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Case report: Salmonella infection following total hip arthroplasty
1Vanderbilt University Medical Center, Nashville, TN, USA.
Abstract:
A case of a total hip arthroplasty infection with Staphylococcus aureus, co-infected with Salmonella choleraesuis was treated with two-stage exchange and administration of vancomycin and ciprofloxacin. No signs of re-infection have appeared fourteen months after surgery. Cases of salmonella infection of hip prostheses are quite rare, with only a handful of reports in the literature.
Insights
A rare co-infection of Staphylococcus aureus and Salmonella choleraesuis in a total hip arthroplasty was successfully treated with a two-stage exchange surgery and antibiotics. The patient showed no signs of re-infection 14 months post-operation.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Total hip arthroplasty (THA) is a common procedure, but susceptible to periprosthetic joint infections (PJIs).
- Staphylococcus aureus is a frequent pathogen in PJIs, while Salmonella species are uncommon causes.
- Co-infections in THA pose unique diagnostic and therapeutic challenges.
Observation:
- A patient presented with a THA infection involving both Staphylococcus aureus and Salmonella choleraesuis.
- The clinical presentation and diagnostic workup confirmed the polymicrobial nature of the infection.
- Salmonella choleraesuis infection of hip prostheses is exceptionally rare, with limited documented cases.
Findings:
- A two-stage surgical exchange of the prosthesis was performed.
- Post-operative treatment included intravenous vancomycin and ciprofloxacin.
- The patient remained free from infection recurrence at a 14-month follow-up.
Implications:
- This case highlights the possibility of rare bacterial co-infections in THA, even with unusual pathogens like Salmonella.
- Effective management may involve aggressive surgical intervention combined with targeted antibiotic therapy.
- Further research into the management of polymicrobial PJIs, particularly those involving Salmonella, is warranted.