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Two-Stage Revision Arthroplasty for Salmonella enteritidis Periprosthetic Hip Infection
Stavros Lykos1, Konstantinos Tsivelekas1, Dimitrios Pallis1
1Second Department of Orthopaedic Surgery, KAT General Hospital of Attica, Athens, Greece.
Abstract:
Periprosthetic joint infections (PJIs) are severe complications following joint arthroplasty, commonly caused by Gram-positive bacteria, such as Staphylococcus aureus. Infections due to Gram-negative organisms like Salmonella enteritidis are exceedingly rare. In this study, we report a case of a 68-year-old male who developed a late-onset PJI caused by Salmonella enteritidis 10 years after primary total hip arthroplasty (THA). A two-stage revision arthroplasty with an interim antibiotic spacer was performed, followed by 6 weeks of intravenous antibiotic therapy. Three months postoperatively, the patient demonstrated full recovery with normal function. This case highlights the necessity of considering uncommon pathogens like Salmonella enteritidis in PJIs, even in patients without identifiable predisposing factors, and underscores the effectiveness of combined surgical and targeted antimicrobial therapy.
Insights
Periprosthetic joint infections (PJIs) are rare but serious. This case study details a late-onset PJI caused by Salmonella enteritidis following hip arthroplasty, successfully treated with surgery and antibiotics.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Periprosthetic joint infections (PJIs) are significant complications after joint replacement surgery.
- Gram-positive bacteria, like Staphylococcus aureus, are typical PJI pathogens.
- Infections by Gram-negative bacteria, such as Salmonella enteritidis, are uncommon.
Purpose of the Study:
- To report a rare case of late-onset PJI caused by Salmonella enteritidis.
- To emphasize the importance of considering unusual pathogens in PJI diagnosis.
- To highlight effective treatment strategies for PJI caused by uncommon bacteria.
Main Methods:
- A case report of a 68-year-old male patient with late-onset PJI 10 years post-total hip arthroplasty (THA).
- Diagnosis of PJI caused by Salmonella enteritidis.
- Treatment involved a two-stage revision arthroplasty with an antibiotic spacer and 6 weeks of intravenous antibiotics.
Main Results:
- The patient experienced a full recovery with normal function three months after the second stage of surgery.
- Successful eradication of Salmonella enteritidis infection.
- Demonstrated the efficacy of a combined surgical and antimicrobial approach.
Conclusions:
- Salmonella enteritidis should be considered in the differential diagnosis of PJIs, even without apparent risk factors.
- A combination of surgical intervention and targeted antibiotic therapy is effective for treating rare Gram-negative bacterial PJIs.
- Early recognition and appropriate management are crucial for favorable outcomes in PJI cases.
