Published online Jan 26, 2023. doi: 10.12998/wjcc.v11.i3.677
Peer-review started: November 24, 2022
First decision: December 13, 2022
Revised: December 26, 2022
Accepted: January 5, 2023
Article in press: January 5, 2023
Published online: January 26, 2023
Processing time: 63 Days and 3.7 Hours
Brucellosis is the most common zoonosis worldwide and is endemic in the Middle East, Africa, Asia, and Latin America. However, it is uncommon in Central Europe, and periprosthetic infections caused by Brucella are therefore rare. Due to the low prevalence and nonspecific clinical presentation of the disease, accurate diagnosis can be challenging; no gold standard currently exists for treating brucellosis.
Here, we present a 68-year-old Afghan woman living in Austria with a periprosthetic knee infection caused by Brucella melitensis. The interval from total knee arthroplasty to septic loosening was five years. A profound medical history and examinations suggested that the patient had been suffering from unrecognized chronic osteoarticular brucellosis prior to total knee arthroplasty. She was successfully treated by two-stage revision surgery and combined antibiotic therapy over three months.
Clinicians should consider brucellosis as a possible cause of chronic arthralgia and periprosthetic infection in patients originating from countries with a high brucellosis burden.
Core Tip: Periprosthetic infections caused by Brucella species are rare, difficult to diagnose, and challenging to treat. We present here our experience in treating a 68-year-old Afghan woman with a periprosthetic knee joint infection caused by Brucella melitensis. In conclusion we recommend clinicians to consider Brucellosis as a possible cause for chronic arthralgia and periprosthetic infection in patients originating from countries with a high brucellosis burden.