Reactive Thrombocytosis Leading to Recurrent Arterial Thrombosis Reversed by Management of a Prosthetic Joint Infection of the Hip

Prosthetic joint infections (PJIs) still pose a severe challenge for patients and the overall health care system. Infection, and PJI in particular, is a known cause of reactive thrombocytosis. Thromboembolic complications secondary to reactive thrombocytosis are infrequent and arterial thromboses are rarely described. We present the case of a 64-year-old female with reactive thrombosis and recurrent arterial thrombosis due to bilateral streptococcal PJI of the hip. Multiple episodes of acute ischemia of the right lower limb ultimately led to transfemoral amputation. Only after bilateral irrigation and debridement for infection control did the thrombocytosis resolve without any further thromboembolic complications. Early recognition of thrombocytosis, use of anti-platelet agents and early surgical treatment of the underlying infection (even when a conservative treatment may otherwise be considered) could have avoided this potentially life-threatening complication.