Salmonella Septic Arthritis in A Patient with A Hip Implant: A Case Report

• Main Authors: I-fan Lo, Hao-chiun Chang
• Format: Article
• Language: English
• Published: Taiwan Society of Geriatric Emergency and Critical Medicine (TSGECM) 2018-12-01
• Series: International Journal of Gerontology
• Online Access: http://www.sciencedirect.com/science/article/pii/S1873959818300620

Summary: Joint infections due to non-typhi Salmonella are rare, and usually associated with sickle cell anemia or other immunosuppressive disorders. An 80-year-old female, with a recent history of lung adenocarcinoma and a 20 year history of rheumatoid arthritis with steroid use, presented with hip pain. Her right hip had 3 screws due to a femoral neck fracture 5 years previously, and she reported suffering from intermittent right hip pain for the previous 3 years. Patrick's test was positive and X-rays showed rapid progression of femoral head collapse and screw penetration within 3 weeks, suggesting hip infection. We removed the implant, performed sequestrectomy of the femoral head, and inserted a cement spacer with debridement. We administered antibiotics after surgery to control hip sepsis, based on Salmonella-positive cultures. The patient ultimately died of sepsis. This case illustrates successful management of hip sepsis requires prompt identification of infection, surgical intervention, and administration of appropriate systemic antibiotics. When a patient presents with musculoskeletal discomfort, the clinician should perform thorough examinations as soon as possible, especially of the patient is immunodeficient. Keywords: Avascular necrosis, Immunosuppression, Non-typhi salmonella