Citations

Background This study aimed to evaluate outcomes of different antibiotic durations in patients with severe diverticulitis. Methods Initial electronic medical record review identified 2437 adult patients who underwent sigmoid colectomy. Manual chart review identified 133 patients who underwent sigmoid resection and proximal diversion for Hinchey stage 3 or 4 diverticulitis. Patients who received a short antibiotic course (SAC, ≤5 days) were compared with those who received a long antibiotic course (LAC, >5 days). The primary composite outcome included superficial, incisional, organ-space infections or death within 30 days post procedure. Results A total of 53 SAC patients and 55 LAC patients were identified. The composite outcome occurred more frequently in LAC patients than in SAC patients (40% vs 15%; P = .005). Organ-space infection occurred more frequently in LAC patients than in SAC patients (31% vs 13%; P = .04). Conclusions Extended duration of antibiotics after adequate source control does not improve outcomes even in the setting of extensive intra-abdominal contamination.

Periprosthetic joint infection (PJI) is a devastating complication of total joint surgery. Surgical management of PJI has increased surgical risks and is costly to the healthcare system. This case study presents a unique clinical scenario involving a patient who was diagnosed with Lyme PJI at the total knee arthroplasty site after undergoing surgical management. Lyme PJI is a rare condition, and there is limited guidance on the diagnosis and management of this condition. It should be considered in the differential of certain individuals with appropriate epidemiological risk factors. This report aims to highlight the complexities associated with the diagnosis and management of periprosthetic Lyme infections.