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Arthroscopy ; 19(3): E26, 2003 Mar.
Article in English | MEDLINE | ID: mdl-12627143

ABSTRACT

A case of septic arthritis caused by Erysipelothrix rhusiopathiae, after an arthroscopically assisted anterior cruciate ligament (ACL) substitution in a non-immunosuppressed patient is described. An 18-year-old man underwent an ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, the patient developed fever, knee pain, and effusion without erythema or suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate, C-reactive protein level, and white blood cell count were high. The joint was aspirated and the fluid was sent for cultures that revealed the presence of E rhusiopathiae. E rhusiopathiae is widespread in nature, it is transmitted by direct cutaneous laceration, and it causes septic arthritis, meningitis, endocarditis, and renal failure in immunosuppressed people with poor prognosis. In our case, the infection was treated with arthroscopic lavage and debridement, retention of the graft and hardware, and intravenous antibiotic administration for 6 weeks, followed by oral administration for 16 weeks.


Subject(s)
Anterior Cruciate Ligament/surgery , Arthritis, Infectious/etiology , Arthroscopy , Erysipelothrix Infections/etiology , Erysipelothrix/isolation & purification , Surgical Wound Infection/etiology , Adolescent , Anterior Cruciate Ligament Injuries , Arthritis, Infectious/blood , Arthritis, Infectious/drug therapy , Arthritis, Infectious/microbiology , Arthritis, Infectious/surgery , Ciprofloxacin/therapeutic use , Clindamycin/therapeutic use , Combined Modality Therapy , Debridement , Drug Therapy, Combination/therapeutic use , Erysipelothrix Infections/blood , Erysipelothrix Infections/microbiology , Humans , Knee Injuries/complications , Knee Injuries/microbiology , Lacerations/complications , Lacerations/microbiology , Male , Penicillins/therapeutic use , Recurrence , Rupture/surgery , Soccer/injuries , Surgical Wound Infection/blood , Surgical Wound Infection/drug therapy , Surgical Wound Infection/microbiology , Surgical Wound Infection/surgery , Synovial Fluid/microbiology , Teicoplanin/therapeutic use , Therapeutic Irrigation
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