Rare Occurrence of Acute Hematogenous Periprosthetic Joint Infection Due to Fusobacterium Nucleatum in the Background of a Dental Procedure: A Case Report

Abstract

Objective: Fusobacterium nucleatum is an anaerobic gram-negative bacilli that is one of the oral and other mucosal surface microbiota. It involves a wide range of human diseases and was first found in periodontal diseases, but reports of bone-related infections caused by F. nucleatum are rare, especially periprosthetic joint infections (PJI).

Methods: Here, we present the first case of acute hematogenous PJI of the hip joint caused by F. nucleatum, and debridement, antibiotics, and implant retention (DAIR) was performed.

Results: The patient was successfully treated with DAIR, identification of isolates by metagenomics next-generation sequencing was confirmed by polymerase chain reaction.

Conclusions: For stable acute hematogenous PJI after hip replacement, quick and accurate diagnosis, the identification of pathogenic microorganisms, and the use of DAIR combined with sufficient sensitive antibiotics have a certain clinical effect and can achieve the purpose of both preserving the prosthesis and infection control.

Keywords: Debridement, antibiotics, and implant retention (DAIR); Fusobacterium nucleatum; Periprosthetic joint infections.

Fig. 1

Admission X‐ray of the patient showed local bone resorption around the left prosthesis and no obvious loosening and dislocation of the left prosthesis.

Fig. 2

Intraoperative photograph shows a significant amount of thick dark pus and polyethylene abrasive particles in the subcutaneous and articular capsule.

Fig. 3

A postoperative follow‐up X‐ray showing the position of the prosthesis was good and the bone callus grew well, following eradication of Fusobacterium nucleatum infection.