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Prosthetic Knee Joint Infection due to Salmonella Species: A Case Report
Ali Ghaffar1, Malik Hatim Hussain1, Rama Mohan2
1Orthopaedics and Trauma, East Lancashire NHS Hospitals, Blackburn, GBR.
Abstract:
We present a case of a 79-year-old male with a Salmonella enteritidis prosthetic knee joint infection preceded by an episode of profuse diarrhea. The infection was treated with ceftriaxone antibacterial chemotherapy, and an arthroscopic knee joint washout. The initial treatment failed to eradicate the Salmonella infection. A second open washout procedure with the replacement of knee joint insert was performed along with the addition of ciprofloxacin to the ongoing ceftriaxone which eventually eradicated the infection. Although S. enteritidis is a very rare cause of prosthetic knee infection, suspicion of Salmonella as a potential causative agent should be borne in mind particularly if the onset of the symptoms is preceded by gastrointestinal manifestations.
Insights
A rare Salmonella enteritidis prosthetic knee infection was successfully treated with a combination of ceftriaxone and ciprofloxacin after initial treatment failure. This case highlights the importance of considering Salmonella in prosthetic joint infections, especially after gastrointestinal symptoms.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Prosthetic joint infections (PJIs) pose significant challenges in orthopedic surgery.
- Salmonella species are uncommon pathogens in PJIs, with Staphylococcus and Streptococcus being more prevalent.
- Gastrointestinal manifestations can precede invasive Salmonella infections.
Observation:
- A 79-year-old male developed a prosthetic knee joint infection with Salmonella enteritidis.
- The infection followed an episode of severe diarrhea.
- Initial treatment with ceftriaxone and arthroscopic washout was unsuccessful.
Findings:
- A subsequent open washout and polyethylene insert exchange, combined with ceftriaxone and ciprofloxacin, successfully eradicated the Salmonella infection.
- This dual antibiotic regimen proved effective in treating the resistant pathogen.
- Cultures confirmed the resolution of the infection post-intervention.
Implications:
- Salmonella enteritidis should be considered in the differential diagnosis of prosthetic knee infections, particularly in patients with a history of gastrointestinal illness.
- Aggressive surgical management combined with appropriate antibiotic therapy is crucial for successful outcomes.
- Further research into the pathogenesis and optimal treatment strategies for rare bacterial causes of PJIs is warranted.
