Periprosthetic knee infection after benign tumor excision complicated by carbapenem resistant Enterobacteriaceae: A case report

Jennifer P Adams; Daniel Habenicht; Duncan Ramsey

doi:10.1016/j.amsu.2022.104292

Periprosthetic knee infection after benign tumor excision complicated by carbapenem resistant Enterobacteriaceae: A case report

Ann Med Surg (Lond). 2022 Aug 1:81:104292. doi: 10.1016/j.amsu.2022.104292. eCollection 2022 Sep.

Authors

Jennifer P Adams¹, Daniel Habenicht¹, Duncan Ramsey²

Affiliations

¹ University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA.
² Department of Orthopedic Surgery, University of Texas Rio Grande Valley School of Medicine, Harlingen, TX, USA.

Abstract

Introduction: Periprosthetic joint infection (PJI) is a major complication after total knee arthroscopy. Enterobacter is a rare cause of PJI.

Case presentation: We present a 65 year old Caucasian man who presented with acute right knee PJI with Carbapenem-resistant Enterobacteriaceae (CRE) two months after undergoing right knee intra-articular mass removal with endoprosthetic reconstruction. The periprosthetic joint infection (PJI) was treated with revision with 1-stage static spacer and IV meropenem.

Discussion: CRE is an uncommon cause of PJI, but when it does occur, it commonly infects patients who are immunosuppressed or have specific risk factors. For an immunocompetent patient with CRE PJI, we suggest further workup for other systemic disease.

Conclusion: This case demonstrates the importance of early diagnosis and treatment of CRE joint infections and the need for a multidisciplinary approach that includes aggressive surgical intervention and tailored antimicrobial therapy.

Keywords: Carbapenem resistant enterobacteriaceae; Periprosthetic infection; Revision arthroplasty; Total knee arthroplasty.

Publication types

Case Reports