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Salmonella infection of a total knee replacement

G.S. CarlileaCorresponding Author Informationemail address, J. Elvyb1email address, A.D. Tomsa2email address

Received 25 March 2009; received in revised form 5 October 2009; accepted 6 October 2009. published online 09 November 2009.
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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.

a Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, United Kingdom

b Department of Medical Microbiology, Royal Devon & Exeter Hospital, Church Lane, Exeter EX2 5AD, United Kingdom

Corresponding Author InformationCorresponding author. Tel.: +44 7977299952.

1 Tel.: +44 1392402978.

2 Tel.: +44 1392403562.

PII: S0968-0160(09)00200-2

doi:10.1016/j.knee.2009.10.003