Streptococcus gordonii—a rare cause of prosthetic joint infection in a total hip replacement

A 69-year-old female with a history of bilateral total hip replacements presented with rigors, fever and sudden onset left groin pain. A pelvic X-ray showed well-fixed implants. Blood results revealed a leucocytosis (white cell count 22.3 × 10(9) l(–1)) and elevated C-reactive protein (211 mg/l). Ultrasound-guided aspiration of her left hip grew Streptococcus gordonii. No source infection could be identified apart from a new chronic sinus infection in a left upper incisor. Following a discussion with the patient a 6-week course of intravenous ceftriaxone was started and was successful in normalizing her inflammatory markers. She was placed on long-term suppressive amoxicillin following this. Her suppressive antibiotic therapy was complicated by the development of a clostridium difficile infection and her antibiotics were changed to doxycycline. At 1-year follow-up, she was asymptomatic with no further episodes of groin pain or fever.