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Yu D, Luo Y, Sun L. Nontyphoidal salmonella septic arthritis in A patient with systemic lupus erythematosus: A case report. Diagn Microbiol Infect Dis 2024; 109:116332. [PMID: 38692203 DOI: 10.1016/j.diagmicrobio.2024.116332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/21/2024] [Accepted: 04/25/2024] [Indexed: 05/03/2024]
Abstract
We report a case of septic arthritis in a 43-year-old female patient. Despite initial treatment with ceftriaxone for Nontyphoidal Salmonella based on blood and joint fluid culture results, the shoulder joint pain worsened. Suspected systemic lupus erythematosus associated synovitis did not respond to immunosuppressive therapy including methylprednisolone, hydroxychloroquine and methotrexate. Subsequent radiograph revealed a shoulder joint abscess, leading to arthroscopic joint debridement. Ceftriaxone was administered post-operatively until analgesic efficacy was attained. This case highlights the significance of accurate diagnosis and appropriate treatment for nontyphoidal Salmonella septic arthritis.
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Affiliation(s)
- Dongjie Yu
- Department of Orthopedics, Shenzhen Qianhai Taikang Hospital, Shenzhen, China
| | - Yuansen Luo
- Department of the Second Plastic and Aesthetic Surgery, the First People's Hospital of Foshan, Foshan, China
| | - Linlin Sun
- Department of clinical microbiology and infection control, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
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2
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Manthey CF, Epple HJ, Keller KM, Lübbert C, Posovszky C, Ramharter M, Reuken P, Suerbaum S, Vehreschild M, Weinke T, Addo MM, Stallmach A, Lohse AW. S2k-Leitlinie Gastrointestinale Infektionen der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS). ZEITSCHRIFT FUR GASTROENTEROLOGIE 2024; 62:1090-1149. [PMID: 38976986 DOI: 10.1055/a-2240-1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Affiliation(s)
- Carolin F Manthey
- I. Medizinische Klinik und Poliklinik - Schwerpunkt Gastroenterologie; Sektionen Infektions- und Tropenmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Gemeinschaftspraxis Innere Medizin Witten, Witten, Deutschland
| | - Hans-Jörg Epple
- Antibiotic Stewardship, Vorstand Krankenversorgung, Universitätsmedizin Berlin, Berlin, Deutschland
| | - Klaus-Michael Keller
- Klinik für Kinder- und Jugendmedizin, Helios Dr. Horst Schmidt Kliniken, Klinik für Kinder- und Jugendmedizin, Wiesbaden, Deutschland
| | - Christoph Lübbert
- Bereich Infektiologie und Tropenmedizin, Medizinische Klinik I (Hämatologie, Zelltherapie, Infektiologie und Hämostaseologie), Universitätsklinikum Leipzig, Leipzig, Deutschland
| | | | - Michael Ramharter
- I. Medizinische Klinik und Poliklinik - Schwerpunkt Gastroenterologie; Sektionen Infektions- und Tropenmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Philipp Reuken
- Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie, Infektiologie, Zentrale Endoskopie), Universitätsklinikum Jena, Jena, Deutschland
| | - Sebastian Suerbaum
- Universität München, Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie, München, Deutschland
| | - Maria Vehreschild
- Medizinische Klinik II, Universitätsklinikum Frankfurt, Frankfurt, Deutschland
| | - Thomas Weinke
- Klinik für Gastroenterologie und Infektiologie, Klinikum Ernst von Bergmann, Potsdam, Deutschland
| | - Marylyn M Addo
- I. Medizinische Klinik und Poliklinik - Schwerpunkt Gastroenterologie; Sektionen Infektions- und Tropenmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
- Institut für Infektionsforschung und Impfstoffentwicklung Sektion Infektiologie, I. Med. Klinik, Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Andreas Stallmach
- Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie, Infektiologie, Zentrale Endoskopie), Universitätsklinikum Jena, Jena, Deutschland
| | - Ansgar W Lohse
- I. Medizinische Klinik und Poliklinik - Schwerpunkt Gastroenterologie; Sektionen Infektions- und Tropenmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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3
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Casado-Castillo F, Kobayashi T, Sekar P, Streit J, Molano De Pena I. Prosthetic hip infection due to Salmonella enterica serovar Enteritidis. IDCases 2021; 25:e01170. [PMID: 34094868 PMCID: PMC8167264 DOI: 10.1016/j.idcr.2021.e01170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/20/2021] [Accepted: 05/21/2021] [Indexed: 11/06/2022] Open
Abstract
Prosthetic joint infection (PJI) due to Salmonella spp. is uncommon, with an estimated prevalence of <0.3 % of all PJI. Salmonella enterica serovar Enteritidis and Salmonella enterica serovar Typhimurium are the most common isolates causing PJI. Risk factors include malignancy, hemoglobinopathies, diabetes mellitus, HIV/AIDS, alcohol dependency and immunosuppressed state. PJI due to Salmonella spp. can occur without significant preceding gastrointestinal symptoms of infection.
