Septic arthritis with Staphylococcus lugdunensis following arthroscopic ACL revision with BPTB allograft

  • Omer Mei-Dan
  • Gideon Mann
  • Gilbert Steinbacher
  • Soleda J. Ballester
  • Ramon Bertomeu Cugat
  • Pedro Diaz Alvarez
Knee

Abstract

Septic arthritis following anterior cruciate ligament reconstruction is an uncommon but a serious complication resulting in six times greater hospital costs than that of uncomplicated ACL surgery and an inferior postoperative activity level. Promptly initiating a specific antibiotic therapy is the most critical treatment, followed by open or arthroscopic joint decompression, debridement and lavage. Staphylococcus lugdunensis is a coagulase-negative staphylococcus predominantly infecting the skin and soft tissue. The few reported cases of bone and joint infections by S. lugdunensis indicate that the clinical manifestations were severe, the diagnosis elusive, and the treatment difficult. If the microbiology laboratory does not use the tube coagulase (long) test to confirm the slide coagulase test result, the organism might be misidentified as Staphylococcus aureus. S. lugdunensis is more virulent than other coagulase-negative staphylococcus; in many clinical situations it behaves like S. aureus, further increasing the confusion and worsening the expected outcome. S. lugdunensis is known to cause infective endocarditis with a worse outcome, septicemia, deep tissue infection, vascular and joint prosthesis infection, osteomyelitis, discitis, breast abscess, urine tract infections, toxic shock and osteitis pubis. We present the first case report in the literature of septic arthritis with S. lugdunensis following arthroscopic ACL revision with bone–patellar–tendon–bone allograft.

Keywords

Septic arthritis Staphylococcus lugdunensis ACL Allograft 

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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Omer Mei-Dan
    • 1
    • 2
  • Gideon Mann
    • 1
  • Gilbert Steinbacher
    • 2
  • Soleda J. Ballester
    • 3
  • Ramon Bertomeu Cugat
    • 2
  • Pedro Diaz Alvarez
    • 2
    • 4
  1. 1.Orthopedic and Sports DivisionMeir University HospitalKfar-SabaIsrael
  2. 2.Mutualidad de futbolistas EspañolesDelegación CatalanaBarcelonaSpain
  3. 3.Hospital del MarIMASBarcelonaSpain
  4. 4.Clinica QuirónBarcelonaSpain

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