Table 3.
Cases of APJI in literature
| Patients (literature) | Joint age (days) | Location | Previous surgeries/ comorbidities |
Actinomyces species/subspecies | Other pathogen | Surgical therapy | Medical therapy | Outcome |
|---|---|---|---|---|---|---|---|---|
| 1 | 3650 | THA | Steroids, dental extractions and caries filling 1 month before onset of hip pain | Actinomyces israelii | No | Resection arthroplasty followed by reimplantation 8 month later | 6 weeks of high dose IV Penicillin G | No clinical evidence of infection at 6 month follow up |
| 2 | 5840 | THA | None | Actinomyces viscosus | No | Girdlestone resection | 6 weeks of IV Penicillin G | Cured, not reimplanted due to poor Bone stock |
| 3 | 180 | THA | None | Actinomyces naeslundii | No | Needle aspiration | 6 weeks of Rifampin + Cefuroxime | Doing well clinical at last F/U |
| 4 | 90 | TKA | None | Actinomyces naeslundii | No | 2 stage exchange | 9 weeks of IV ceftriaxone and lifelong doxycycline after reimplanation | Good functional outcome, still some pain |
| 5 | 4015 | THA | Steroids, IVDA, femoral head AVN | Actinomyces israelii | No | Resection with spacer | Ampicillin IV x 20 days, then left AMA | Lost to follow up |
| 6 | 730 | THA | Dental prosthesis | Actinomyces neuii subsp. neuii | No | 2 stage exchange | PCN G IV until 2 weeks post reimplantation and then 4 week Amoxicillin 1 gram tid | good radiological control, not seen for follow up |
| 7 | 3285 | THA | DM2 | Actinomyces israelii | No | 2 stage exchange | 6 weeks of vancomycin | no clinical or lab evidence of infection |
| 8 | 60 | TKA | DM2, COPD | Actinomyces naeslundii | No | 2 stage exchange | 6 weeks of PCN and clindamycin | no recurrence, doing well |
| 9 | 300 | THA | Dental cleaning without prophylaxis 1 mo ago | Actinomyces spp | No | 2 stage exchange revision | 8 weeks of PCN G, following reimplantation, 1 year of PCN VK | No signs of infection and good functional and radiographic outcome |
| 10 | 4015 | THA | Warfarin therapy, GB syndrome | Actinomyces gerencseriae | Staphylococcus aureus, staphylococcus hominis | I and D | Amoxicillin and TMP/SMX x 3 wks | Cured |
| 11 | 2190 | THA | IUD device with foul smelling discharge | Actinomyces israelii | No | Patient refused hip surgery, IUD removed | 10 days of PCN G 24 M U/d x 10 days, then lost to F/U | Left AMA |
| 12 | 365 | THA | None | Actinomyces israelii | No | Girdlestone resection arthroplasty | High dose IV benzylpenicillin | Superinfection with Staph aureus leading to femoral osteomyelitis |