Case Report: Salmonella Infection of a Prosthetic Shoulder Joint Requiring Long-term Antibiotic Suppression.

Abstract

Salmonella infection most frequently presents as gastroenteritis in developed countries, while septic arthritis represents a much rarer occurrence. Salmonella septic arthritis most commonly occurs in the hip joint, while existing reports of Salmonella infection of the shoulder joint are limited to the pediatric population. Here we report a case of an immunocompetent elderly male presenting with Salmonella septic arthritis to the left shoulder joint status post total shoulder arthroplasty three years prior. The definitive source of infection remains unclear, though potential etiologies include preceding gastroenteritis and iatrogenic inoculation. Treatment was complicated by an inability to completely remove and replace the prosthetic hardware and therefore consisted of left shoulder incision and drainage with debridement, antibiotic bead placement, surgical revision, and long-term oral antibiotics. This paper explores the incidence and diagnosis of Salmonella joint infections and demonstrates a treatment plan when curative surgery is not available.