Woman's vigorous FLOSSING triggers a nasty knee infection 'after bacteria seeped into her bloodstream via her bleeding gums'

When a female patient visited hospital complaining of knee pain and swelling, doctors in Wisconsin diagnosed an infection.
But it was the source of the bacterial infection that surprised medics.
Before her symptoms suddenly appeared, the 65-year-old patient had voluntarily embarked on a vigorous dental flossing regime.

Five years prior to that she had been diagnosed with osteoarthritis and underwent a knee replacement operation.
And six months before the patient visited the emergency room she began to notice mild right leg and knee pain, the report published in the journal BMJ Case Reports revealed.
Doctors diagnosed a condition common in runners and cyclists, iliotibial band syndrome, and advised she underwent acupuncture to relieve her pain.

The iliotibial band is a thick band of tissue that begins in the pelvis and runs down the outer part of the thigh, and crosses the knee to attach to the top part of the tibia, or shinbone.

But the patient then experienced a sudden onset of pain, swelling and chills, around 10 hours before arriving at hospital.
Tests on fluid taken from her right knee revealed the joint was infected with the bacteria Streptococcus gordonii.

S.gordonii is a bacteria typically found in the mouth and linked to dental plaque formation, and as such its presence provoked confusion among the medics treating the female patient.

However, when the patient told doctors that she had voluntarily started this vigorous dental flossing regime, and had suffered bleeding gums, the link became clearer.
It is likely the bacteria spread from the woman's mouth via her bloodstream, travelling to her leg where it infected the prosthetic knee joint.

Dr Ala Dababneh, an infectious diseases doctor at the Mayo Clinic in Minnesota, and co-author of the report, told Livescience: 'This bacteria lives in the mouth, (but doctors) happened to find it in a place where we don't typically find it, which is the knee joint.'

The case report is the first in North America to link flossing to a S.gordonii infection in a joint replacement, and only the second thought to be documented worldwide.
Dr Dababneh added: 'It's a rare event. I don't want people to worry that just flossing is going to cause them an infection in their prosthetic joint.'
Doctors treating the woman operated, opening up her knee to remove the infection by washing out the bacteria.

She was also prescribed a course of antibiotics.
The case report's authors noted that prosthetic joint infection is 'one of the most serious complications' of joint replacement surgeries.
They added: 'Although it is difficult to establish direct causation, the only risk factor identified was the vigorous dental flossing regimen that the patient initiated prior to the onset of her symptoms.
'It is reasonable to speculate that the dental flossing regimen was responsible, given the timing of the infection, the organism identified... and the known association between dental flossing and dental procedures producing transient bacteraemia.'
The patient was said to be doing well at a follow-up appointment 12 months after her initial infection.