Robert Whitfield MD presents a clinical-focused YouTube talk on implant infections, using a case of a patient whose unexplained fatigue was due to a chronic E. coli infection associated with an implant. The patient’s fatigue resolved after targeted antibiotic treatment. Whitfield outlines three routes by which implants become infected and describes packaging and a 'no-touch' insertion technique intended to reduce contamination risk.
Chapters
So I went back through all the notes and everything, and we didn't have any clues in the examination, the history. The only clue in the history was she was tired, she had fatigue, which happens from patients who get chemotherapy. They get a lot of bone marrow suppression. So fatigue is a relatively common thing. But that was the only thing in this patient. And so we treated her appropriately with an antibiotic for that specific bacteria, E. Coli, and all of her fatigue went away. So she had been carrying this around for an undetermined amount of time. So people ask me, well, how'd that happen? There's three ways to get an infection with an implant. Hip, knee, breast, dental, neurologic, it doesn't really matter. So if someone opens the implant and contaminates it before they give it to the surgeon, that can be an opportunity. So. So opening this. Yeah. It comes in a package with two layers, really. There's an outer and an inner layer. Okay. And then typically, we don't touch it at all. So basically, we put it in something that looks like a pastry funnel and that allows you to avoid touching the skin and just place it in the pocket. So that's a no touch technique.
