Septic arthritis of the hip caused by nontyphi Salmonella after urinary tract infection

• Published in: The American journal of emergency medicine 2009-03, Vol.27 (3), p.373.e5-373.e8
• Main Authors: Muñoz-Mahamud, Ernesto, MD, Casanova, Luis, MD, Font, LLuis, MD, Fernández-Valencia, Jenaro A., PhD, Bori, Guillem, MD
• Format: Article
• Language: English
• Subjects: Anti-Infective Agents - therapeutic use; Arthritis, Infectious - drug therapy; Arthritis, Infectious - microbiology; Diagnosis, Differential; Emergency; Emergency medical care; Hip Joint; Hospitalization; Humans; Infections; Joint surgery; Lymphocytes; Male; Medical imaging; Middle Aged; Pain; Salmonella; Salmonella enteritidis - isolation & purification; Salmonella Infections - diagnosis; Salmonella Infections - drug therapy; Studies; Urinary Tract Infections - drug therapy; Urinary Tract Infections - microbiology
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2008.07.024

On admission, the patient's axillary temperature was 37.9°C. Laboratory studies indicated a white blood cell count (WBC) of 18 660/mm3 (75.4% neutrophils and 11.8% lymphocytes), a C-reactive protein level of 11.4 mg/L and an erythrocyte sedimentation rate of 96 mm/h. Magnetic resonance imaging of the pelvis revealed inflammatory signs and effusion of the right hip as well as degenerative changes indicative of early osteonecrosis of both hips (Fig. 2). After 3 months without any sign of infection, the spacer was removed and a noncemented total hip prosthesis (Echelon 14/190, Reflection 56, XL-PE, long neck +4, Cr-Co head) (Smith & Nephew, Memphis, TN) was implanted (Fig. 3).