{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:39:27Z","timestamp":1787755167346,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>\n                      A healthy 49-year-old man with a well-functioning total knee replacement developed a painful swollen knee. The erythrocyte sedimentation rate was 12 mm\/hour, and C-reactive protein was 20.3 mg\/L. Aspiration revealed 24,440 white blood cells and 5% neutrophils. His 2018 International Consensus Meeting (ICM) definition score of 5 met criteria for \u201cpossibly infected.\u201d He was diagnosed with reactive arthritis (ReA) secondary to\n                      <jats:italic toggle=\"yes\">Giardia lamblia<\/jats:italic>\n                      , mimicking acute periprosthetic infection. He was successfully treated with a 10-week course of multiple oral antiparasitic medications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Systemic parasitic infectious ReA can mimic acute infection in the presence of total knee arthroplasty. Careful application of the 2018 ICM criteria can be critical for workup and the treatment of suspected periprosthetic infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.21.00165","type":"journal-article","created":{"date-parts":[[2021,7,23]],"date-time":"2021-07-23T14:08:28Z","timestamp":1627049308000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Giardia lamblia Reactive Arthritis Mimicking Acute Periprosthetic Knee Infection"],"prefix":"10.2106","volume":"11","author":[{"given":"Rachael A.","family":"Turner","sequence":"first","affiliation":[{"name":"University of Texas Rio Grande Valley School of Medicine, Edinburg, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin N.","family":"Duke","sequence":"additional","affiliation":[{"name":"OrthoColorado Hospital, Lakewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared 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