Lactobacillus Rhamnosus Infection of a Metal on Metal Hip Arthroplasty

Lactobacillus rhamnosus is a Gram positive rod, which forms part of the normal bacterial flora in humans. It has low pathogenicity and is widely used in the food industry. We present a patient who had a primary metal on metal hip replacement, which subsequently became infected with the organism. He was successfully treated with daptomycin and rifampicin combination therapy. Due to its low pathogenicity,Lactobacillus rhamnosus infections have been previously reported in only vulnerable patients. Our patient had good health and we discuss the factors that may have led to him developing the infection. Prosthetic joint infection with this organism has not been previously reported in the literature. This is the first report of successful treatment with daptomycin in combination with rifampicin.