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Lactobacillus Infection of Total Hip Arthroplasty After Probiotic Ingestion

Jones, Christopher Wynne PhD, MBBS (Hons), BEng(Hons), BCom*†; Low, Tim MBBS, BResEc (Hons); Milne, Benjamin FAOA, FRACS, MBBS

Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0000000000000145
Case Reports

Abstract: We present the first reported case of a total hip arthroplasty infected with Lactobacillus casei as a result of enteric bacterial translocation. A 76-year-old woman was found to have an infected right total hip arthroplasty hip 4 and a half years after her primary procedure. The patient who was treated underwent a 2-stage revision total hip arthroplasty. This patient was a regular consumer of probiotic yoghurt drinks and had multiple risk factors for developing this rare infection. Because of the high mortality of infections caused by lactobacillus, if a patient develops a chronic lactobacillus prosthetic joint infection, we recommend aggressive 2-stage revision arthroplasty surgery with multidisciplinary management involving both orthopedic and infectious diseases specialists.

Author Information

From the *School of Medicine, Sydney University, Sydney and †Department of Orthopaedic Surgery, Orange Base Hospital, Orange, New South Wales, Australia.

Correspondence to: Christopher Wynne Jones, PhD, MBBS(Hons), BEng(Hons), BCom, 3/32-40 Gibbens St, Camperdown NSW, Australia 2050. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2014 by Lippincott Williams & Wilkins.