Published online Apr 18, 2021. doi: 10.5312/wjo.v12.i4.246
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.
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.