply.
PJI caused by Haemophilus parainfluenzae is a rare occurrence. Prompt microbiological diagnosis is vital in ensuring favourable outcomes through surgical debridement combined with culture-directed antimicrobial agents in the treatment of rare infections such as this.
副流感嗜血杆菌是上呼吸道常见的共生菌，是人工关节周围感染（PJI）极为罕见的病因。
一名92岁男性，出现右膝疼痛5天，膝关节活动范围减小，炎症指标升高。通过膝关节穿刺液培养，他被诊断为由副流感嗜血杆菌引起的右全膝关节置换术（TKA）PJI，并接受了清创、抗生素治疗和植入物保留（DAIR）。手术顺利，他接受了为期六周的静脉抗生素治疗，随后通过口服抗生素进行了六个月的抑制治疗。术后一年时，感染未复发。
仅报告了5例副流感嗜血杆菌PJI病例，其中只有1例没有免疫功能低下状态或既往牙科治疗史。我们的病例是现有文献中第二例涉及该细菌在无明显危险因素的健康个体中引起PJI的病例。尽管副流感嗜血杆菌是PJI的罕见病因，但PJI的手术干预和治疗原则仍然适用。
副流感嗜血杆菌引起的PJI很少见。及时进行微生物学诊断对于通过手术清创结合针对培养结果的抗菌药物治疗此类罕见感染以确保良好预后至关重要。
