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Table 1 Clinical details of the patient

From: Sonication contribution to identifying prosthetic joint infection with Ralstonia pickettii: a case report and review of the literature

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.13-17 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. 0-15 mm/h) 69 27 22 47 46 16
C-reactive protein (R.V. <6 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
  1. aSigns of femoral and acetabular component loosening were present; b according to the Krenn and Morawietz [2]: type I periprosthetic membrane (ppm) of the wear particle-induced type, type II ppm of the infectious type, type III ppm of the combined type, type IV indeterminate type; c Beacon-based fluorescent in situ hybridization kit (hemoFISH® Masterpanel, miacom diagnostics GmbH Düsseldorf, Germany); R.V references values, WBC White blood cells, HGB hemoglobin, NEUT neutrophils, ESR erythrocyte sedimentation rate, NA not available