Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis
We present the case of a 55-year-old female patient with metamizole-induced agranulocytosis after total knee arthroplasty, leading to septic periprosthetic joint infections (PJIs). Owing to metamizole-induced agranulocytosis, the synovial leukocyte count was negative. Here, we discuss the diagnostic...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2020-12-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235234412030159X |
| _version_ | 1818127258420772864 |
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| author | Sebastian Oenning, Cand Med Burkhard Moellenbeck, MD Georg Gosheger, MD Tom Schmidt-Bräkling, MD Jan Schwarze, MD Thomas Ackmann, MD Kristian Nikolaus Schneider, MD Christoph Theil, MD |
| author_facet | Sebastian Oenning, Cand Med Burkhard Moellenbeck, MD Georg Gosheger, MD Tom Schmidt-Bräkling, MD Jan Schwarze, MD Thomas Ackmann, MD Kristian Nikolaus Schneider, MD Christoph Theil, MD |
| author_sort | Sebastian Oenning, Cand Med |
| collection | DOAJ |
| description | We present the case of a 55-year-old female patient with metamizole-induced agranulocytosis after total knee arthroplasty, leading to septic periprosthetic joint infections (PJIs). Owing to metamizole-induced agranulocytosis, the synovial leukocyte count was negative. Here, we discuss the diagnostic challenges evolving from sepsis and neutropenia in patients with suspected PJIs. We suggest an urgent surgical approach, mainly focusing on the clinical presentation preoperatively. Later, our patient developed candidemia and periprosthetic tissue samples were positive for Candida albicans. For fungal PJIs, long-term follow-up studies are lacking and therapeutic recommendations differ. Here, we present our therapeutic approach, including staged revision and 12 weeks of systemic antifungal therapy, and discuss recent findings regarding the therapy of fungal PJIs. |
| first_indexed | 2024-12-11T07:14:30Z |
| format | Article |
| id | doaj.art-124a8afe715445889023385177a90058 |
| institution | Directory Open Access Journal |
| issn | 2352-3441 |
| language | English |
| last_indexed | 2024-12-11T07:14:30Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj.art-124a8afe715445889023385177a900582022-12-22T01:16:16ZengElsevierArthroplasty Today2352-34412020-12-0164726730Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced AgranulocytosisSebastian Oenning, Cand Med0Burkhard Moellenbeck, MD1Georg Gosheger, MD2Tom Schmidt-Bräkling, MD3Jan Schwarze, MD4Thomas Ackmann, MD5Kristian Nikolaus Schneider, MD6Christoph Theil, MD7Corresponding author. Muenster University Hospital, 48149 Muenster, North Rhine-Westphalia, Germany. Tel.: +4915772023995.; Department of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyDepartment of General Orthopedics and Tumor Orthopedics, Muenster University Hospital, Muenster, North Rhine-Westphalia, GermanyWe present the case of a 55-year-old female patient with metamizole-induced agranulocytosis after total knee arthroplasty, leading to septic periprosthetic joint infections (PJIs). Owing to metamizole-induced agranulocytosis, the synovial leukocyte count was negative. Here, we discuss the diagnostic challenges evolving from sepsis and neutropenia in patients with suspected PJIs. We suggest an urgent surgical approach, mainly focusing on the clinical presentation preoperatively. Later, our patient developed candidemia and periprosthetic tissue samples were positive for Candida albicans. For fungal PJIs, long-term follow-up studies are lacking and therapeutic recommendations differ. Here, we present our therapeutic approach, including staged revision and 12 weeks of systemic antifungal therapy, and discuss recent findings regarding the therapy of fungal PJIs.http://www.sciencedirect.com/science/article/pii/S235234412030159XPeriprosthetic infectionAgranulocytosisFungal infectionCandida infectionTotal knee arthroplastyRevision arthroplasty |
| spellingShingle | Sebastian Oenning, Cand Med Burkhard Moellenbeck, MD Georg Gosheger, MD Tom Schmidt-Bräkling, MD Jan Schwarze, MD Thomas Ackmann, MD Kristian Nikolaus Schneider, MD Christoph Theil, MD Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis Arthroplasty Today Periprosthetic infection Agranulocytosis Fungal infection Candida infection Total knee arthroplasty Revision arthroplasty |
| title | Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis |
| title_full | Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis |
| title_fullStr | Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis |
| title_full_unstemmed | Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis |
| title_short | Fungal Periprosthetic Knee Joint Infection in a Patient with Metamizole-Induced Agranulocytosis |
| title_sort | fungal periprosthetic knee joint infection in a patient with metamizole induced agranulocytosis |
| topic | Periprosthetic infection Agranulocytosis Fungal infection Candida infection Total knee arthroplasty Revision arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S235234412030159X |
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