[A man with pain following a knee operation]

Abstract

Background: Infection after arthroscopy is a rare, but feared complication. Aggressive infection with atypical microbiological agents severely complicates the clinical evaluation.

Case presentation: A man in his thirties, previously healthy man had undergone elective knee arthroscopy with synovectomy. Eight days after surgery he was admitted to hospital with swelling and pain in the operated knee. Re-arthroscopy revealed bleeding in the affected joint, but no obvious signs of infection. The patient developed severe pain, fever and elevated infection parameters. Staphylococcus lugdunensis was detected in the joint fluid taken during re-arthroscopy. He was treated with a combination of antibiotics, including cloxacillin, gentamicin and linezolid, and made a full recovery after treatment.

Interpretation: S lugdunensis is a highly virulent, coagulase-negative staphylococcus, capable of causing significant infections. It should never be dismissed as a contaminant without careful review.