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West Florida


Largo Medical Center


Orthopedic Surgery

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Prevotella Biva, Prevotella Sp., Osteomyelitis, Tenosynovitis, Amputation, Infection


Bacterial Infections and Mycoses | Infectious Disease | Orthopedics | Surgical Procedures, Operative


  • Prevotella bivia is an anaerobic, non-pigmented, Gram-negative bacillus species that is known to inhabit the human female vaginal tract and oral flora. It is most commonly associated with endometritis and pelvic inflammatory disease.1, 2
  • Rarely, P. bivia has been found in the nail bed, chest wall, intervertebral discs, and hip and knee joints.1 The bacteria has been linked to necrotizing fasciitis, osteomyelitis, or septic arthritis.3, 4
  • Only 3 other reports have described P. bivia infections in the upper extremity with one patient requiring amputation2, and one with deep soft tissue infection requiring multiple debridements and extensive tenosynovectomy.5
  • Delays in diagnosis are common due to P. bivia’s long incubation period and association with aerobic organisms that more commonly cause soft tissue infections leading to inappropriate antibiotic coverage.
  • Here we present a case on P. bivia that resulted in extensive tenosynovectomy, multiple irrigations and debridements and eventually amputation of the 4th ray and digit of the hand.

Novel Infection Status Post Electrocution Requiring a 4th Ray Amputation



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