Journal
AMERICAN JOURNAL OF MEDICINE
Volume 127, Issue 8, Pages -Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjmed.2014.03.013
Keywords
Coxiella burnetii; Culture-negative prosthetic joint arthritis; Q fever
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Funding
- French National Referral Center for Q Fever
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BACKGROUND: The number of hip and knee arthroplasty procedures is steadily increasing as life expectancy increases. Coxiella burnetii may be responsible for culture-negative prosthetic joint arthritis and is associated with antibiotic failure and repeated surgeries. We report the first case series of C. burnetii-related culture-negative prosthetic joint arthritis. METHODS: Cases were retrieved from the French National Referral center for Q fever. Diagnosis was based on (18)fluorodeoxyglucose positron emission tomography, serology, broad-range polymerase chain reaction, and C. burnetii-specific polymerase chain reaction. RESULTS: Four cases of C. burnetii-related culture-negative prosthetic joint arthritis were found. Standard bacteriologic procedures would have missed the diagnosis in all cases. Etiologic diagnosis improved the outcome in all but 1 case. CONCLUSIONS: A systematic, comprehensive diagnostic strategy should be used in culture-negative prosthetic joint arthritis, including testing for C. burnetii in endemic areas. (C) 2014 Elsevier Inc. All rights reserved.
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