Chronic and Severe Prosthetic Joint Infection Complicated by Amyloid A Amyloidosis With Renal and Bladder Impairment

A 66-year-old woman presented with renal failure and purulent discharge associated with a chronic prosthetic joint infection (PJI) of the left knee. Her medical history consisted of an untreated chronic hepatitis B and recurrent giant-cell tumour of bone revealed by spontaneous fractures 20 years previously. Multiple tumour resections led to knee prosthesis implantation in 1992 with no tumour relapse thereafter.

The patient experienced a methicillin-susceptible Staphylococcus aureus chronic PJI in the following months that required two-stage prosthesis replacement and a prolonged antibiotherapy. A clinical suspicion of superinfection was confirmed in 2002 by a puncture of the synovial fluid that found a methicillin-resistant Staphylococcus epidermidis. The patient declined both surgical and medical treatment and was lost to follow-up.