Published online Jul 16, 2014. doi: 10.12998/wjcc.v2.i7.304
Revised: April 17, 2014
Accepted: May 28, 2014
Published online: July 16, 2014
We describe two cases of prosthetic joint infection (PJI) of the hip due to Salmonella. The first patient presented with an early infection 5 d after being discharged following a total hip replacement and the second patient presented at the emergency ward with a late infection, thirteen years following a total hip replacement. Both cases occurred within one month of each other at our institution and both were successfully treated with a one-stage revision. PJI caused by Salmonella species is very rare: so far only 20 Salmonella PJIs of the hip have been described. Therefore, full consensus on the best treatment approach has not yet been reached. An aggressive two-stage approach is advised because of the virulence of Salmonella, although a limited number of successful one-stage approaches have been described as well. According to the latest guidelines, one-stage revision has comparable success rates and less morbidity compared to two-stage treatment, when selecting the right patients. In our opinion, PJI caused by Salmonella should be treated just as PJI caused by other bacteria, with consideration of the selection criteria as mentioned in several treatment guidelines. As illustrated by these two cases, one-stage revision can be successful in both early and late Salmonella PJI of the hip.
Core tip: Prosthetic joint infection (PJI) of the hip by Salmonella species is rare. There is an ongoing debate whether treatment of prosthetic joint infection should consist of a one- or two-stage approach and also whether or not PJI caused by Salmonella should be treated similarly to PJI caused by other bacteria. We report two cases of Salmonella PJI, one early and one late infection, successfully treated by one-stage revision.