Prosthetic joint infection (PJI) is a serious complication of prosthetic joint implantation with a prevalence of about 1–2 % of all prosthetic joint surgeries. While Staphylococcus spp. are the most common organisms isolated, Salmonella spp. are a rare cause of PJI (estimated prevalence < 0.3 %). We present a case of a 62-year-old patient with a history of previous joint trauma complicated by osteonecrosis, infection and chronic alcohol abuse with late hematogenous prosthetic hip infection due to Salmonella enterica serovar Enteritidis. PJI due to Salmonella spp. should be considered in the differential diagnosis when a patient has risk factors such as malignancy, hemoglobinopathies, diabetes mellitus, human immunodeficiency virus/acquired immunodeficiency syndrome, alcohol dependency or immunosuppressed state, even without significant preceding gastrointestinal symptoms. Our patient had a few of these risk factors and required surgical debridement in addition to antimicrobials for treatment of his PJI.
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Affiliation(s)
- Fernando Casado-Castillo
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States
| | - Takaaki Kobayashi
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States
| | - Poorani Sekar
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States
| | - Judy Streit
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States
| | - Ilonka Molano De Pena
- Division of Infectious Diseases, Department of Internal Medicine, University of Iowa Hospitals and Clinics, United States
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4
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I-fan Lo, Hao-chiun Chang. Salmonella Septic Arthritis in A Patient with A Hip Implant: A Case Report. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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5
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Dojode CMR, Hemingway JS, Damodaran P, Shah NN. Total hip arthroplasty infection caused by an unusual organism, Salmonella; its successful management and literature review. BMJ Case Rep 2018; 2018:bcr-2018-224792. [PMID: 29950362 DOI: 10.1136/bcr-2018-224792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Prosthetic joint infection due to Salmonella spp is rare. Here we report an acute case of Salmonella enteritidis infection of a total hip arthroplasty in a man taking immunosuppressant medication. He was managed with antibiotics and two-stage revision surgery.
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Affiliation(s)
- Chetan Muralidhara Rao Dojode
- Furlong Fellow in Arthroplasty & Revision Surgery, Trauma & Orthopaedic Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK
| | | | - Puthur Damodaran
- Furlong Fellow in Arthroplasty & Revision Surgery, Trauma & Orthopaedic Surgery, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK
| | - Nirav N Shah
- Consultant Trauma & Orthopaedic Surgeon, Western Sussex Hospitals NHS Foundation Trust, Worthing, West Sussex, UK
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6
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Rajgopal A, Panda I, Gupta A. Unusual Salmonella typhi periprosthetic joint infection involving bilateral knees: management options and literature review. BMJ Case Rep 2017; 2017:bcr-2017-221221. [PMID: 29141925 DOI: 10.1136/bcr-2017-221221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 70-year-old Indian woman, who had undergone primary bilateral total knee arthroplasty (TKA) for rheumatoid arthritis 10 months prior, presented with 10 days history of pain, swelling and erythema over both knees with pus discharging from the right knee. She had type 2 diabetes mellitus and was on long-term steroid, leflunomide and antitumour necrosis factor therapy for rheumatoid arthritis. Her clinical and laboratory features were suggestive of a haematogenous periprosthetic joint infection (PJI). The final diagnosis of bilateral Salmonella typhi PJI was made based on culture reports. Considering her underlying immunosuppression, a bilateral two-stage revision TKA was done with complete remission of symptoms and good functional recovery at last follow-up after 18 months. S. typhi infection of prosthetic joint has not been reported in the literature. Patients presenting with gastrointestinal complaints and PJI should alert the clinician to the possibility of infection with such atypical organisms endemic to the region.
