Late-onset Group B Streptococcus Periprosthetic Joint Infection Cured after Dental Clearance: A Case Report from Barbados and Literature Review

Periprosthetic joint infection (PJI) is a devastating complication of total joint arthroplasty, with significant morbidity and economic burden [1,2]. Late-onset PJIs, occurring more than 24 months post-operatively, are often associated with hematogenous seeding from distant infection sites, with the oral cavity being a potential source [3,4]. This case report presents a rare instance of late-onset Group B Streptococcus (GBS) PJI in a patient from Barbados who underwent total knee replacement (TKR) surgery nine years prior. Despite multiple surgical debridement and prolonged antibiotic therapy, the infection persisted until the identification and treatment of an initially overlooked source severe periodontitis. This case underscores the role of oral health assessment in patients with unexplained PJI, and the role of dental clearance in successful treatment. A literature review of the association between periodontitis and PJIs is also presented.