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Mycoplasma pneumoniae Periprosthetic Joint Infection Identified by 16S Ribosomal RNA Gene Amplification and SequencingA Case Report
Zhuolin Han, MD, MS1; Carey-Ann D. Burnham, PhD1; John Clohisy, MD1; Hilary Babcock, MD, MPH1
1 Department of Medicine (Z.H. and H.B.), Pediatrics (C.-A.D.B.), Pathology & Immunology (C.-A.D.B.), and Orthopedics (J.C.), Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8116, St. Louis, MO 63110. E-mail address for Z. Han: zhan@dom.wustl.edu. E-mail address for C.-A.D. Burnham: Burnham_c@kids.wustl.edu. E-mail address for J. Clohisy: clohisyj@wudosis.wustl.edu. E-mail address for H. Babcock: hbabcock@im.wustl.edu
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Investigation performed at Washington University School of Medicine, St. Louis, Missouri

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Sep 21;93(18):e103 1-3. doi: 10.2106/JBJS.K.00318
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Extract

Chronic, culture-negative septic arthritis represents a major clinical dilemma. It often results in prolonged courses of antimicrobial therapy, which may or may not have activity against the organism responsible for the infection. It is not possible to cultivate all types of pathogens in vitro with use of traditional laboratory testing methods, but emerging techniques can be helpful to define the etiology of these infections in some cases. We describe a case of a periprosthetic joint infection in a thirty-year-old woman with juvenile rheumatoid arthritis (JRA) and hypogammaglobulinemia, who developed septic arthritis after prolonged pneumonia. She received multiple courses of antimicrobial therapy without improvement of the joint symptoms. The microbiologic diagnosis was made with use of 16S ribosomal RNA (rRNA) gene amplification and sequencing from synovial fluid and tissue. The patient gave permission for this information to be submitted for publication.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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