INTRODUCTION: The incidence of early deep @entity281 after arthroplasty of the knee is very low but could represent a serious future problem. MATERIAL AND METHODS: The authors report on a 71-year-old @entity1 with gonarthritis who was supplied with a total knee endoprosthesis and developed a @entity281 followed by @entity326 . RESULTS: The @entity281 was evidently caused by a multiresistant @entity794 (Staph. aureus). The primary clinical signs closely resembled a necrotizing @entity9156 . Systemic and local application of @entity2176 led to an improvement of the symptoms at secondary sites, but only the amputation of the primarily infected leg was lifesaving. CONCLUSION: In order to prevent such events, the authors recommend a number of additional presurgical measures. Firstly, a swab from the nose and throat should be taken prior to an elective surgery in @entity1 with elevated risk of @entity465 , for example in @entity1 with @entity6 . The @entity6 should be adequately treated before an elective operation is undertaken. Secondly, an early punction of the knee joint should be carried out if there is any doubt regarding inflammation. Isolated infectious agents should be grounds for early revision, which should always be completed with a rinsing procedure and with adequate antibiotics. Immunotherapy should be taken into consideration. Antiepidemic measures are recommended in cases with known Staph. aureus.

Overwhelming @entity281 with a multi-resistant XXXX ( @entity794 ) after total knee replacement.

@entity1 :: ('9606', 'Species') :: ['woman', 'patients'] @entity2176 :: ('MESH:D014640', 'Chemical') :: ['vancomycin'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity794 :: ('1280', 'Species') :: ['Staphylococcus aureus'] @entity281 :: ('MESH:D007239', 'Disease') :: ['local infection', 'infection'] @entity465 :: ('MESH:D007153', 'Disease') :: ['immunodeficiency'] @entity9156 :: ('MESH:D005208', 'Disease') :: ['fasciitis']
@entity794 :: (1280,Species) :: ['Staphylococcus aureus']