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Affiliation(s)
- Ashok Rajgopal
- Department of Orthopaedics, Fortis Escorts Bone and Joint Institute, New Delhi, Delhi, India
| | - Inayat Panda
- Department of Orthopaedics, Fortis Escorts Bone and Joint Institute, New Delhi, Delhi, India
| | - Anu Gupta
- Department of Microbiology, Fortis Escorts Heart Institute, New Delhi, Delhi, India
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Ekinci M, Bayram S, Akgül T, Ersin M, Yazicioğlu Ö. Periprostetic Joint Infection Caused by Salmonella: Case Reports of Two Azathioprine and Prednisolone Induced-immunocompromised Patients. Hip Pelvis 2017; 29:139-144. [PMID: 28611966 PMCID: PMC5465396 DOI: 10.5371/hp.2017.29.2.139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 03/30/2017] [Accepted: 03/31/2017] [Indexed: 11/24/2022] Open
Abstract
Periprosthetic joint infection (PJI) due to Salmonella is rare. It frequently occurs patients receiving immunosuppressive medicine. We describe two periprosthetic Salmonella infection of two immunocompromised patients. Both of patients were receiving azathioprine and prednisolone therapy. First patient presented six years after total hip arthroplasty with a huge abscess on her right thigh that was reached to femoral component through the lytic area of lateral femur. Second patient presented with drainage from his hip and he had undergone two-step revision surgery for PJI 3 months ago. There is no consensus in the treatment of periprosthetic salmonella infections. We prefer two-step revision surgery for these infections as previously described in the literature.
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Affiliation(s)
- Mehmet Ekinci
- Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Serkan Bayram
- Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Turgut Akgül
- Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Ersin
- Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Önder Yazicioğlu
- Department of Orthopaedics and Traumatology, Istanbul University Faculty of Medicine, Istanbul, Turkey
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8
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Mahmoud SSS, Sukeik M, Alazzawi S, Shaath M, Sabri O. Salvage Procedures for Management of Prosthetic Joint Infection After Hip and Knee Replacements. Open Orthop J 2016; 10:600-614. [PMID: 28144373 PMCID: PMC5226968 DOI: 10.2174/1874325001610010600] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 06/24/2016] [Accepted: 07/15/2016] [Indexed: 02/07/2023] Open
Abstract
Background: The increasing load placed by joint replacement surgery on health care systems makes infection, even with the lowest rates, a serious concern that needs to be thoroughly studied and addressed using all possible measures. Methods: A comprehensive review of the current literature on salvage procedures for recurrent PJIs using PubMed, EMBASE and CINAHL has been conducted. Results: Prolonged suppressive antibiotic therapy (PSAT), resection arthroplasty and arthrodesis were the most common procedures performed. Suppressive antibiotic therapy is based on the use of well tolerated long term antibiotics in controlling sensitive organisms. Resection arthroplasty which should be reserved as a last resort provided more predictable outcomes in the hip whereas arthrodesis was associated with better outcomes in the knee. Various methods for arthrodesis including internal and external fixation have been described. Conclusion: Despite good union and infection control rates, all methods were associated with complications occasionally requiring further surgical interventions.
