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Septic arthritis caused by Klebsiella pneumonia in adults is rare and is rarely observed after total knee arthroplasty. Acute or early onset of septic arthritis caused by K. pneumoniae has been reported after total knee arthroplasty. However, to date the only one overseas case of late K. pneumoniae infection after total knee arthroplasty has been reported, with no such case in Korea. In addition, monomicrobial infections by K. pneumoniae are not frequently found but are found primarily in the form of polymicrobial infections. The purpose of this paper is to report on a case in which an 85-year-old female patient, who had undergone a total joint arthroplasty 11 years ago, developed the late onset of septic arthritis caused by monomicrobial K. pneumonia infection with a periprosthetic fracture through literature reviews.

Streptococcus sanguis (S. sanguis) is a gram positive streptococcus bacteria which is found in the normal bacterial fl ora of the oral cavity and the upper respiratory tract. It has low virulence, but it can cause bacterial endocarditis through the blood circulation when dental calculus are removed from the teeth or during surgical treatment. Septic arthritis caused by S. sanguis has been reported as infecting the sternoclavicular joint and the knee joint, but it is a quite rare infectious disease that has not been reported in Korea. Therefore, the authors report a case of the septic arthritis in the knee joint caused by S. sanguis in a patient with osteoarthritis of the knee, who has the history of periodontitis.