Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review

Authors

  • Anis Tebourbi Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Khaled Hadhri Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia http://orcid.org/0000-0001-7424-8592
  • Mohamed Ben Salah Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia
  • Ramzi Bouzidi Department of Orthopedics and Traumatology Mongi Slim Hospital La Marsa Tunisia
  • Mondher Kooli Department of Orthopedics and Traumatology Charles Nicolle Hospital Boulevard 9 Avril 1006 Tunis Tunisia

DOI:

https://doi.org/10.15438/rr.6.4.164

Keywords:

Total hip arthroplasty, Prosthetic joint infection, Brucellosis.

Abstract

Context:

Brucellosis is actually considered to be the commonest zoonotic infection worldwide; conversely prosthetic infection due to brucella is extremely rare. Although diagnostic is easily achieved, management of such situations is extremely challenging.

Aims

To report the case of prosthetic hip loosening due to brucellar infection, discuss management manners and to summarize data about 19 cases reported in the literature.

Methods

We report the case of a 73-year-old woman with brucellar prosthetic hip loosening treated with 2-stage exchange of the prosthesis and prolonged double antibiotherapy

Results

At two years follow up the patient is pain free with total functional recovery and no clinical and radiographic signs of prosthetic loosening

Conclusions

Brucella should be evocated as a cause of total joint arthroplasty infection especially in patients from endemic regions and with occupational exposure. Antibiotic treatment alone can be followed if there are no signs of implant loosening. Tow stage revision should be considered in other cases.

 

References

Corbel MJ. Brucellosis: an overview. Emerg Infect Dis. 1997;3:213-2.

Pappas G, Akritidis N, Bosilkovski M, Tsianos E. Brucellosis. N Engl J Med. 2005;352: 2325-36.

Mousa AR, Muhtaseb SA, Almudallal DS, Khodeir SM, Marafie AA. Osteoarticular complications of brucellosis: a study of 169 cases. Rev Infect Dis. 1987;9:531-43.

Rote-Querol J. Osteo-articular sites of brucellosis. Ann Rheum Dis.1957;16:63-8.

Ariza J, Gudiol F, Valverde J et al. Brucellar spondylitis: a detailed analysis based on current findings. Rev Infect Dis. 1985;7:656-64.

Ariza J, Pujol M, Valverde J et al. Brucellar sacroiliitis: findings in 63 episodes and current relevance. Clin Infect Dis. 1993;16:761-5.

Gonzalez-Gay MA, Garcia-Porrua C, Ibanez D, Garcia-Pais MJ. Osteoarticular complications of brucellosis in an Atlantic area of Spain. J Rheumatol.1999;26:141-5.

Gotuzzo E, Alarcon GS, Bocanegra TS et al. Articular involvement in human brucellosis: a retrospective analysis of 304 cases. Semin Arthritis Rheum. 1982;12:245–55.

Khateeb MI, Araj GF, Majeed SA, Lulu AR. Brucella arthritis: a study of 96 cases in Kuwait. Ann Rheum Dis. 1990;49:994-8.

Solera J, Lozano E, Martinez-Alfaro E et al. Brucellar spondylitis: review of 35 cases and literature survey. Clin Infect Dis. 1999;29:1440-9.

Zaks N, Sukenik S, Alkan M et al. Musculoskeletal manifestations of brucellosis: a study of 90 cases in Israel. Semin Arthritis Rheum. 1995;25:97-102.

Lentino JR. Prosthetic joint infections: bane of orthopedists, challenge for infectious disease specialists. Clin Infect Dis. 2003;36(9):1157–61.

Blom AW, Brown J, Taylor AH, et al. Infection after total knee arthroplasty. J Bone Joint Surg Br. 2004;86(5):688–91.

Blom AW, Taylor AH, Pattison G, et al. Infection after total hip arthroplasty: The Avon experience. J Bone Joint Surg Br. 2003; 85(7):956–9.