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Affiliation(s)
- Samer S S Mahmoud
- Department of Trauma and Orthopaedics, South Tees NHS Foundation Trust, Marton Road, Middlesbrough, TS4 3 BW, United Kingdom
| | - Mohamed Sukeik
- Department of Trauma and Orthopaedics, The Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom
| | - Sulaiman Alazzawi
- Department of Trauma and Orthopaedics, The Royal London Hospital, Whitechapel, London, E1 1BB, United Kingdom
| | - Mohammed Shaath
- Department of Trauma and Orthopaedics, North Manchester General Hospital, Delaunay's Road, Crumpsall, M8 5RB, United Kingdom
| | - Omar Sabri
- Department of Trauma and Orthopaedics, St Georges NHS Foundation Trust, Tooting, London, SW17 0QT, United Kingdom
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Gupta A, Berbari EF, Osmon DR, Virk A. Prosthetic joint infection due to Salmonella species: a case series. BMC Infect Dis 2014; 14:633. [PMID: 25424009 PMCID: PMC4258011 DOI: 10.1186/s12879-014-0633-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 11/13/2014] [Indexed: 02/08/2023] Open
Abstract
Background Prosthetic joint infection (PJI) due to Salmonella is rare. Numerous outbreaks of Salmonella have been reported throughout the United States in the last decade. We reviewed and analyzed cases of Salmonella PJI seen at our institution. Methods The medical records of all patients diagnosed with a Salmonella PJI between 1969–2013 were reviewed. Patients were followed till death, treatment failure or loss to follow-up. Results Six patients of Salmonella PJI were identified during the 44 year study period. Five were male; median age was 63.5 years (range 52–76). Five patients were immunodeficient. Five had a total hip arthroplasty infection, while one had a total knee arthroplasty infection. Median prosthesis age at the time of diagnosis of first episode of Salmonella PJI was 5 years (range 4 months-9 years). Four presented with fever and constitutional signs within two weeks of symptom onset. Two patients each had gastrointestinal symptoms and Salmonella bacteremia. Salmonella enterica serovar Enteritidis was the most common organism isolated (4 patients). None were Salmonella enterica serovar Typhi. Initial management included aspiration and antimicrobial therapy only (3), debridement and component retention (1) and two-staged exchange (2). All four patients treated without resection failed treatment a median of 2.5 months (range 2–11) after diagnosis and required resection arthroplasty. All six patients who underwent prosthesis removal (and exchange or arthrodesis) had successful outcome with a median duration of follow-up of 11 years (range 4–21). Three of these received oral antimicrobial therapy for a median duration eight weeks (range 4–8) and three received parenteral antimicrobial therapy for a median duration of six weeks (range 4–6). Conclusions The increase in Salmonella outbreaks does not seem to lead to increased Salmonella PJI. PJIs due to Salmonella remain rare, and the presentation is often acute with fever. It frequently occurs in immunocompromised patients. In our patient population, removal of prosthesis with or without reimplantation, along with 4–6 weeks of effective parenteral antimicrobial therapy was most often associated with successful eradication of infection.
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Affiliation(s)
- Arjun Gupta
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA. .,Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Texas, USA.
| | - Elie F Berbari
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
| | - Douglas R Osmon
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
| | - Abinash Virk
- Division of Infectious Diseases, Department of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55905, USA.
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Nandagudi AC, Kelly S. Ultrasound Detection of Salmonella Septic Arthritis in a Rheumatoid Arthritis Patient on Anti-TNF Treatment. J Investig Med High Impact Case Rep 2014; 2:2324709614532799. [PMID: 26425605 PMCID: PMC4528892 DOI: 10.1177/2324709614532799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We report a case of Salmonella septic arthritis detected by ultrasound in a 40-year-old man with rheumatoid arthritis while he was on anti–tumor necrosis factor-α monoclonal antibody certolizumab. An aspirate of his left elbow joint showed Salmonella enteritidis infection that was sensitive to ceftraixone. This was preceded by a brief episode of loose stools following a visit to the Far East. He was treated with antibiotics and made a good recovery. There have only been a few case reports of Salmonella septic arthritis in a rheumatoid arthritis patient on anti–tumor necrosis factor treatment but none previously in association with certolizumab.
