Staphylococcus aureus is still by far the commonest cause of septic arthritis [
1,
2]. A patient’s age group and clinical condition usually predisposed one to infective bacteria outside of usual cases due to SA [
1‐
3]. Rarer causes of septic arthritis include
Prevotella species [
4‐
6,
8]. The literature reports these micro-organisms to be isolated in only a handful of cases [
4‐
9]. And as such, there is no level 1 evidence for diagnosis, treatment, and eventual outcomes for PSA. Our case of discussion was a young male who fits the profile for PSA as per his risk factors [
4]. Shalman et al. reported the condition to affect individuals in the 5th and 6th decades but it can also be expected in younger patients suffering from medical co-morbidities and risk factors, as was the case in our patient [
4‐
8]. On history, he had a prior surgical history of the same (LEFT) hip for a previous infective arthritis that was treated and had healed uneventfully. Naseir et al. also reported
Prevotella septic arthritis in a joint with previous surgery. However, Shalman et.al and others reported the infection in surgically naive joints [
5,
9]. Recent dental surgery has also been associated with PSA following dental tooth extraction [
6,
7]. PSA post-dental surgery can develop as early as 48 hours post-tooth extraction especially in elderly patients [
6]. Usually in cases that follow post-dental work there is an underlying arthropathy of sorts [
7]. Joint inflammatory arthritides have always been noted to be risk factors for the development of infective arthritis on the whole [
8‐
11].
Clinically PSA presents with the classic signs of infective arthritis with pain, swelling, warmth, and loss of function of the involved joint, however usually with an associated draining sinus [
4,
5]. The picture can be easily confused with that of subacute and even chronic infective arthritis like the one seen in tuberculosis of the joints. Ironically, radiological changes with PSA are similar to those of chronic infective arthritis. Our case presented with an increased joint space and an effusion. Surgical drainage usually reveals a yellowish-to-greenish collection of pus [
4]. Microscopy revealed a small gram-negative rod on Haematoxylin and Eosin staining previously referred to as Bacteroides species. Fortunately, these microorganisms are usually sensitive to antibiotics [
12,
13]. However the duration of treatment is not well defined in the literature and so we adopted treatment as per the usual SA infective arthritis with the use of intravenous antibiotics for 4 weeks and an additional 2 weeks of oral antibiotics post-discharge [
4,
13]. Metronidazole is the gold standard of treatment with clindamycin being the only alternative [
13]. Traction was applied for the 1st four weeks with the plan to have the joint heal in an acceptable arthrodesis position of hip flexion at 15 degrees. Arthrodesis was preferred in our case since there was established joint destruction at presentation and the patient was not an ideal candidate for arthroplasty replacement due to his age and co-morbidities. At the last follow-up, the patient was seen to be mobilising non-weight bearing with crutches, and pain-free on the left hip.