Could it be Brucella melitensis? Recognizing and managing a rare pathogen in periprosthetic infections.

IF 1.5 4区 医学 Q4 MEDICINE, RESEARCH & EXPERIMENTAL
Journal of International Medical Research Pub Date : 2025-05-01 Epub Date: 2025-05-28 DOI:10.1177/03000605251337568
Mehmet Süleyman Abul, Ömer Faruk Sevim, Muhammed Enes Karataş, Furkan Başak
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引用次数: 0

Abstract

Periprosthetic joint infections caused by Brucella melitensis are rare and present significant diagnostic and therapeutic challenges, especially in endemic regions such as Anatolia. The indolent nature of Brucella infections often results in subclinical presentations, complicating early detection and management. This case series highlights the importance of recognizing Brucella melitensis as a potential pathogen in periprosthetic joint infection and explores the treatment options for this condition. Herein, we present five cases of Brucella melitensis-associated periprosthetic joint infections involving three hip replacements and two knee replacements. Diagnoses were confirmed through advanced diagnostic techniques, including prolonged cultures and serological testing, as routine methods often yielded negative results. Two patients underwent one-stage revision arthroplasty, two underwent two-stage revision arthroplasty, and one patient was managed conservatively with targeted antibiotics due to the absence of prosthetic loosening. All patients showed excellent functional recovery and infection eradication at follow-up, with normalized inflammatory markers and no evidence of recurrence. This case series emphasizes the importance of clinical suspicion and the use of advanced diagnostics in endemic areas for timely recognition of Brucella-associated periprosthetic joint infections. One-stage revision arthroplasty combined with prolonged antibiotic therapy demonstrated favorable outcomes and may serve as an effective treatment strategy.

会是布鲁氏菌吗?识别和处理假体周围感染的罕见病原体。
由梅利特布鲁氏菌引起的假体周围关节感染是罕见的,并提出了重大的诊断和治疗挑战,特别是在安纳托利亚等流行地区。布鲁氏菌感染的惰性通常导致亚临床表现,使早期发现和管理复杂化。本病例系列强调了认识到布鲁氏菌作为假体周围关节感染的潜在病原体的重要性,并探讨了这种情况的治疗选择。在此,我们提出5例与梅氏布鲁氏菌相关的假体周围关节感染,包括3例髋关节置换术和2例膝关节置换术。通过先进的诊断技术确诊,包括长期培养和血清学检测,因为常规方法经常产生阴性结果。2例患者接受一期翻修关节置换术,2例接受两期翻修关节置换术,1例患者因假体无松动而接受靶向抗生素保守治疗。所有患者在随访中均表现出良好的功能恢复和感染根除,炎症指标正常化,无复发迹象。这一系列病例强调了临床怀疑和在流行地区使用先进诊断方法的重要性,以便及时识别与布鲁氏菌相关的假体周围关节感染。一期翻修关节置换术联合长期抗生素治疗显示出良好的结果,可能是一种有效的治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
0.00%
发文量
555
审稿时长
1 months
期刊介绍: _Journal of International Medical Research_ is a leading international journal for rapid publication of original medical, pre-clinical and clinical research, reviews, preliminary and pilot studies on a page charge basis. As a service to authors, every article accepted by peer review will be given a full technical edit to make papers as accessible and readable to the international medical community as rapidly as possible. Once the technical edit queries have been answered to the satisfaction of the journal, the paper will be published and made available freely to everyone under a creative commons licence. Symposium proceedings, summaries of presentations or collections of medical, pre-clinical or clinical data on a specific topic are welcome for publication as supplements. Print ISSN: 0300-0605
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