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Journal of Bone and Joint Infection An open-access journal of the European Bone and Joint Infection Society and the MusculoSkeletal Infection Society
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Volume 5, issue 1
J. Bone Joint Infect., 5, 50–53, 2020
https://doi.org/10.7150/jbji.40635
© Author(s) 2020. This work is distributed under
the Creative Commons Attribution 4.0 License.
J. Bone Joint Infect., 5, 50–53, 2020
https://doi.org/10.7150/jbji.40635
© Author(s) 2020. This work is distributed under
the Creative Commons Attribution 4.0 License.

Case report 21 Feb 2020

Case report | 21 Feb 2020

Near-fatal Periprosthetic Infection with Streptobacillus moniliformis: Case and Review

Matthew Smallbones1, Mohammed Monem1, Marina Baganeanu1, Michael Okocha2, and Rajesh Sofat1 Matthew Smallbones et al.
  • 1Department of Trauma & Orthopaedics, Lister Hospital, East and North Herts NHS Trust, Lister Hospital, Stevenage, Hertfordshire, SG1 4AB, United Kingdom
  • 2Department of Trauma & Orthopaedics, Brunel Building, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, United Kingdom.

Keywords: Streptobacillus, moniliformis, periprosthetic, joint, infection, rodent

Abstract. Case presentation of a 66 year old female with penicillin hypersensitivity, who suffered late acute periprosthetic infection of her total knee replacement. After emergency surgery and admission to intensive care, the responsible organism was later identified as Streptobacillus moniliformis.

This serves as the first documented case of Streptobacillus moniliformis prosthetic joint infection. As standard culture mediums provide an exceedingly low detection rate, 16S PCR should instead be used as the first line method of identification. As a result, its detection is largely dependent on clinicians recognising relevant factors within the patient's history, namely close contact with rodents. In a patient with penicillin hypersensitivity, carbapenems have demonstrated potential as an effective treatment strategy.

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