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What Causes Repetitive Need Of Vancomycin Therapy After Bi-lateral Total Shoulder Replacement?

Posted on Thu, 14 May 2015

Question: About seven years ago, I had bi-lateral total shoulder replacements. Because of severe bone erosion the "reverse" technique and hardware was used. In the interim, infection set in my right shoulder which necessitated Vancomycin therapy three times. The last treatment was four years ago and since then the infection has not returned but a large amount of fluid has collected in the area. There is no pain associated and three different orthopedic surgeons have advised doing nothing. Intuitively, I have thought that intervention in the form of draining the site would be indicated even though I was advised by one source that it would probably return. At this point I don't care--I just want the "hump" to go away.

Answered by Dr. Sunil Kumar Srivastava (16 minutes later)

Brief Answer:
aspiration for culture.search for any metallic reaction,consult surgeon

Detailed Answer:
Hi
To assess for infection status an aspiration and analysis of fluid with culture for bacteria/microbes comes to my thinking.
if culture comes out sterile then no need for antibiotics.
Also I would want to have an MRI of shoulder and get some tests for metal reactions done to rule out any metal ionic reaction causing collection .Metal implants often give local reactions sometimes due to metalic content which is foreign to body tissues.
I would suggest to seek and consult for above with your surgeon who operated.
MRI for bursitis around shoulder joint

Regards,

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Above answer was peer-reviewed by : Dr. Raju A.T