AUTHOR=Pham Truong-Thanh , Lazarevic Vladimir , Gaia Nadia , Girard Myriam , Cherkaoui Abdessalam , Suva Domizio , Schrenzel Jacques 

TITLE=Second Periprosthetic Joint Infection Caused by Streptococcus dysgalactiae: How Genomic Sequencing Can Help Defining the Best Therapeutic Strategy

JOURNAL=Frontiers in Medicine

VOLUME=7

YEAR=2020

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2020.00053

DOI=10.3389/fmed.2020.00053

ISSN=2296-858X

ABSTRACT=<p>Primary and revision arthroplasties are increasing worldwide, as are periprosthetic joint infections (PJI). The management of PJI requires surgery, the strategy of which is dictated by the acute or chronic nature of the infection, with an exchange of the implant in the event of a chronic PJI or in the case of recurrence with the same pathogen. We report the case of a 63-year-old man with two episodes of <italic>Streptococcus dysgalactiae</italic> subsp. <italic>equisimilis</italic> PJI within 9 months. Based on clinical suspicion of an haematogenous PJI, the patient was treated by DAIR (debridement, antibiotics, implant retention), while genomic sequencing revealed two different strains, confirming our hypothesis that no additional surgery was needed. Hence, we report a case where genomic analysis was decisive for the decision of the best therapeutic strategy.</p>