Periprosthetic Joint Infection With Salmonella Species 2 Years After Unicompartmental Knee Arthroplasty Treated With Debridement, Antibiotics, and Implant Retention (DAIR): A Case Report and Review of the Literature.

BACKGROUND: Unicompartmental knee arthroplasty (UKA) is a minimally invasive surgical procedure aimed at treating selected patients with osteoarthritis confined to a single compartment of the knee. The concept is to minimize soft-tissue damage retaining the natural ligaments and thus providing kinematics close to normal knee. Periprosthetic joint infection (PJI) is a potentially devastating complication following UKA. Although not a common occurrence, it can lead to prolonged hospitalization, need for repeated surgical intervention, and joint failure. Although Staphylococcus spp. consisting the majority of the pathogens, Salmonella can also be found on rare occasions, particularly in individuals with immunosuppression or vascular disease in the setting of underlying diseases such as sickle cell disease, diabetes mellitus, renal failure, human immunodeficiency virus (HIV) infection, or chronic corticosteroid use.

CASE REPORT: We describe a case of PJI of the knee following UKA in a 73-year-old woman with a history of long-term corticosteroid oral treatment for polymyalgia rheumatica (PMR). The patient presented with a painful, swollen right knee and elevated inflammatory markers. She was successfully treated with arthroscopic drainage, irrigation, and a 9-week course of antibiotic therapy.

CONCLUSION: This case highlights the virulence of Salmonella in an immunocompromised patient with a joint prosthesis. To our knowledge, this is a rare case that has not previously been reported in the literature. Continuous monitoring, early diagnosis, and close collaboration between infectious disease specialists and orthopedic surgeons were crucial in achieving a successful resolution of the infection.