Journal of Foot and Ankle Surgery
Volume 49, Issue 5 , Pages 489.e1-489.e4, September 2010

Late Hematogenous Infection of First Metatarsophalangeal Joint Replacement: A Case Presentation

  • Paul A. Stone, DPM, FACFAS

      Affiliations

    • Director of Podiatric Research, Presbyterian St. Lukes, Greenwood Village, CO
    • Corresponding Author InformationAddress correspondence to: Esther S. Barnes, DPM, Presbyterian St. Lukes, 1719 E. 19th Ave, Denver, Colorado 80218.
  • ,
  • Esther S. Barnes, DPM

      Affiliations

    • Third-year Medical Student, Presbyterian St. Lukes, Greenwood Village, CO
  • ,
  • Thomas Savage, DPM, FACFAS

      Affiliations

    • Attending Physician, Presbyterian St. Lukes, Greenwood Village, CO
  • ,
  • Matthew Paden, DPM, FACFAS

      Affiliations

    • Director of Residency Education, Presbyterian St. Lukes, Greenwood Village, CO

published online 30 June 2010.

Abstract 

Late hematogenous infection of previously asymptomatic orthopedic implants is extremely rare and usually associated with total joint replacements, such as those of the hip or knee. We present the case of an otherwise healthy female who developed a deep space infection 18 months after a first metatarsophalangeal joint implant arthroplasty. The patient presented with pain and swelling at the site, and over the course of several days developed fever and tachycardia and leukocytosis. Cultures of the surrounding soft tissues and the implant grew Streptococcus pneumoniae. The patient reported a 1- to 2-week history of symptoms consistent with an upper respiratory tract infection and it is believed that this distant focus of infection was the probable source of late hematogenous seeding of the first metatarsophalangeal joint implant.

Level of Clinical Evidence: 4

Keywords: hematogenous joint infection, implant infection, joint implant, septic inflammatory response syndrome (SIRS)

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 25.00 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

 Financial Disclosure: None reported

 Conflicts of Interest: None reported

PII: S1067-2516(10)00056-6

doi:10.1053/j.jfas.2010.02.016

Journal of Foot and Ankle Surgery
Volume 49, Issue 5 , Pages 489.e1-489.e4, September 2010