A Life- and Limb-Threatening Case of Clostridium septicum in a Total Hip Arthroplasty.

A 46-year-old male with bilateral metal-on-metal hip prostheses presented with a left periprosthetic hip infection, as well as chronic, progressive osteolysis of the proximal femur and acetabulum with pelvic erosion. Three years before, the bearing surface was changed to metal-on-polyethylene prosthesis during an attempted revision but was complicated by extensive blood loss. At our institution, gross inspection demonstrated a soft-tissue hip mass of unknown etiology. Open biopsy and culture were performed, but extensive hemorrhaging required interventional radiology. Cultures revealed Clostridium septicum infection-known for its associations with gastrointestinal malignancy. Workup in the hospital was negative for malignancy, and definitive management was left hip disarticulation and intravenous antibiotics. The patient developed a chronic wound on the left hip incision but was ultimately lost to follow-up.