Hip Pelvis.  2017 Jun;29(2):139-144. 10.5371/hp.2017.29.2.139.

Periprostetic Joint Infection Caused by Salmonella: Case Reports of Two Azathioprine and Prednisolone Induced-immunocompromised Patients

• Ekinci M
• Bayram S
• Akgül T
• Ersin M
• YazicioÄŸlu O

• KMID: 2424243
• DOI: http://doi.org/10.5371/hp.2017.29.2.139

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.

Keyword

Periprosthetic joint infection; Salmonella; Azathioprine; Immunosuppressive; Two-step revision

MeSH Terms

Abscess
Arthroplasty, Replacement, Hip
Azathioprine*
Consensus
Drainage
Femur
Hip
Humans
Immunocompromised Host
Joints*
Prednisolone*
Salmonella Infections
Salmonella*
Thigh
Azathioprine
Prednisolone

Figure

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  Fig. 1 Magnetic resonance imaging showed a huge abscess in the right thigh, which was urgently treated with percutaneous drainage.

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  Fig. 2 Gram staining of materials of abscess in the right thigh shows Gram negative bacilli.

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  Fig. 3 The X-ray (A) and computed tomography (B) images showed that huge abscess on the right thigh had reached to femoral component through the lytic area of lateral femur related to periprostetic joint infection.

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  Fig. 4 Postoperative X-ray after first step (A) and second step (B) revision surgery for periprostetic joint infection. Second step surgery was performed after 15 months.

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  Fig. 5 Bilateral total hip arthroplasty, periprostetic joint infection was left side. Left side was revised once in another clinic.

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  Fig. 6 Postoperative X-ray after first step (A) and second step (B) revision surgery for periprosthetic joint infection. Second step surgery was performed after 20 months.

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