First Case Report of a Late Onset Knee Periprosthetic Joint Infection Caused by Lactococcus garvieae.

Lactococcus garvieae is known as a Gram-positive, catalase-negative, and facultatively anaerobic fish pathogen. The association between Lactococcus spp. and human infectious diseases is described as being mainly associated with lumbar osteomyelitis, hepatic abscess, and infective endocarditis. In the literature of orthopedic post-prosthetic infections, L. garvieae was associated with a case of hip prosthetic infection in a fishmonger woman. We present the case of a 79-year-old male patient with multiple comorbidities, who is admitted to our center with a 5-day history of pain, swelling, and motility disorder of the right knee by the presence of a bicondylar knee replacement surgery, which was performed due to gonarthrosis 17 years ago. The radiographies of the right knee revealed no signs of displacement or loosening of the prothesis. After multiple radical debridements including VAC therapy and targeted antibiotic therapy we have managed to defeat the infection without exchange arthroplasty. Although we could not demonstrate the source of infection, we can only presume that in our case the source of infection was represented by the ingestion of possibly contaminated food. The patient had a habit of eating Nile perch fish (Lates niloticus) every 4 weeks. We illustrated once more the possibility of a late onset L. garvieae related orthopedic periprosthetic joint infection by multiple comorbidities.

Total thyroidectomy with LigaSure Small Jaw versus conventional thyroidectomy - a clinical study.

INTRODUCTION: The emergence of LigaSure device in surgical practice brings some real benefits in thyroid surgery. UsingLigaSure Small Jaw device in total thyroidectomy is an important step in thyroid surgery. The aim of this study is to present the initial experience of Surgical Clinic I of Targu Mures staff in terms of total thyroidectomy using this procedure, without ligatures compared to the conventional technique with ligatures. MATERIAL AND METHOD: The study included 20 consecutive patients (19 females and one male) who have undergone total thyroidectomy in Surgical Clinic I of the Emergency County Hospital Targu Mures, between September 2012 - February 2013. Group I included 10 patients who underwent total thyroidectomty using the LigaSure Small Jaw device (without ligatures) while the second group included 10 patients in whom total thyroidectomy was performed by classical procedure (using vascular ligatures). The two groups were compared using statistical analysis following the next parameters: the thyroid pathology, operation time, number of hospitalization days,analgesia and immediate postoperative complications. RESULTS: This method provides a statistically significant decrease of the operative time and hospitalization days. CONCLUSION: Using LigaSure Small Jaw device in thyroid surgery is a safe procedure with little complications rate.