Sonication assisted microbiological diagnosis of implant-related infection caused by Prevotella disiens and Staphylococcus epidermidis in a patient with cranioplasty

• Published in: BMC research notes 2015-07, Vol.8 (1), p.307-307, Article 307
• Main Authors: Thomaidis, Pavlos C, Pantazatou, Angeliki, Kamariotis, Spyros, Vlachos, Konstantinos, Roussos, George, Panagiotou, Petros, Stylianakis, Antonios
• Format: Article
• Language: English
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacteroidaceae Infections - diagnosis; Bacteroidaceae Infections - drug therapy; Bacteroidaceae Infections - etiology; Bacteroidaceae Infections - microbiology; Care and treatment; Case Report; Daptomycin - therapeutic use; Diagnosis; Health aspects; Humans; Implants, Artificial; Infection; Male; Metronidazole - therapeutic use; Microbiology; Middle Aged; Prevotella - drug effects; Prevotella - growth & development; Prevotella - isolation & purification; Prostheses and Implants - microbiology; Prosthesis; Reconstructive Surgical Procedures - adverse effects; Risk factors; Skin; Skull - drug effects; Skull - microbiology; Skull - surgery; Sonication; Staphylococcal infections; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - etiology; Staphylococcal Infections - microbiology; Staphylococcus epidermidis - drug effects; Staphylococcus epidermidis - growth & development; Staphylococcus epidermidis - isolation & purification; Surgical Flaps; Titanium - chemistry; Treatment Outcome
• ISSN: 1756-0500; 1756-0500
• DOI: 10.1186/s13104-015-1274-x

Infections present a major complication of cranioplasty procedures and in many cases removal of the implant material becomes a necessity. Sonication of the artificial implant material has been used during the last years, in order to facilitate better diagnosis of these infections, nevertheless its use in cranial implant infections is still limited. A case of a 63-year-old Caucasian male patient who underwent a decompressive craniectomy, due to intracranial hemorrhage, and a consequent cranioplasty using an autogenic bone flap fixed by titanium clamps, is reported. After three unsuccessful cranioplasty efforts to repair a persistent skin defect, removing the bone flap and the titanium clamps was a necessity. Tissue and bone cultures were unable to reveal any microorganism whilst sonication of the removed titanium clamps and consequent culture of the resulting sonication liquid yielded Prevotella disiens and Staphylococcus epidermidis. The patient was treated with daptomycin and metronidazole until discharge and the skin defect was successfully repaired. The present case report indicates that the use of the sonication procedure assisted the microbiological diagnosis. This is the first known neurosurgical case of the implementation of the sonication procedure.