One-stage Revision in a Brucella Prosthetic Hip Joint Infection with Late Presentation: A Case Report

Abstract

A 69-year-old female patient, who had been operated on 20 years ago (unipolar hip prosthesis), presented with a complaint of pain in the thigh and a limp with onset 1 year before. An X ray revealed stem subsidence and varus collapse. One-stage revision hip replacement was performed in view of poor cardiac status, and Brucella melitensis grew in the tissue culture. Oral doxycycline and rifampicin were administered for six weeks. The patient remained asymptomatic until the last follow up. Prosthetic joint infection by B. melitensis should be considered in a late onset, insidious presentation in an endemic country. One exchange arthroplasty with the administration of systemic antibiotics resulted in a good outcome.

Keywords: Brucella; arthroplasty, replacement, hip; bone cements; hip; prosthesis-related infections.

Fig. 1

Preoperative radiograph on anteroposterior (AP) and lateral views.

Fig. 2

Immediate postoperative X-ray on AP view.

Fig. 1

Radiografia pré-operatória em projeções anteroposterior e em perfil.

Fig. 2

Radiografia obtida no período pós-operatório imediato em projeção anteroposterior.