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11
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Frickmann H, Hänle A, Essig A, Dekker D, Boahen K, Acquah S, Sarpong N, Adu-Sarkodie Y, Schwarz NG, May J, Marks F, Hagen RM, Poppert S. Fluorescence in situ hybridization (FISH) for rapid identification of Salmonella spp. from agar and blood culture broth--an option for the tropics? Int J Med Microbiol 2013; 303:277-84. [PMID: 23642903 DOI: 10.1016/j.ijmm.2013.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 04/02/2013] [Accepted: 04/07/2013] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Salmonella enterica is an important cause of diarrhea with the potential to cause systemic infection including sepsis, particularly in the tropics. Sepsis in particular requires quick and reliable identification to allow a rapid optimization of antibiotic therapy. We describe the establishment and evaluation of fluorescence in situ hybridization (FISH) as a rapid and easy-to-perform molecular identification procedure from agar and blood culture broths. METHODS Two newly developed FISH probes with specificity for Salmonella spp. were evaluated with 10 reference strains, 448 clinical isolates of Gram-negative bacteria from Germany and Ghana including 316 Salmonella spp. strains, and 39 environmental Salmonella spp. isolates from rivers and streams in Ghana. One FISH probe was further tested with 207 pre-incubated blood culture broths from Germany with Gram-negative rod-shaped bacteria in Gram stain. RESULTS Evaluation of the newly designed FISH probes demonstrated sensitivity of 99.2% and specificity of 98.4% for clinical isolates, sensitivity of 97.4% for environmental Salmonella spp. isolates, and sensitivity of 100% and specificity of 99.5% for blood culture materials. CONCLUSIONS FISH proved to be highly reliable for a rapid identification of Salmonella spp. directly from pre-incubated blood culture broths as well as after growth on agar. The inexpensive and easy-to-perform procedure is particularly suitable for resource-limited areas where more sophisticated procedures are not available.
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Affiliation(s)
- Hagen Frickmann
- Department of Tropical Medicine at the Bernhard-Nocht Institute, German Armed Forces Hospital of Hamburg, Germany.
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de la Torre B, Tena D, Arias M, Romanillos O. Recurrent prosthetic joint infection due to Salmonella enteritidis: case report and literature review. EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2012; 22 Suppl 1:89-97. [DOI: 10.1007/s00590-012-0955-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2011] [Accepted: 01/20/2012] [Indexed: 12/17/2022]
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Kumar VA, Krishna S, Thilak J, Dinesh KR, Karim S. Salmonella typhimurium in the hip: look before a SLE patient leaps. Trop Doct 2011; 41:166-7. [PMID: 21724687 DOI: 10.1258/td.2011.110015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Salmonellosis is a common infection in systemic lupus erythematosus patients. The present study reports on two such cases of Salmonella typhimurium septic arthritis among the 102 patients seen during a four-year period.
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Affiliation(s)
- V Anil Kumar
- Department of Microbiology, Amrita Institute of Medical Sciences, Ponekara, Kochi - 682041, Kerala, India.
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14
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Salmonella septic arthritis following total knee arthroplasty for rheumatoid arthritis in a patient receiving etanercept. J Orthop Sci 2011; 16:258-62. [PMID: 21301900 DOI: 10.1007/s00776-011-0023-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2009] [Accepted: 05/19/2010] [Indexed: 10/18/2022]
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15
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Carlile GS, Elvy J, Toms AD. Salmonella infection of a total knee replacement. Knee 2010; 17:356-8. [PMID: 19897369 DOI: 10.1016/j.knee.2009.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2009] [Revised: 10/05/2009] [Accepted: 10/06/2009] [Indexed: 02/02/2023]
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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Affiliation(s)
- G S Carlile
- Princess Elizabeth Orthopaedic Centre, Royal Devon & Exeter Hospital, Barrack Road, Exeter, EX2 5DW, United Kingdom.
