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Case report
Late prosthetic shoulder joint infection due to Actinomyces neuii in an adult man
  1. Benjamin C Chen1,
  2. Takaaki Kobayashi1,
  3. Bradley Ford2 and
  4. Poorani Sekar1
  1. 1Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  2. 2Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
  1. Correspondence to Dr Benjamin C Chen; benjamin-chen{at}


A 72-year-old man with a history of right reverse shoulder arthroplasty presented with a 1-month history of erythema, pain and drainage from the right shoulder. Arthrocentesis was performed and synovial fluid gram stain revealed gram-positive rods. Clinical diagnosis of prosthetic shoulder joint infection was made. Orthopaedic surgeons performed irrigation and debridement with resection of the right shoulder prothesis and implantation of an antimicrobial spacer. Operative cultures grew Actinomyces neuii. The patient was treated with 6 weeks of ceftriaxone with improvement in both clinical symptoms and laboratory values. Actinomyces species remain a rare cause of late prosthetic joint infection (PJI) due to their slow growing and indolent course. While generalised actinomycosis is often treated with 6–12 months of antibiotics, the treatment course of Actinomyces PJI is not well characterised, with some sources suggesting a minimum of 6 weeks of antimicrobial therapy.

  • infectious diseases
  • orthopaedics
  • bone and joint infections

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  • Contributors BCC wrote the first draft of the manuscript. TK, BF and PS critically reviewed and revised the manuscript. All authors read and approved the final paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.