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Salmonella infection of a total knee replacement
Authors:G.S. Carlile  J. Elvy  A.D. Toms
Affiliation:1. Department of Orthopaedic Surgery, Gil Medical Center, Gil Hospital, Gachon University School of Medicine, 1198 Guwol-dong, Namdong-gu, Incheon 405-760, Korea;2. Department of Internal Medicine, Gachon University School of Medicine, Gil Hospital, Incheon, Korea;1. Sapienza, University of Rome, Department of Cardiac Surgery, Ospedale Sant''Andrea, Roma, Italy;2. Department of Cardiothoracic Surgery, Harefield Hospital, London UK;3. Québec Heart & Lung Institute, Québec, QC, Canada;1. Department of Orthopedic Surgery, Gangnam Nanoori Hospital, 731 Eonju-ro, Gangnam-gu, Seoul 06048, South Korea;2. Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea;3. Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea;4. Stem Cell & Regenerative Medicine Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, South Korea;5. Department of Orthopedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, 102 Heukseok-ro, Dongjak-gu, Seoul 06973, South Korea
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.
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