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Kobayashi H, Hall GS, Tuohy MJ, Knothe U, Procop GW, Bauer TW. Bilateral periprosthetic joint infection caused by Salmonella enterica serotype Enteritidis, and identification of Salmonella sp using molecular techniques. Int J Infect Dis 2009; 13:e463-6. [PMID: 19269872 DOI: 10.1016/j.ijid.2008.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 11/17/2008] [Accepted: 12/15/2008] [Indexed: 12/18/2022] Open
Abstract
Salmonella septic arthritis is rare. Our objective was to identify bacterial species from joint fluid using a broad-range real-time PCR and pyrosequencing technique. We describe a case of bilateral Salmonella enterica serotype Enteritidis infection of right and left total knee arthroplasties. DNA was extracted from the joint fluid of the left knee, amplified by PCR, and the amplicons were evaluated by pyrosequencing. The patient was treated with ciprofloxacin, and the polyethylene liners were replaced in both knees. The results of pyrosequencing detected a Salmonella species. To the best of our knowledge, this is the first report describing the detection of Salmonella in joint fluid by universal PCR followed by pyrosequencing.
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Affiliation(s)
- Hideo Kobayashi
- Pathology and Laboratory Medicine Institute, The Cleveland Clinic, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA
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Muñoz-Mahamud E, Casanova L, Font LL, Fernández-Valencia JA, Bori G. Septic arthritis of the hip caused by nontyphi Salmonella after urinary tract infection. Am J Emerg Med 2009; 27:373.e5-373.e8. [DOI: 10.1016/j.ajem.2008.07.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2008] [Accepted: 07/20/2008] [Indexed: 11/16/2022] Open
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Pezone I, Penna MRD, Flamini S, Nigro G. Non-typhoidal Salmonella septic arthritis in an immunocompetent child with a pharyngeal streptococcal infection. Int J Infect Dis 2008; 13:e35-6. [PMID: 18707909 DOI: 10.1016/j.ijid.2008.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 06/02/2008] [Indexed: 10/21/2022] Open
Abstract
We report the case of an immunocompetent child who showed monoarticular arthritis and fever, preceded by pharyngitis and arthralgias. Because group A beta-hemolytic Streptococcus had been detected in the pharyngeal swab, erythromycin was given on admission. However, based on ultrasound examination, therapy with ceftriaxone and joint fluid drainage were promptly performed, and a rapid and full recovery followed. Meanwhile, Salmonella enterica infection was revealed in blood and joint fluid. Our case suggests that septic arthritis caused by a non-typhoidal Salmonella infection may occur without gastrointestinal manifestations and concomitantly with a pharyngeal streptococcal infection.
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Affiliation(s)
- Ilaria Pezone
- Department of Pediatrics, University of L'Aquila, L'Aquila, Italy
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Abstract
A 5-year-old male child was undergoing chemotherapy for pre-B acute lymphoblastic leukemia. He developed Salmonella typhi arthritis of his left hip joint during neutropenic phase. Infection was successfully treated with intravenous antibiotics without surgical management. S. typhi is a potential cause of arthritis, especially in immunocompromised children. More than 100 other cases of Salmonella arthritis are reviewed and reveal a disease primarily of children and young adults with a favorable treatment response.
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Marculescu CE, Berbari EF, Cockerill FR, Osmon DR. Unusual aerobic and anaerobic bacteria associated with prosthetic joint infections. Clin Orthop Relat Res 2006; 451:55-63. [PMID: 16906072 DOI: 10.1097/01.blo.0000229317.43631.81] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The association of certain microorganisms, such as Staphylococcus epidermidis, Staphylococcus aureus, and beta-hemolytic streptococci, with prosthetic joint infection (PJI) has been recognized for many years. To our knowledge, a systematic review of the presentation and management of less commonly encountered species of coagulase-negative staphylococci, nutritional-variant streptococci, aerobic non-spore and spore forming Gram-positive or anaerobic bacteria is not available. We therefore sought to provide a comprehensive literature review of PJI due to these microorganisms that will provide a valuable and quick reference for clinicians caring for these patients. We conducted a Medline search of all case reports and case series of PJI due to unusual aerobic and anaerobic bacteria. The presentation, surgical, and medical management strategies were reviewed. Appropriate medical and surgical management of such infections is complex and evolving as newer diagnostic tests, surgical techniques and antimicrobials become available. Management of patients with these infections requires close collaboration between the orthopaedic surgeon, infectious disease specialist and microbiology laboratory.
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Affiliation(s)
- David B Musante
- Division of Orthopedics, Duke University Medical Center, Durham, NC 27710, USA
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