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These guidelines are intended for use by infectious disease specialists, orthopedists, and other healthcare professionals who care for patients with prosthetic joint infection (PJI). They include evidence-based and opinion-based recommendations for the diagnosis and management of patients with PJI treated with debridement and retention of the prosthesis,(More)
BACKGROUND Culturing of samples of periprosthetic tissue is the standard method used for the microbiologic diagnosis of prosthetic-joint infection, but this method is neither sensitive nor specific. In prosthetic-joint infection, microorganisms are typically present in a biofilm on the surface of the prosthesis. We hypothesized that culturing of samples(More)
BACKGROUND The incidence of cardiac device infection is not well understood. Bloodstream infection (BSI) in patients with permanent pacemakers or implantable cardioverter-defibrillators (hereafter, defibrillators) may reflect device infection. METHODS Retrospective, population-based cohort study of all adult patients with cardiac devices who resided in(More)
PURPOSE Criteria for the interpretation of synovial fluid are well established for native joint disorders but lacking for the evaluation of prosthetic joint failure. Our aim was to define cutoff values for synovial fluid leukocyte count and neutrophil percentage for differentiating aseptic failure and prosthetic joint infection. METHODS We performed a(More)
BACKGROUND The preoperative diagnosis of prosthetic joint infection in patients with a total hip or knee arthroplasty may rely in part on the use of systemic inflammation markers. These markers have unclear accuracy. The objective of this review was to summarize the evidence on the accuracy of the peripheral white blood-cell count, the erythrocyte(More)
BACKGROUND Culture-negative (CN) prosthetic joint infection (PJI) has not been well studied. We performed a retrospective cohort study to define the demographic characteristics and determine the outcome of patients with CN PJI. METHODS All cases of CN total hip arthroplasty and total knee arthroplasty infections (using a strict case definition) treated at(More)
BACKGROUND Spinal implant infections provide unique diagnostic and therapeutic challenges. METHODS We conducted a retrospective cohort study to evaluate risk factors for treatment failure in patients with early- and late-onset spinal implant infections at the Mayo Clinic (Rochester, MN) during 1994-2002. RESULTS We identified 30 patients with(More)
BACKGROUND C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) have been shown to be useful for diagnosis of prosthetic hip and knee infection. Little information is available on CRP and ESR in patients undergoing revision or resection of shoulder arthroplasties or spine implants. METHODS/RESULTS We analyzed preoperative CRP and ESR in 636(More)
The majority of patients with prosthetic joint replacement (arthroplasty) experience dramatic relief of pain and restoration of satisfactory joint function. In the United States, more than.5 million people have a primary arthroplasty each year. Less than 10% of prosthesis recipients have complications develop during their lifetime, commonly as a result of(More)
I nfective endocarditis (IE) carries a high risk of morbidity and mortality. Rapid diagnosis, effective treatment, and prompt recognition of complications are essential to good patient outcome. Therapy of IE caused by the more commonly encountered organisms, including streptococci, entero-cocci, staphylococci, and the HACEK organisms (Hemophi-lus(More)