Table 1 Clinical details of the patient
Date and type of surgery | November 2014 Debridement, and retention of fixed prosthetic components | March 2016 Debridement, explanation of the prosthesis, and implantation of preformed spacer loaded with gentamicina | June 2016 Internal Medicine Department Hospitalization | July 2016 Debridement, and changing of the preformed spacer loaded with gentamicin | September 2016 Debridement, and changing of the preformed spacer loaded with gentamicin | February 2017 Debridement, and reimplantation of a revision prosthesis |
|---|---|---|---|---|---|---|
Blood sugar mg/dl (R.V. 83–110) | 190 | 139 | 139 | 109 | 239 | 142 |
Fibrinogen mg/dl (R.V. 180–400) | 530.5 | 424.7 | 438.2 | 523.2 | 560 | 388.9 |
WBCs (R.V. 4–10 × 103/μl) | 8.46 | 8.9 | 8.33 | 11.07 | 9.11 | 4.96 |
HGB (R.V.13-17Â g/dl) | 10.5 | 11.6 | 11.5 | 11.0 | 9.4 | 11.7 |
NEUT (R.V. 2–7.5 × 103/μl) | 6.16 | 6.1 | 6.47 | 8.38 | 7.61 | 3.31 |
ESR (R.V. 0-15Â mm/h) | 69 | 27 | 22 | 47 | 46 | 16 |
C-reactive protein (R.V. <6Â mg/dl) | NA | 27 | 22 | 24 | 24 | 6 |
Joint fluid hs-CRP (R.V. 0.00–0.50 mg/dl) | NA | NA | - | NA | 0.78 | 0.89 |
Histopathology Resultsb | Type II | Type III | - | Type II | Type II | Type II |
Culture results | ||||||
Preoperative samples (joint fluid) | Negative | Negative | - | Negative | Negative | Negative |
Intraoperative samples (tissue biopsies – 3 samples) | Negative | Pseudomonas aeruginosa (in all samples) | - | Negative | Pseudomonas aeruginosa (in 2 samples) | Pseudomonas aeruginosa (in 1 sample) |
Sonication fluid culture | NA | NA | - | NA | Negative | Ralstonia pickettii |
Molecular identification of bacteria by 16S rRNA bbFISH® technologyc | ||||||
On Sonication Fluid | NA | NA | - | NA | Negative | Negative |