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Septic Arthritis By Serratia Marcescens After Arthroscopical ACL Reconstruction With Hamstrings: A Case Report

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Author(s): Dimitrios S. Mastrokalos

Journal: Journal of Orthopaedics
ISSN 0972-978X

Volume: 3;
Issue: 3;
Date: 2006;
Original page

Keywords: Serratia marcescens | septic arthritis knee | ACL reconstruction

ABSTRACT
A case of septic arthritis caused by Serratia marcescens, after arthroscopical anterior cruciate ligament (ACL) reconstruction in a patient with no history of intravenous drug abuse, is reported. A 37-year-old man underwent arthroscopical ACL reconstruction with a quadruple hamstring graft. Eight days postoperatively, he developed fever (> 39o C), knee pain, erythema and effusion with suppuration. He was readmitted to the hospital with the diagnosis of septic arthritis. The patient's erythrocyte sedimentation rate (73mm/1st hour), C-reactive protein level (143mg/L), and white blood cell count were high (10.47x103 /μL). The joint was aspirated and fluid was sent for cultures that revealed the presence of S. marcescens. S. marcescens, is a gram negative bacteria which belongs to enterobacteriae and is mainly involved in nosocomial and intravenous drug users’ infections. In our case, the infection was first treated with immediate arthroscopic irrigation and debridement, in order to save the graft. Due to persistence of symptoms, clinical and laboratory findings, a second arthroscopic irrigation and debridement with removal of the graft and hardware was necessary. Intravenous antibiotic administration for 6 weeks, followed by oral administration for 18 weeks was also given.
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