title: Salmonella infection of a total knee replacement.
abstract: Salmonella enterica serotype Choleraesuis is a rare infective pathogen in total knee arthroplasty and accounts for less than 1% of all cases. In the United Kingdom, the most prevalent organisms are Staphylococci, which account for over 50% of cases. We present an interesting case report of an infected revision total knee replacement following foreign travel to a region with an increased prevalence of Salmonella. The patient presented typically with an effused knee and raised inflammatory markers. Tissue samples demonstrated Salmonella choleraesuis as the infective organism. Though this serotype has previously been isolated from an infected total hip prosthesis, we believe this could be the first reported case involving a total knee replacement. Following involvement of our microbiology team and aggressive antibiotic therapy, the patient was successfully treated with two-stage revision surgery and at one-year post-op is making a satisfactory recovery.
authors.affiliation: Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, United Kingdom. graeme_carlile@hotmail.com
authors.forename: G S
authors.initials: GS
authors.lastname: Carlile
authors.forename: J
authors.initials: J
authors.lastname: Elvy
authors.forename: A D
authors.initials: AD
authors.lastname: Toms
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D019645:Arthroplasty, Replacement, Knee; D002439:Cefotaxime / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000382:microbiology* / Q000628:therapy; D012086:Reoperation; D012480:Salmonella Infections / Q000382:microbiology* / Q000628:therapy; D019779:Salmonella enterica / Q000145:classification / Q000302:isolation & purification*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002439:Cefotaxime