Streptococcus viridans periprosthetic joint infections
The increasing rate of total joint arthroplasty (TJA) in the United States will lead to more cases of periprosthetic joint infection (PJI), including those caused by Streptococcus viridans (S. viridans) group organisms, which are relatively rare culprits of infection. The S. viridans organisms are divided into five subfamilies based on specific criteria. Since the primary source of each subfamily is the oral cavity, the role of antibiotic prophylaxis prior to invasive dental procedures has been debated to best suit the interest of the patient. Diagnostic criteria have recently been standardized for all organisms responsible for PJI. Treatment regimens are determined by maximal antibiotic susceptibility based on the specific S. viridans subfamily identified. The collective information presented on S. viridans PJI in this review paper will help prepare orthopaedic surgeons in preventing and treating these difficult infections.