Table 1.
Summary of the 6 patients with 10 episodes of Salmonella Prosthetic joint infections 1
| Patient no. | Prosthetic joint (indication) | Co-morbidities | Prosthesis age at time of infection | Clinical presentation | Microbiology | Antimicrobial therapy | Surgical management | Failed treatment | Follow-up duration |
|---|---|---|---|---|---|---|---|---|---|
| 1. | Left TKA (RA) | RA, Bladder cancer | 3 years | Deep joint pain, discomfort x 4 months | Salmonella enterica serovar Enteritidis (aspirate) | Oral TMP-SMX x 12 weeks | Aspiration only | Yes | 3 months |
| ‘’ | ‘’ | 3 years | Pain in region of joint, unresolved after 3 months of suppressive oral therapy | ‘’ (operativesample) | Oral TMP-SMX x 8 weeks | Removal, debridement and arthrodesis | No | 15 years | |
| 2. | Right THA (DJD) | Colonic polyps status post colectomy | 6 years | Cholecystectom y 2 weeks prior, with positive blood and stool cultures. Fever and joint pain x 5 days | Salmonella enterica serovar Enteritidis (operative sample) | IV ampicillin x 4 weeks and oral amoxicillin x 10 months | Debride and retain | Yes | 11 months |
| ‘’ | ‘’ | 7 years | Pain in region of prosthetic joint, unresolved after 11 months of suppressive oral therapy | ‘’ (operative sample) | IV ampicillin x 4 weeks | Removal, debridement and arthrodesis | No | 8 years | |
| 3 | Left THA (dislocated hip) | Diabetes mellitus | 5 months | Fever, joint pain, joint swelling starting 5 day prior, negative stool cultures but diarrhea 1 week earlier | Salmonella enterica serovar Choleraesui s (aspirate) | Oral ampicillin x 8 weeks | Aspiration only | Yes | 2 months |
| ‘’ | ‘’ | 7 months | Continuing symptoms | ‘’ (operative sample) | Oral ampicillin x 4 weeks | Two- stage exchange | No | 21 years | |
| 4. | Left THA (DJD) | CLL, multiple skin cancers | 4 years | Fever, chills x 2 days, Joint pain and swelling x 2 days | Salmonella enterica serovar Enteritidis (operative sample) | Oral ciprofloxacin x 8 weeks | Two- stage exchange | No | 10 years |
| 5. | Left THA (aseptic necrosis) | Ulcerative colitis, now on 6-MP | 5 months | Fever and joint pain x 2 weeks | Salmonella enterica serovar Enteritidis (operative sample) | IV ceftriaxone x 6 weeks | Two- stage exchange | No | 12 years |
| 6. | Left THA (DJD) | CKD, h/o stroke | 9 years | Complicated Salmonella UTI and septic shock 1 month prior, now left hip joint pain x 4 days | Salmonella bongori (aspirate) | Oral ciprofloxacin x 8 weeks | Aspiration only | Yes | 2 months |
| ‘’ | ‘’ | 9 years | Continuing hip pain | ‘’ + MSCONS, viridans group Streptococc us sp., (operative sample) | IV ceftriaxone x 6 weeks | Two- stage exchange | No | 4 years |
1M- male, F- female, TKA- total knee arthroplasty, THA- total hip arthroplasty, RA- rheumatoid arthritis, TMP-SMX – trimethoprim-sulfamethoxazole, DJD- degenerative joint disease, CLL- chronic lymphocytic leukemia, 6-MP- 6-mercaptopurine, CKD- chronic kidney disease, UTI- urinary tract infection, MSCONS- methicillin- susceptible Coagulase negative Staphylococci.