Culture-negative Prosthetic Joint Arthritis Related to Coxiella Burnetii

Overview

Journal Am J Med

Specialty General Medicine

Date 2014 Mar 26

PMID 24662624

Citations 27

Authors

Matthieu Million

Lucile Bellevegue

Anne-Sophie Labussiere

Michal Dekel

Tristan Ferry

Philippe Deroche

Cristina Socolovschi

Serge Cammilleri

Didier Raoult

Affiliations

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Abstract

Background: The number of hip and knee arthroplasty procedures is steadily increasing as life expectancy increases. Coxiella burnetii may be responsible for culture-negative prosthetic joint arthritis and is associated with antibiotic failure and repeated surgeries. We report the first case series of C. burnetii-related culture-negative prosthetic joint arthritis.

Methods: Cases were retrieved from the French National Referral center for Q fever. Diagnosis was based on (18)fluorodeoxyglucose positron emission tomography, serology, broad-range polymerase chain reaction, and C. burnetii-specific polymerase chain reaction.

Results: Four cases of C. burnetii-related culture-negative prosthetic joint arthritis were found. Standard bacteriologic procedures would have missed the diagnosis in all cases. Etiologic diagnosis improved the outcome in all but 1 case.

Conclusions: A systematic, comprehensive diagnostic strategy should be used in culture-negative prosthetic joint arthritis, including testing for C. burnetii in endemic areas.

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