Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Apr 18, 2021; 12(4): 246-253
Published online Apr 18, 2021. doi: 10.5312/wjo.v12.i4.246
Salmonella infection after anterior cruciate ligament reconstruction: A case report
Thomas Neri, Margaux Dehon, Elisabeth Botelho-Nevers, Celine Cazorla, Sven Putnis, Remi Philippot, Frederic Farizon, Bertrand Boyer
Thomas Neri, Margaux Dehon, Remi Philippot, Frederic Farizon, Bertrand Boyer, Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
Thomas Neri, EA 7424-Inter-University Laboratory of Human Movement Science, University Lyon-University Jean Monnet Saint Etienne, Saint Etienne 42000, France
Elisabeth Botelho-Nevers, Celine Cazorla, Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne 42000, France
Sven Putnis, Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, United Kingdom
Author contributions: Neri T, Dehon M, Putnis S, Philippot R, Farizon F and Boyer B reviewed the literature and contributed to manuscript drafting; Boyer B was the patient’s surgeon, reviewed the literature and contributed to manuscript drafting; Botelho-Nevers E and Cazorla C performed the infectious diseases consultation, reviewed the literature and drafted the manuscript; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016)
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Thomas Neri, MD, PhD, Assistant Professor, Senior Researcher, Surgeon, Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Avenue Albert Raimond, Saint-Etienne 42000, France.
Received: December 31, 2020
Peer-review started: December 31, 2020
First decision: February 15, 2021
Revised: February 25, 2021
Accepted: March 28, 2021
Article in press: March 28, 2021
Published online: April 18, 2021

Infections after anterior cruciate ligament reconstruction (ACLR) are rare. No cases of Salmonella infection have been described to our knowledge.


We describe a rare case of Salmonella infection in a 23-year-old patient following an ACLR. The patient presented with subacute septic arthritis, 26 d after a hamstring autograft ACLR. The pathogen, Salmonella enterica typhimurium was isolated by bacteriological sampling of the first arthroscopic lavage. Two arthroscopic lavages were required, with intravenous antibiotic therapy for two weeks with cefotaxime and ciprofloxacin, followed by oral antibiotics with amoxicillin and ciprofloxacin for a total duration of three months. This approach treated the infection but two years after the septic arthritis, faced with ongoing knee instability due to graft damage, a revision ACLR with a bone-tendon-bone graft was performed. At the last follow-up, full range of knee motion had been achieved and sports activities resumed.


Infection after ACLR is rare and requires an early diagnosis and management in order to treat the infection and prevent arthritis-related joint cartilage destruction and damage to the graft.

Keywords: Knee, Anterior cruciate ligament, Infection, Salmonella, Case report

Core Tip: Infection after anterior cruciate ligament reconstruction (ACLR) is uncommon, with staphylococci found in more than 90% of cases. We present herein, an exceptional case of Salmonella infection after ACLR. This case highlights the importance of early diagnosis and management: arthroscopic washing for acute infections or arthrotomy for late infections and appropriate antibiotic therapy. The purpose of the surgical treatment is to prevent arthritis-related joint cartilage destruction and to protect the graft.