A Successfully Treated Patient with Prosthetic Joint Infection Caused by Pseudomonas aeruginosa Diagnosed from PCR of Periprosthetic Joint Fluid

Abstract

Most of prosthetic joint infection (PJI) cases require surgical treatment and appropriate antimicrobial therapy over a long period, so identification of the causative microorganisms is very important to give appropriate antimicrobial therapy for affected patients. However, the utility of joint fluid cultures has been questioned based on relatively high false negative rates because of previous antimicrobial therapy and biofilm formation in PJI. In PJI patients with negative results of joint fluid cultures, PCR testing of the infected joint fluid or tissue is reported to be useful to identify the causative microorganisms.
We report herein on a case of PJI caused by Pseudomonas aeruginosa which was detected with PCR of periprosthetic joint fluid. The patient was treated successfully with intravenous, combined antimicrobial therapy followed by long-term oral antimicrobial therapy, which targeted P. aeruginosa, without surgery. In cases with high clinical suspicion of PJI but negative cultures, PCR tests might be helpful to identify the causative microorganisms.