Department of Orthopedic Surgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 849-8501, Japan
The risk of periprosthetic joint infection from hematogenous bacterial seeding is increased in patients undergoing
dental procedures that facilitate the development of bacteremia.
We herein report the case of a patient without a history of dental procedures who suffered from an acute metastatic
infection of a hip prosthesis by the oral bacterium Streptococcus mutans 18 months after undergoing revision total hip
arthroplasty. The patient was successfully treated by two-stage revision surgery.
It is important to realize that the efficacy of antibiotic prophylaxis against joint infections has not yet been convincingly
proven. As a result, optimal dental hygiene and regular dental visits may be more important than antibiotic prophylaxis for
maintaining joint health. Therefore, orthopedic surgeons should educate patients with joint prostheses about good oral
Keywords: : Antibiotic prophylaxis, bacteremia, hematogenous, infection, oral bacteria, Streptococcus mutans, total hip
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
* Address correspondence to this author at the Department of Orthopaedic
Surgery, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga
849-8501, Japan; Tel: +81-952-34-2343; Fax: +81-952-34-2059;