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Case Report · Open access

Eradication of Salmonella enteritidis periprosthetic hip infection using a custom-made articulating spacer: A case report

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Kwong Weng Loh

Department of Orthopaedic Surgery, Universiti Malaya, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Kuala Lumpur, Malaysia

ORCID: 0000-0002-2307-8877

Khairul Anwar Ayob

Department of Orthopaedic Surgery, Universiti Malaya, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Kuala Lumpur, Malaysia

ORCID: 0000-0003-1651-1684

Azlina Amir Abbas

Department of Orthopaedic Surgery, Universiti Malaya, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Kuala Lumpur, Malaysia

ORCID: 0000-0003-4423-4653

Veenesh Selvaratnam

Department of Orthopaedic Surgery, Universiti Malaya, National Orthopaedic Centre of Excellence for Research and Learning (NOCERAL), Faculty of Medicine, Kuala Lumpur, Malaysia

ORCID: 0000-0002-3821-1781

Abstract

Periprosthetic joint infection (PJI) remains a challenging complication following total hip arthroplasty (THA), commonly managed through a two-stage revision which can lead to significant morbidity. In this article, we present a rare case of Salmonella enteritidis PJI, initially presenting as prosthetic hip dislocation. Preoperative hip aspiration utilizing blood culture bottles enabled early identification of the organism and guided targeted antimicrobial therapy. The patient underwent revision THA using a well-fixed custom-made articulating spacer (CUMARS) construct, with targeted antibiotic-loaded bone cement. One-year follow-up demonstrated successful eradication of the infection, stable implant fixation, and good functional outcomes. In conclusion, this case underscores the importance of diagnostic hip aspiration and highlights the potential of the CUMARS technique as an effective and durable solution for managing rare PJIs caused by atypical organisms such as Salmonella enteritidis.

Declarations

Author Contributions

Conceptualization: V.S.; Managed patient care: L.K.W., A.A.A., K.A.A., V.S.; Data collection: A.A.A, V.S.; Writing draft: L.K.W., V.S.; Review & editing: A.A.A., K.A.A.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.