{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T16:50:10Z","timestamp":1790009410788,"version":"4.0.1"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>\n                    Periprosthetic joint infections caused by\n                    <jats:italic toggle=\"yes\">Brucella melitensis<\/jats:italic>\n                    are rare and present significant diagnostic and therapeutic challenges, especially in endemic regions such as Anatolia. The indolent nature of\n                    <jats:italic toggle=\"yes\">Brucella<\/jats:italic>\n                    infections often results in subclinical presentations, complicating early detection and management. This case series highlights the importance of recognizing\n                    <jats:italic toggle=\"yes\">Brucella melitensis<\/jats:italic>\n                    as a potential pathogen in periprosthetic joint infection and explores the treatment options for this condition. Herein, we present five cases of\n                    <jats:italic toggle=\"yes\">Brucella melitensis<\/jats:italic>\n                    -associated periprosthetic joint infections involving three hip replacements and two knee replacements. Diagnoses were confirmed through advanced diagnostic techniques, including prolonged cultures and serological testing, as routine methods often yielded negative results. Two patients underwent one-stage revision arthroplasty, two underwent two-stage revision arthroplasty, and one patient was managed conservatively with targeted antibiotics due to the absence of prosthetic loosening. All patients showed excellent functional recovery and infection eradication at follow-up, with normalized inflammatory markers and no evidence of recurrence. This case series emphasizes the importance of clinical suspicion and the use of advanced diagnostics in endemic areas for timely recognition of\n                    <jats:italic toggle=\"yes\">Brucella<\/jats:italic>\n                    -associated periprosthetic joint infections. One-stage revision arthroplasty combined with prolonged antibiotic therapy demonstrated favorable outcomes and may serve as an effective treatment strategy.\n                  <\/jats:p>","DOI":"10.1177\/03000605251337568","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T06:36:48Z","timestamp":1748414208000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Could it be\n                    <i>Brucella melitensis<\/i>\n                    ? Recognizing and managing a rare pathogen in periprosthetic infections"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3197-5770","authenticated-orcid":false,"given":"Mehmet S\u00fcleyman","family":"Abul","sequence":"first","affiliation":[{"name":"Department of Orthopedics and Traumatology, Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4883-5579","authenticated-orcid":false,"given":"\u00d6mer Faruk","family":"Sevim","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Kartal Dr. L\u00fctfi K\u0131rdar City Hospital, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammed Enes","family":"Karata\u015f","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, Bart\u0131n State Hospital, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Furkan","family":"Ba\u015fak","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Traumatology, \u00dcmraniye Training and Research Hospital, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/21.2.283"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.aott.2017.11.003"},{"key":"e_1_3_8_4_2","first-page":"9423946","article-title":"Brucella periprosthetic joint infection involving bilateral knees with negative synovial fluid alpha-defensin","volume":"2019","author":"Balkhair A","year":"2019","unstructured":"Balkhair A, Al Maskari S, Ibrahim S, et\u00a0al. Brucella periprosthetic joint infection involving bilateral knees with negative synovial fluid alpha-defensin. Case Rep Infect Dis 2019; 2019: 9423946.","journal-title":"Case Rep Infect Dis"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v11.i3.677"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-008-0031-x"},{"key":"e_1_3_8_7_2","first-page":"342","article-title":"Brucella arthritis following total knee arthroplasty in a patient with hemophilia: a case report","volume":"5","author":"Mortazavi SMJ","year":"2017","unstructured":"Mortazavi SMJ, Sobhan MR, Mazoochy H. Brucella arthritis following total knee arthroplasty in a patient with hemophilia: a case report. Arch Bone Jt Surg 2017; 5: 342\u2013346.","journal-title":"Arch Bone Jt Surg"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2007.03.013"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/230949900601400122"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/03000605241234050"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.5152\/etd.2012.24"},{"key":"e_1_3_8_12_2","first-page":"252","article-title":"Total Artroplasti Uygulanan Dizde Brusella Protez Enfeksiyonu: Artroskopi ve Medikal Tedavi ile Protezi Korunan Bir Olgu Sunumu [Brucellar prosthetic infection after total knee arthroplasty: a case with retained prosthesis by arthroscopic and medical treatment]","volume":"25","author":"Atay T","year":"2008","unstructured":"Atay T, Baydar ML, Heybel\u00ef N, et\u00a0al. Total Artroplasti Uygulanan Dizde Brusella Protez Enfeksiyonu: Artroskopi ve Medikal Tedavi ile Protezi Korunan Bir Olgu Sunumu [Brucellar prosthetic infection after total knee arthroplasty: a case with retained prosthesis by arthroscopic and medical treatment]. Balkan Medical Journal 2008; 25: 252\u2013255.","journal-title":"Balkan Medical Journal"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.3844\/ajidsp.2016.65.72"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967114S00175"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2002.30284"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00111-13"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01700416"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1086\/368084"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12246"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.7150\/jbji.37096"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.3181\/00379727-84-20703"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.7150\/jbji.18408"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-019-4263-9"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-022-04410-x"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61595-6"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis966"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.53738\/REVMED.2007.3.107.1007"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00073-19"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251337568","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605251337568","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605251337568","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:47:25Z","timestamp":1777459645000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605251337568"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":27,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/03000605251337568"],"URL":"https:\/\/doi.org\/10.1177\/03000605251337568","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"article-number":"03000605251337568"}}