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Case Reports
. 2025 Mar 12;17(3):e80460.
doi: 10.7759/cureus.80460. eCollection 2025 Mar.

A Rare Cause of Infection Following Total Knee Arthroplasty: Abiotrophia defectiva Linked to Recurrent Urinary Tract Infections

Anas Nooh  1 , Bashar Reda  1 , Raed M Sharaf  2 , Mohammed Alsubaie  3 , Faisal F Alzahrani  3
Affiliations
Case Reports

A Rare Cause of Infection Following Total Knee Arthroplasty: Abiotrophia defectiva Linked to Recurrent Urinary Tract Infections

Anas Nooh et al. Cureus. .

Abstract

Abiotrophia defectiva (A. defectiva) is a rare cause of prosthetic joint infection (PJI), and its role in surgical site infections remains unclear. A 66-year-old female developed an A. defectiva infection two years following primary right total knee arthroplasty (TKA). The patient presented with fever, knee pain, and urinary tract infection (UTI). She had a history of recurrent UTIs, likely contributing to the hematogenous spread of the pathogen. Knee aspiration was initially negative; however, subsequent cultures detected A. defectiva. The PJI was managed with surgical debridement, removal of prosthetic components, and a dynamic antibiotic spacer. We highlight the challenges associated with A. defectiva PJIs. The pathogen's fastidiousness complicates identification, and its biofilm formation on prosthetic materials makes eradication difficult. Despite its rarity, A. defectiva should be considered as a possible cause of PJIs, particularly in patients with recurrent UTIs. Early recognition and aggressive management are crucial.

Keywords: abiotrophia defectiva; case report; prosthetic joint infection; total knee arthroplasty; urinary tract infection.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Preoperative lateral and anteroposterior views of the right knee joint.
Figure 2
Figure 2. Removal of the femoral and tibial components and insertion of the antibiotic-loaded cement.
Figure 3
Figure 3. Intraoperative view of the right knee antibiotic knee spacer.
Figure 4
Figure 4. Postoperative cross-table and anteroposterior views of the right antibiotic knee spacer.
See this image and copyright information in PMC

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