A Rare Case of Staphylococcus Caprae Periprosthetic Hip Infection with Unusual Clinical Presentation.

Daniele Grassa, Francesco Cavola, Alessandro Giuliani, Rashma Rajeev, Alessandro Singlitico, Ivan De Martino
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Abstract

Introduction: Total hip arthroplasty (THA) surgeries are rapidly increasing due to an aging population, leading to an increase in degenerative hip osteoarthritis. However, 1% of these patients go through prosthetic joint infection (PJI), which gives rise to implant failure with prolonged periods of patient incapacitation and higher mortality risk.

Case report: In this article, we report an unusual case of a 62-year-old male who developed a PJI 7 months after a THA. The patient complained of groin, buttock pain, and swelling. He underwent MRI examination, which revealed the presence of a voluminous three-lobed formation with liquid content located around the prosthesis. After several attempts where microbiological samples reported negative results, a microbiological sample came out positive for Staphylococcus Caprae at the time of femoral component sonication. S. caprae is a Gram-positive bacillus belonging to the Staphylococcus spp. It is most commonly found as a commensal in goats and sheep, but it is a rare pathogen in human infections. The patient underwent two-stage revision surgery, resulting in the total resolution of the infection.

Conclusion: Staphylococcus Caprae still remains an unusual cause of infection. We report the 11th hip PJI due to S. caprae successfully treated with a two-stage exchange protocol.

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罕见的卡普拉葡萄球菌髋关节假体周围感染1例,临床表现不寻常。
导言:由于人口老龄化,全髋关节置换术(THA)手术迅速增加,导致退行性髋关节骨关节炎的增加。然而,这些患者中有1%会经历假体关节感染(PJI),这导致假体失败,患者丧失活动能力的时间延长,死亡风险更高。病例报告:在这篇文章中,我们报告了一位62岁男性在THA术后7个月出现PJI的罕见病例。病人主诉腹股沟、臀部疼痛和肿胀。他接受了MRI检查,发现假体周围有一个巨大的三叶状结构,含有液体。经过几次尝试,微生物样品报告阴性结果,在股骨成分超声检查时,微生物样品显示出卡氏葡萄球菌阳性。葡萄球菌是葡萄球菌属的革兰氏阳性芽孢杆菌,最常见于山羊和绵羊的共生菌,但在人类感染中是罕见的病原体。患者接受了两期翻修手术,导致感染完全解决。结论:卡普拉葡萄球菌仍是一种罕见的感染原因。我们报告了第11例由S. caprae引起的髋关节PJI通过两阶段交换方案成功治疗。
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