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Case Reports in Infectious Diseases
Volume 2013 (2013), Article ID 642805, 3 pages
http://dx.doi.org/10.1155/2013/642805
Case Report

Salmonella enteridis Septic Arthritis: A Report of Two Cases

1Department of Orthopedics and Traumatology, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
2Royal Orthopaedic Hospital, Birmigham, UK
3Department of Physical Therapy and Rehabilitation, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey
4Department of Infectious Diseases, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey
5Department of Pathology, Istanbul Medeniyet University, Göztepe Training and Research Hospital, Istanbul, Turkey

Received 29 July 2013; Accepted 15 September 2013

Academic Editors: L. M. Bush and A. Marangoni

Copyright © 2013 Esat Uygur et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. Nontyphoidal salmonellosis causes significant morbidity, is transmitted via fecal-oral route, and is a worldwide cause of gastroenteritis, bacteremia, and local infections. Salmonella is a less common etiologic factor for septic arthritis compared with other gram-negative bacteria. Cases. We present two septic arthritis cases with Salmonella enteridis as a confirmed pathogen and also discuss the predisposing factors and treatment. Discussion. Septic arthritis is an orthopedic emergency. The gold standard treatment of septic arthritis is joint debridement, antibiotic therapy according to the culture results, and physiotherapy, which should start in the early postoperative period to prevent limitation of motion. Salmonella is an atypical agent for septic arthritis. It must be particularly kept in mind as an etiologic factor for the acute arthritis of a patient with sickle cell anemia and systemic lupus erythematosus. Clinicians should be cautious that the white blood cell count in synovial fluid can be under 50.000/mm3 in immune compromised individuals with septic arthritis. The inflammatory response can be deficient, or the microorganism may be atypical. Conclusion. Atypical bacteria such as Salmonella species in immune compromised patients can cause joint infections. Therefore, Salmonella species must always be kept in mind for the differential diagnosis of septic arthritis in a clinically relevant setting.