<i>Salmonella enteritidis</i> : a rare pathogen in a polymicrobial acute prosthetic joint infection following total hip arthroplasty treated with double debridement, antibiotics, and implant retention (DAIR)

Prosthetic joint infection (PJI) with <i>Salmonella enteritidis</i> is rare following orthopedic surgery and joint arthroplasty. This is a case of a 77-year-old female with left femoral transcervical fracture underwent total hip arthroplasty. At 2-weeks follow-up, the patient developed a PJI that was treated with double debridement, antibiotics, and implant retention (DAIR). Intraoperative cultures revealed unusual <i>S. enteritidis</i> without a primary focus of infection as part of polymicrobial PJI. She received a 3-month course of antibiotics including per os (PO) azithromycin and intravenous (IV) ceftriaxone that was switched to IV meropenem. At last follow-up, infection had resolved, inflammatory markers normalized, there was no evidence of prosthetic loosening and the patient was ambulatory. <i>Salmonella</i> organism is an atypical isolate in PJI. In the absence of a primary cause and in the context of acute infection, double DAIR is a viable option to salvage the prosthesis when a dual approach of aggressive intraoperative debridement and postoperative antibiotics coverage is employed.