Zimmerli W, Trampuz A, Ochsner PE. Prosthetic-joint infections. N Engl J Med. 2004;351(16):1645–54.

Jones RB, Smith J, Hofmann A, Rogers D. Secondary infection of a total hip replacement with Brucella abortus. Orthopedics. 1983;6:184–6.

Agarwall S, Kadhi SKM, Rooney RJ. Brucellosis complicating bilateral knee arthroplasty. ClinOrthop. 1991;267:179–81.

Malizos KN, Makris CA, Soucacos PN. Total knee arthroplasties infected by Brucella melitensis: case report. Am J Orthop. 1997;26:283–5.

Orti A, Roig P, Alcala R, et al. Brucellar prosthetic arthritis in a total knee replacement. Eur J Clin Microbiol Infect Dis. 1997;16:843–5.

Ortega M, Rodriguez EC, Aguera M. Brucellosis as a cause of septic loosening of total hip arthroplasty. J Arthrop. 2002;17:384–7.

Weil Y, Mattan Y, Liebergall M, Rahav G. Brucella prosthetic joint infection: a report of 3 cases and review of the literature. Clin Infect Dis. 2003;36:81–6.

Kasim RA, Araj GF, Afeiche NE, Tabbarah ZA. Brucella infection in total hip replacement: case report and review of the literature. Scand J Infect Dis. 2004;36:65–7.

Cairo M, Calbo E, Gomez L at al. Foreign-body osteoarticular infection by Brucella melitensis. J Bone Joint Surg. 2006;88:202–4.

Tena D, Romanillos O, Rodríguez-Zapata M at al. Prosthetic hip infection due to Brucella melitensis: case report and literature review. Diagn Microbiol Infect Dis. 2007;58(4):481-5.

Tassinari E, Di Motta D, Giardina F, Traina F, De Fine M, Toni A. Brucella infection in total knee arthroplasty. Case report and revision of the literature. Chir Organi Mov. 2008;92(1):55-9.

Ruiz-Iban MA, Crespo P, Diaz-Peletier R, Rozado AM, Lopez-Pardo A. Total hip arthroplasty infected by Brucella: a report of two cases. J OrthopSurg. 2006;14(1):99-103

Erdogan H, Cakmak G, Erdogan A, Arslan H. Brucella melitensis infection in total knee arthroplasty: a case report. Knee Surg Sports Traumatol Arthrosc. 2010;18(7):908-10.

Wünschel M, Olszowski AM, Weissgerber P, Wülker N, Kluba T. Chronic brucellosis: a rare cause of septic loosening of arthroplasties with high risk of laboratory-acquired infections. Z OrthopUnfall. 2011;149(1):33-6.

Franco MP, Mulder M, Gilman RH, Smits HL. Human brucellosis. Lancet Infect Dis. 2007;7:775-86.

Sanchez-Sousa A, Torres C, Campello MG at al. Serological diagnosis of neurobrucellosis. J Clin Pathol. 1990;43:79 – 81.

Del Pozo I.L., Patel R. Infection associated with prosthetic joints, N Engl J Med. 2009;361(8):787-794.

Corbel MJ. Brucellosis in Humans and Animals. Geneva: World Health Organization, 2006.

Joint FAO-WHO expert committee on brucellosis. World Health Organ Tech Rep Ser. 1986;740:1-132.

Ariza J, Bosilkovski M, Cascio A et al. Perspectives for the treatment of brucellosis in the 21st century: the Ioannina recommendations. PLoS Med. 2007;4:317.

Published

2016-12-30

How to Cite

Tebourbi, A., Hadhri, K., Ben Salah, M., Bouzidi, R., & Kooli, M. (2016). Prosthetic Hip Loosening Due to Brucellar Infection: Case Report and Literature Review. Reconstructive Review, 6(4). https://doi.org/10.15438/rr.6.4.164

Issue

Section

Case Report

Most read articles by the same author(s)