Prosthetic joint infection diagnosed after two-year-history of hip pain and urinary tract infection

Prosthetic joint infection diagnosed after two-year-history of hip pain and urinary tract infection

We report a case of a Staphylococcusaureus infection in a 74-year-oldwoman who underwent bilateral hiparthroplasty and experienced hippain for 2 years after an episode of aurinary tract infection. She underwentbilateral total hip arthroplasty in 2007for treatment of degenerative jointdisease. Her postoperative coursewas uneventful until 2014 when shedeveloped diarrhea,vomiting, fever,and chills. Lab findings revealedpyuria; blood and urine culturesshowed Staphylococcus aureus.Antibiotics were administered andher fever subsided, but she developedintermittent leg pain after discharge.She presented to our emergency roomin May, 2016 owing to aggravatedleft leg pain and a fall injury due to leg weakness. The peripheral white blood cell count was 5800 cells/mm3, theerythrocyte sedimentation ratio was109 mm/h, and C-reactive protein level was 1.24 mg/dL. A radiography of thehip joints revealed soft tissue swelling (*), increased cortical reaction (white arrow), and widening of the lucentline in the medial side of the femoral implant (black arrow) in the left leg (Figure 1).