Citrobacter koseri as a Cause of Early Periprosthetic Infection After Primary Total Hip Arthroplasty

• Published in: The Journal of arthroplasty Vol. 26; no. 6; pp. 978.e13 - 978.e16
• Main Authors: Kaufman, Adam M., MD, Watters, Tyler Steven, MD, Henderson, Robert A., BA, MSc, Wellman, Samuel S., MD, Bolognesi, Michael P., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-09-2011
• Subjects: Anti-Bacterial Agents - therapeutic use; Arthroplasty, Replacement, Hip - instrumentation; Arthroplasty, Replacement, Hip - methods; beta-Lactams - therapeutic use; Citrobacter koseri; Citrobacter koseri - isolation & purification; Citrobacter koseri - pathogenicity; Debridement - methods; early infection; Enterobacteriaceae Infections - microbiology; Enterobacteriaceae Infections - therapy; Hip Joint - diagnostic imaging; Hip Joint - surgery; Hip Prosthesis - microbiology; Humans; Joint Diseases - surgery; Male; Middle Aged; Orthopedics; periprosthetic; Prosthesis-Related Infections - microbiology; Prosthesis-Related Infections - therapy; Radiography; Therapeutic Irrigation; total hip arthroplasty; Treatment Outcome; total hip arthroplasty; early infection; Citrobacter koseri; periprosthetic
• ISSN: 0883-5403; 1532-8406
• DOI: 10.1016/j.arth.2010.10.004

Abstract Periprosthetic joint infection in the acute setting is usually caused by gram-positive species and remains a major problem facing total joint surgeons. We report a case of a 53-year-old male who presented with drainage 3 weeks after primary total hip arthroplasty. Citrobacter koseri was cultured from an infected hematoma in his deep tissues. Surgical treatment included irrigation and debridement with femoral head and liner exchange. He received a 6-week course of ertapenem and is currently asymptomatic. We present C. koseri as a rare cause of acute periprosthetic infection and offer an effective treatment protocol.