“A Difficile-cult Case” – Clostridioides difficile prosthetic joint infection; case report, microbiology, and review of the literature.

This paper reports a rare case of an extra-colonic Clostridioides difficile infection presenting as a left hip prosthetic joint infection in a 76-year-old man, occurring six weeks after surgical revision for a periprosthetic fracture. The authors describe microbiologic workup and management, noting that curative surgery was not feasible and that the patient underwent repeated debridement with intravenous vancomycin and oral metronidazole, followed by successful suppression using oral doxycycline—a strategy the authors state had not been previously documented. They also review the literature and report that only seven C. difficile–associated prosthetic joint infection cases had been published, emphasizing limited guidance for management, and they highlight that this case is the first known instance using whole genome sequencing for the isolate. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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